title: A prospective randomised controlled clinical trial comparing hydrosurgery debridement with conventional surgical debridement in lower extremity ulcers.
abstract: Debridement of devitalised tissue is an essential component of the effective treatment of chronic wounds. The Versajet Hydrosurgery System is a new technology that simultaneously cuts and aspirates soft tissue. In this study we compared Versajet with conventional surgical techniques in the debridement of lower extremity ulcers to assess impact on time and resources for debridement. Forty-one patients with a mean age of 68 years (range 33 to 95 years) underwent surgical debridement of a lower extremity ulcer. Operating room (OR) sessions were randomised to Versajet (n= 22) or conventional debridement (n= 19) with scalpel plus pulsed lavage. Procedure time and utilisation of consumables were recorded. Wound areas were monitored for 12 weeks. There was significant evidence (P < 0.008) of a shorter debridement time (10.8 min) using Versajet over conventional debridement (17.7 min); a mean saving of 6.9 minutes (39%). In addition, a significant reduction in use of pulsed lavage and saline (P < 0.001) was observed with Versajet. Overall, clinical efficacy of the shorter debridement procedure was similar: median time to wound closure 71 days (Versajet) vs. 74 days (conventional) (P= 0.733). We found Versajet to be quicker than conventional debridement in the debridement of lower extremity ulcers without compromising wound healing. Potential cost savings were identified from the use of VERSAJET through the shorter debridement time allowing more patients to be treated in the same operating schedule.
authors.affiliation: Clara Maass Medical Center, 1 Clara Maass Drive, Belleville, New Jersey 07109, USA. w_j_caputo@juno.com
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Caputo
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Beggs
authors.forename: Jessica L
authors.initials: JL
authors.lastname: DeFede
authors.forename: Lisa
authors.initials: L
authors.lastname: Simm
authors.forename: Hussein
authors.initials: H
authors.lastname: Dharma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003646:Debridement / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006875:Hydrotherapy / Q000295:instrumentation / Q000379:methods*; D007871:Leg Ulcer / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing