Effectiveness of conventional and hydrosurgical debridement methods in reducing Staphylococcus aureus inoculation of equine muscle in vitro

Abstract

SummaryReasons for performing study: The success of primary healing of equine traumatic wounds is dependent on thorough debridement. A specific hydrosurgical debridement device (Versajet TM ) a is gentle to viable tissues, yet effectively removes macroscopic contaminants and debris. We wished to investigate whether it is effective in reducing bacterial burden and whether it differs from traditional methods. No previous reports compare hydrosurgical debridement and conventional wound debridement with regard to bacterial reduction from in vitro inoculated soft tissue. Objectives: To assess the effectiveness of hydrosurgical debridement in reducing the Staphylococcus aureus load from in vitro inoculated equine muscle compared with conventional wound debridement methods. Study design: In vitro experimental study. Methods: The surface of equine masseter muscle was inoculated with a S. aureus broth and subsequently debrided using one of the following 4 methods: saline irrigation; sharp debridement; saline irrigation and sharp debridement; or hydrosurgical debridement. Tissue samples for quantitative cultures were collected before and after debridement, and the colony-forming units per gram of tissue were calculated and log transformed. The reductions in bacterial counts were analysed statistically using Wilcoxon signed-rank tests and Friedman two-way ANOVA. Results: Hydrosurgical debridement was more effective than conventional debridement methods in reducing the S. aureus load (P<0.05). Hydrosurgical debridement reduced the bacterial load by 99.7%, in comparison to saline irrigation and sharp debridement (87.4%), sharp debridement (82.2%) and saline irrigation (46.0%). Conclusions: Hydrosurgical debridement reduces the S. aureus load from in vitro contaminated equine muscle significantly more than conventional debridement methods.

Severe Phymatous Rosacea of the Nose, Cheeks, and Chin Treated With Hydrosurgery

“…A randomized controlled trial in burn patients in which treatment with Versajet was compared to traditional debridement found no significant difference in postoperative pain, healing time, and contracture rate. 13 Overall, tangential excision of our patient's phymatous rosacea using the Versajet II Hydrosurgery System yielded excellent contouring. However, due to the paucity of literature on the subject, it is difficult to discern the optimal treatment modality.…”

“…12 Hydrosurgical debridement also has been shown to reduce Staphylococcus aureus inoculate levels from in vitrocontaminated equine models significantly more than conventional debridement methods (P<.05). 13 Versajet surgery appears to be well tolerated, with side effects comparable to those of classic surgical excision. A randomized controlled trial in burn patients in which treatment with Versajet was compared to traditional debridement found no significant difference in postoperative pain, healing time, and contracture rate.…”

BEVA primary care clinical guidelines: Wound management in the horse

“…Six veterinary publications were identified through the search. One met the inclusion criteria and was assessed using the GRADE framework 23 . This study measured Staphylococcus aureus colony forming units post debridement in equine cadaver muscle tissue.…”

Biofilm and Equine Limb Wounds

“…Similarly, in equine wound research, no specific guidelines exist on debridement, so to follow the human guidelines seems valid. An equine ex vivo study showed better effectiveness of hydrosurgical debridement compared to normal sharp debridement [123], thus hydrosurgery might be a useful subcategory of surgical debridement. No matter the method, infected tissue should be debrided whenever possible, and debridement should always be combined with other anti-biofilm strategies, as not all of the biofilms and bacteria can be removed [10,27].…”