Hydrosurgery as a safe and efficient debridement method in a clinical wound unit

Ferrer-Sola, Marta; Sureda-Vidal, H; Altimiras-Roset, Jacint; Fontsere-Candell, E; Gonzalez-Martinez, V; Espaulella-Panicot, Joan; Falanga, Vincent; Otero-Viñas, Marta

doi:10.12968/jowc.2017.26.10.593

Cited by 17 publications

(8 citation statements)

References 26 publications

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“…Several adverse events were reported; however, no device‐related serious adverse event was observed 25‐31 …”

Section: Resultsmentioning

confidence: 99%

“…Several adverse events were reported; however, no device-related serious adverse event was observed. [25][26][27][28][29][30][31] 3.3 | Risk of bias within studies Figure 3 illustrates the risk of bias in the two prospective randomised controlled studies. The protocol for Caputo et al's study 25 was obtained from Clinical Trials.gov 32 (NCT00521027).…”

Section: Safety Outcomementioning

confidence: 99%

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Efficacy of Versajet hydrosurgery system in chronic wounds: A systematic review

Shimada

Ojima

Ida

et al. 2021

International Wound Journal

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Studies demonstrating the effectiveness of hydrosurgery for chronic wounds are extremely limited. This systematic review aimed to evaluate the efficacy of hydrosurgery compared with conventional debridement in chronic wounds, skin ulcers, and non‐acute wounds. This PROSPERO‐registered review was performed following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. A systematic search was performed in PubMed, Scopus, and Cochrane Library databases. Abstracts of all studies were screened independently by two reviewers. The bias of prospective randomised controlled studies was assessed using the Cochrane Collaboration's tool for assessing the risk of bias and RevMan 5.4 software, whereas the bias of retrospective comparative studies was evaluated using the Risk of Bias Assessment Tool for Non‐randomised Studies. Two prospective randomised controlled trials, two retrospective comparative studies, and three prospective non‐comparative studies were included. Hydrosurgery enabled rapid debridement. The Versajet Hydrosurgery System saved 8.87 minutes compared with the conventional methods. Similarly, the debridement quality was high with this system. The debridement number needed to achieve adequate wound beds was fewer in the hydrosurgery group than in the conventional group. These superiorities lead to subsequent success and cost‐effectiveness. As there were only two prospective randomised controlled studies, and much information was missing, the risk of bias was unclear. This review confirmed that hydrosurgery is useful for the debridement of chronic wounds, considering the procedural speed and quality.

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“…Several adverse events were reported; however, no device‐related serious adverse event was observed 25‐31 …”

Section: Resultsmentioning

confidence: 99%

Section: Safety Outcomementioning

confidence: 99%

Efficacy of Versajet hydrosurgery system in chronic wounds: A systematic review

Shimada

Ojima

Ida

et al. 2021

International Wound Journal

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“…They are also consistent with previous reports on the use of hydrosurgery in the management of other types of wounds. Limited reports have described using hydrosurgery in the management of sparse cases of PIs: 15 , 30 to our knowledge this is the largest case series to assess these outcomes in a more controlled and detailed setting, and to propose a novel integrated therapeutic and operative approach involving three consecutive stages. There are no relative or absolute contra-indications to hydrosurgery; in extremely severe patients unable to tolerate surgery, enzymatic debridement with conservative/palliative wound care could be preferred.…”

Section: Discussionmentioning

confidence: 99%

Hydrosurgical Debridement Allows Effective Wound Bed Preparation of Pressure Injuries: A Prospective Case Series

Matsumine

Giatsidis

Takagi

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: Pressure injuries (PIs) are common in hospitalized patients, with incidence exceeding 50% in high-risk patients. Immobilization causes a prolonged compression of vascular networks in tissues overlying bony prominences, leading to ischemia and ulceration. Traditionally, PIs are treated with a combination of surgical debridement and reconstruction. This approach can be invasive for debilitated patients who cannot tolerate prolonged surgeries and extensive tissue resection. Hydrosurgery uses high-pressure irrigation to low-invasively debride and cleanse wounds; its use has shown positive outcomes in burn and chronic wounds care. Here, we hypothesize that hydrosurgery allows low-invasive yet effective wound bed preparation in truncal PIs. Methods: We conducted a single-center, prospective, uncontrolled case series. Inclusion criteria for this study were presence of a truncal PI (stage III or IV) and an American Society of Anesthesiologists physical status of ≥2 (no exclusion criteria). Measured outcomes included duration of hydrosurgery, postsurgical local (dehiscence, infection, seroma) or systemic complications in the first 30 days, and PI recurrence rate (6-month follow-up). Results: Seven patients (3 sacral, 2 greater trochanteric, and 2 ischial tuberosity PIs) were enrolled for this study. Average duration of hydrosurgery was 12 minutes (±3.1). No local or systemic complications were observed at a 30-day follow-up (0/7, 0%). All flaps (6/7, 86%) and graft (1/7, 14%) reconstructions successfully survived, and no PI recurrence was reported within a 6-month follow-up (0/7, 0%). Conclusions: Hydrosurgery seems to allow safe, low-invasive, and effective wound bed preparation in truncal PIs. Larger controlled trials are needed to confirm this preliminary evidence, to guide its broader adoption for improved care of high-risk patients with PIs.

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“…Waterjet wound debridement is a widely used method for wound debridment [ 21 ]. Wound bed preparation has been a common medical problem and multiple novel approaches have been proposed and shown promising results.…”

Section: Discussionmentioning

confidence: 99%

Robotic waterjet wound debridement – Workflow adaption for clinical application and systematic evaluation of a novel technology

et al. 2018

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ObjectiveWe evaluated the clinical potential of a novel robotic system for autonomous performance of waterjet wound debridement.Summary background dataWithin the last decade, waterjet wound debridement has proven to be a valid alternative to the conventional approach using sharp spoons and scalpel.MethodsThe DLR MIRO robot using the DLR MICA instrument for robotic surgery was adapted for actuation of an ERBEJET 2 flexible endoscopic waterjet probe. Waterjet debridement of various wound shapes and sizes using a porcine skin model was compared between this novel robotic system and a control group of human medical professionals with regard to wound area cleaned by the waterjet, off-target area, and procedural time.ResultsAfter the wound area was registered in the robotic system, it automatically generated a cleaning path and performed debridement based on generated surface model. While the robotic system demonstrated a significant advantage for the covered wound area (p = 0.031), the average off-target area was not significantly different from human controls. Human participants had high variability in cleaning quality across users and trials, while the robotic system provided stable results. Overall procedural time was significantly lower in trials performed by humans.ConclusionsRobotic waterjet wound debridement is a promising new technological approach compared to the current clinical standard of interventional wound therapy, providing higher efficiency and quality of wound cleaning compared to human performance. Additional trials on more complicated wound shapes and in vivo tissue are necessary to more thoroughly evaluate the clinical potential of this technology.

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Hydrosurgery as a safe and efficient debridement method in a clinical wound unit

Abstract: We demonstrate that hydrosurgery is an effective and rapid debridement method that can be used safely in the outpatient setting.

Cited by 17 publications

References 26 publications

Efficacy of Versajet hydrosurgery system in chronic wounds: A systematic review

Efficacy of Versajet hydrosurgery system in chronic wounds: A systematic review

Hydrosurgical Debridement Allows Effective Wound Bed Preparation of Pressure Injuries: A Prospective Case Series

Robotic waterjet wound debridement – Workflow adaption for clinical application and systematic evaluation of a novel technology

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