title: [Efficacy of a hydrosurgery system applied in the debridement of extensive residual wounds of patients with severe burn].
abstract: OBJECTIVE
  To explore the efficacy of a hydrosurgery system applied in the debridement of extensive residual wounds of patients with severe burn prospectively.
  
  
  METHODS
  Seventy-six severely burned patients with extensive residual wounds after treatment were admitted into Department of Burn Surgery of Changhai Hospital of the Second Military Medical University from May 2012 to November 2015. The patients were divided into hydrosurgery system debridement group (HD, n=34) and traditional debridement group (TD, n=42) according to the random number table, and their residual wounds were debrided by a hydrosurgery system and conventional surgical instruments respectively. The wounds of patients in two groups were repaired with stamp-like grafts made from split-thickness autoskin after debridement. Second time of debridement and skin grafting as above was performed if necessary. The time used in debriding 1% TBSA wound in the first surgery, positive rate of bacterial culture of wound exudate on post first surgery day (PFSD) 3, survival rate of skin grafts on PFSD 7, second debridement rate, and wound healing time of patients in two groups were compared. Data were processed with two independent-sample t test and chi-square test.
  
  
  RESULTS
  The time used in debriding 1% TBSA wound of patients in the first surgery in group HD was (1.2±0.3) min, which was significantly shorter than that in group TD[(1.9±0.4) min, t=-9.098, P<0.001]. On PFSD 3, positive rate of bacterial culture of wound exudate of patients in group HD was 11.76% (4/34), which was significantly lower than that in group TD[38.10% (16/42), χ(2)=6.718, P=0.010]. On PFSD 7, the survival rate of skin grafts of patients in group HD was (90±8)%, which was significantly higher than that in group TD[(83±15)%, t=2.334, P=0.022]. The second debridement rate of patients in group HD was 5.88% (2/34), which was significantly lower than that in group TD[23.81% (10/42), χ(2)=4.542, P=0.033]. The wound healing time of patients in group HD was (10.6±1.5) d, which was significantly shorter than that in group TD[(13.3±2.5) d, t=-5.442, P<0.001].
  
  
  CONCLUSIONS
  The hydrosurgery system applied in the debridement of extensive residual wounds of patients with severe burn is thorough and highly efficient, which is beneficial to improving the survival rate of skin grafts and accelerating wound healing.
authors.affiliation: Department of Burn Surgery, Institute of Burns, Changhai Hospital, the Second Military Medical University, Shanghai 200433, China.
authors.forename: G C
authors.initials: GC
authors.lastname: Liu
authors.forename: Z H
authors.initials: ZH
authors.lastname: Kan
authors.forename: J J
authors.initials: JJ
authors.lastname: Sheng
authors.forename: H H
authors.initials: HH
authors.lastname: Li
authors.forename: L
authors.initials: L
authors.lastname: Li
authors.forename: Y
authors.initials: Y
authors.lastname: Sun
authors.forename: S Z
authors.initials: SZ
authors.lastname: Ji
authors.forename: S H
authors.initials: SH
authors.lastname: Zhu
mesh_terms: D002056:Burns / Q000601:surgery*; D003646:Debridement / Q000379:methods*; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology; D016038:Skin Transplantation / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing