Efficacy and cost‐effectiveness of a high‐powered parallel waterjet for wound debridement

Granick, Mark S.; Posnett, John; Jacoby, BS Michael; Noruthun, Shyam; Ganchi, Parham A.; Datiashvili, Ramazi O.

doi:10.1111/j.1743-6109.2006.00136.x

Cited by 62 publications

(21 citation statements)

References 2 publications

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“…42 Forty-five patients treated between 2002 and 2003 were included and compared with patients who had comparable wounds but had been treated prior to acquisition of the VERSAJET s . The number of debridement procedures required to obtain a healthy wound was reduced from 1.9 to 1.2 per wound (P < 0.005) and there were no postoperative complications in the VERSAJET s group compared with four in the control group.…”

Section: Cost Of Debridementmentioning

confidence: 99%

Toward a common language: surgical wound bed preparation and debridement

Granick

Boykin

Gamelli

et al. 2006

Wound Repair Regeneration

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Wound management encompasses a number of disciplines. As new concepts and innovative technologies develop within this exciting field, it is important to share them in spite of the divergence of clinical perspectives between the expert disciplines. One such divergence exists between surgeons and nonsurgical wound specialists. As a result, there is a need to develop a common language between these two groups. How can we develop a common language that unites surgical expertise within medical wound management? One route may be through the principles of wound bed preparation, which we believe have great potential for the communication of effective surgical techniques. Another is through sharing our concepts of surgical debridement as it is applied to different wounds by a variety of surgical disciplines. In this monograph, we try to bring these two themes together. We discuss how wound bed preparation has added to our understanding of the pathophysiology of the nonhealing wound and has provided us with some general clinical concepts. We discuss what role debridement, and then specifically surgical debridement, has to play within wound bed preparation, before analyzing the importance of surgical debridement in tissue preservation and the control of infection. We finally look at ongoing work that examines the cost of various surgical debridement techniques. We will also review a new hydrosurgery system (VERSAJET, Smith and Nephew, Hull, UK), which we believe has an important role to play in the surgical preparation of the wound. We also expect that this paper will remind our medical colleagues about the critical role played by surgery in wound management.

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Section: Cost Of Debridementmentioning

confidence: 99%

Toward a common language: surgical wound bed preparation and debridement

Granick

Boykin

Gamelli

et al. 2006

Wound Repair Regeneration

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“…Its cost effectiveness is debated, but reductions in operating time compared with conventional surgical débridement suggest potential cost savings with its use. 22,23 When sharp débridement is not an option, conservative management with enzymatic débride-ment has proven effective in removing slough and eschar. Collagenase (Santyl; Smith and Nephew, Inc., Largo, Fla.) shows more rapid removal of necrotic tissue over placebo, [24][25][26] and was shown to be superior to silver sulfadiazine in partialthickness burn wounds.…”

Section: Ementioning

confidence: 99%

Wound Healing

Janis

Harrison

2014

Plastic and Reconstructive Surgery

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Treatment of all wounds requires adequate wound bed preparation, beginning with irrigation and débridement. Complicated or chronic wounds may also require treatment adjuncts or specialized wound healing products. An extensive body of research and development has introduced novel wound healing therapies and scar management options. In this second of a two-part continuing medical education series on wound healing, the reader is offered an update on current wound healing technologies and recommendations for obtaining optimal outcomes.

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“…Some believe that the eschar acts as a protective barrier for the wound [39], while others believe that necrotic heel ulcers should be debrided with caution [40]. Hydrotherapy, which simultaneously cuts and aspirates soft tissue, is a form of surgical debridement that is said to be quicker yet cause minimal damage to tissues [41][42][43].…”

Section: Wound Management: Debridement and Cleansingmentioning

confidence: 99%

Wound Healing in Older Adults

Jones

2009

Aging Health

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Nonhealing wounds are associated with increased morbidity, disability and mortality [13] through complications such as sepsis, contractures, depression and limb amputation. Overall quality of life is significantly reduced by the occurrence and treatment of chronic wounds [12] owing to limited activity and mobility, disruption of work and social activities, pain, odor and appearance of the wound. In spite of their frequency and their impact on quality of life, there is a lack of consensus and weak evidence on the best ways to manage these wounds [14,15]. Traditional treatment strategies have demonstrated limited success [8] and chronic wound care is often performed in a manner that is anecdotal [12], inconsistent and lacking in evidence [16]. As society continues to age, and the number of chronic wounds continues to increase, a better understanding of the most effective approaches to preventing and managing these wounds is required. Basic principles: caring for chronic wounds AssessmentA careful history and thorough assessment of the patient and the wound are necessary to determine the presence of factors that could impair the ability of the wound to heal [17,18]. Confounding factors that may inhibit healing include impaired tissue perfusion, metabolic disturbances, immuno suppression, nutritional deficiencies, advanced age, and tobacco and alcohol use [7,12,17,19]. It is important to differentiate healable wounds from maintenance and nonhealable wounds. Healable wounds have an adequate blood supply, while nonhealable wounds do not [20][21][22]. Maintenance wounds have a sufficient blood supply but other barriers to healing are present, such as poor nutritional status, poor patient adherence, inability to afford Skin is the largest organ of the body and is constantly exposed to potentially destructive elements in the environment [1]. With longer lifespans, an ever-increasing number of individuals have chronic conditions that compromise skin integrity and put them at risk for skin breakdown [2,3]. The normal changes that occur in the aging skin also put individuals at risk for skin breakdown and the formation of chronic ulcers or wounds [2]. Skin structures and normal functions undergo gradual change with age, altering tissue repair processes. Wound contraction and re-epithelialization occur at a slower rate, connective tissue deposition is diminished and, ultimately, wound tensile strength is decreased [4]. Aging also negatively effects wound healing [5]. Nonhealing or slow healing wounds with a poor response to conventional wound management therapy primarily affect individuals over the age of 60 years [6,7]. A 5-year epidemiological study found that the frequency of wound closure was significantly lower in older subjects. The share of closed wounds decreased by nearly 25% in patients over the age of 70 years, with the effect of aging on frequency of wound closure becoming clinically apparent after the age of 60 years [5].When skin integrity is altered by a wound, the healing process is generally well orchestrated...

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Efficacy and cost‐effectiveness of a high‐powered parallel waterjet for wound debridement

Cited by 62 publications

References 2 publications

Toward a common language: surgical wound bed preparation and debridement

Toward a common language: surgical wound bed preparation and debridement

Wound Healing

Wound Healing in Older Adults

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