2005 Symposium on Advanced Wound Care | |
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Case Study
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Debridement septic diabetic foot abscess utilizing a new modality: VersaJet* hydro-incision water scalpel Alan J. Cantor, DPM, FACFAOM, CWS, Attending Surgeon, Burn/Wound & Hyperbaric Medicine Nassau University Medical Centet, East Meadow, NY A 64 year old male, IDDM, neuropathy, PVD, CAD, retinopathy, s/p prior amputations on left 4th toe, HTN, presentedwith a critically infected left heel with cellulitis and gross abscess extending to the plantar midfoot from the poosterior inferior heel. Initial work up revealed on x ray a foreign body in the foot, consistent with a construction staple deep in the tissues. Broad spectrum antibiotiocs were initiated and the patient was brought into the OR for emergent debridemnt and excision of foreign body. Authors used a new debriding modality, “VersaJet”* for the debridement of the wound and extensive necrotic tissue. VersaJet is a hydro-incision instrument, which serves the same purpose as a scalpel in removing devitalized tissues. After extensive debridemnt and removal of foreign body the wound was dressed with NPWT and subsequently resolevd without any return to OR. Additionally, a silver impreganted foam dressing, Algidex Ag (DeRoyal) was placed on the heel after NPWT to offer cushioning and anti-infective therapy to wound bed. Conclusion. VersaJet is an excellent surgical debriding modality. The use of saline, Ringers or antibiotic impreganted fluids to debride tissue allows for less surgical injury to healthy tissues, reduces risk of dessication from cautery units and provides for a clear surgical field. Additionally, the VersaJet has a vacuum on the head of the debriding handle which removes airborne particles as they are released from the wound bed. Thgis Venturi effect reduces airborne contamination and minimzes recontamination of the debrided wound and wound bed, thus reducing risks of delayed healing, recontamination and infection. This patient, with multiple co-morbidities healed without amputation and without complications with a single surgical debridement. * VersaJet, Smith and Newphew, Largo, FL |
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