Clinical Effectiveness of Monofilament Fibre Pads for Bacterial and Biofilm Removal in Pressure Injuries: A Retrospective Cohort Study.

Monofilament fibre pads may offer an effective, less invasive method for managing biofilms in pressure injuries, but their clinical effectiveness in reducing bacteria and biofilms has not been fully evaluated. Although biofilm removal is recommended for wound management, less invasive methods applicable to daily care remain limited. Therefore, this study aimed to assess the effectiveness of monofilament fibre pads compared to gauze in reducing bacterial counts and biofilm burden in pressure injuries. This retrospective cohort study was conducted at a Japanese university hospital. Bacterial counts were measured before and after cleansing using a rapid bacterial quantification system, and biofilm reduction rates were calculated using a wound blotting technique that enables non-invasive and quantitative evaluation of biofilms across the entire wound bed. Linear mixed-effects models were applied to evaluate the association between cleansing materials and outcomes, adjusting for baseline bacterial counts or biofilm brightness and the DESIGN-R2020 total score. Thirty-four pressure injuries in 30 patients were analysed, with 27 wound cleansing procedures performed using gauze and 73 using fibre pads. Fibre pad use significantly reduced bacterial counts (β = 0.389, p = 0.011) and biofilm burden (β = 0.642, p = 0.003) compared with gauze. Sensitivity analyses confirmed that these associations were robust, particularly after adjusting for baseline bacterial counts and biofilm brightness. These findings demonstrate that monofilament fibre pads are effective in reducing bacterial counts and biofilm burden in pressure injuries. Their routine use may provide a practical and less invasive adjunct for routine wound cleansing or maintenance biofilm control by facilitating bacterial and biofilm reduction.