| 204 |
Clinical Research
|
Hydrocision debridement of acute and chronic wounds: a pilot study James Mahoney, MD, FRCSC, D. Brent Howley, BSc, MD, Laura Teague, RN, MN, ACNP Management protocols for the care of acute and chronic wounds stress the importance of preparation of the wound bed for definitive closure. Wound bed preparation often requires sharp debridement of non-viable tissue and copious irrigation to decontaminate the operative field. Traditionally this has been achieved using either a scapel or cautery device for debridement combined with copious irrigation Recently, a new fluid jet device has been developed to facilitate simultaneous irrigation and debridement of these wounds, using a high velocity stream of sterile saline jet and a vacuum system*. Recent studies cite several advantages of these hydrosurgery systems including the ability of the operator to hold, cut and remove non-viable tissue while simultaneously irrigating and freeing the wound field of particulate matter This pilot project documents the clinical efficacy, experience and outcomes of fifteen patients with acute and chronic wounds treated with a fluid jet device Our cohort included diverse wound etiologies including acute/chronic and traumatic/non-traumatic and soft tissue abnormalities. This new hydrosurgery system combining lavage and sharp debridement was highly effective in debriding soft necrotic tissues. Dry eschar, and necrotic fascia and bone were more resistant, requiring traditional sharp debridement techniques. Simultaneous irrigation, debridement and suction removal of debris improves visibility of the operative field, allowing for precise debridement of non-viable tissues while preserving surrounding healthy tissues. Blood loss was consistent with other debridement techniques. We were able to achieve a stable and healthy wound bed in most cases with just one operative episode. This then set the stage for definitive wound closure. The VersaJet was technically straightforward and had a very short learning curve for new operators. The authors find the VersaJet hydrosurgery system* to be a safe, effective and innovative tool in the surgical armamentarium of wound management in select acute and chronic wounds. This pilot study supports the need for further prospective studies to determine overall safety, efficacy and utility of this new technology. *VersaJetTM Hydrosurgery system, Smith & Nephew, Inc., Largo, FL Tortella BJ. Traumatic and Chronic Wound Debridement with a Novel Fluidjet Device: The Versajet Hydrosurgery System. September 2003. HydroCision Document. No.1000Ð1232 Rev A 09/03 Hsu C, Breuing K. Wound Debridement Using Versajet: A Novel Hydrosurgery System. August 2003. HydroCision Document. No. 1000Ð1249 Rev A 08/03. |
|