title: Aerosolized spread of bacteria and reduction of bacterial wound contamination with three different methods of surgical wound debridement: a pilot study.
abstract: BACKGROUND
  Debridement is essential in wound treatment to remove necrotic tissue and wound bacteria, but may lead to the transmission of bacteria by aerosolization.
  
  
  OBJECTIVE
  To investigate bacterial transmission and wound bacterial reduction induced by debridement using a cold steel curette, plasma-mediated bipolar radiofrequency ablation (Coblation(®)) or hydrodebridement (Versajet(®)) using a wound model inoculated with Staphylococcus aureus.
  
  
  METHODS
  A full-thickness dermal wound was created in fresh porcine joint specimens, inoculated with S. aureus and incubated at 37°C for 24h. The specimens were surgically debrided with a curette, Coblation or Versajet, or were left untreated. During and after each debridement, aerosolized bacteria were measured by active and passive sampling. To assess the bacterial load of the wound, three quantitative swabs and one cylinder scrub sample were taken from each wound at baseline, post incubation and post debridement.
  
  
  RESULTS
  Versajet debridement resulted in significant bacterial aerosolization, but this was not the case when using a curette or Coblation. Only Coblation was able to reduce the bacterial load of the wound significantly.
  
  
  CONCLUSIONS
  Extra protective means should be implemented when using Versajet debridement for infected and colonized wounds. The same precautions may be less essential when using a curette or Coblation.
authors.affiliation: Department of Dermatology, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Sweden. Electronic address: henrik.sonnergren@gu.se.
authors.forename: H H
authors.initials: HH
authors.lastname: Sönnergren
authors.forename: L
authors.initials: L
authors.lastname: Strömbeck
authors.forename: F
authors.initials: F
authors.lastname: Aldenborg
authors.forename: J
authors.initials: J
authors.lastname: Faergemann
mesh_terms: D000336:Aerosols; D000818:Animals; D001424:Bacterial Infections / Q000517:prevention & control* / Q000628:therapy; D058491:Bacterial Load; D003646:Debridement / Q000379:methods*; D004195:Disease Models, Animal; D066298:In Vitro Techniques; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013552:Swine; D014946:Wound Infection / Q000517:prevention & control* / Q000628:therapy; D014947:Wounds and Injuries / Q000382:microbiology* / Q000628:therapy*
chemical_list: D000336:Aerosols
keywords: Ablation techniques; Aerosol; Bacterial spread; Bactericidal; Coblation; Debridement; Electrosurgery; Hydrosurgery; Plume; Ulcer; Wound