Experiences with waterjet hydrosurgery system in wound debridement

Background: Recently, a new device, the Versajet™, involving "Hydrosurgery Technology" which combines lavage and sharp debridement instrumentation has been described for soft tissue debridement. Methods: The Versajet™ Hydrosurgery System utilizes a reusable power console with foot pedal activation, disposable handpiece and tubing assembly in conjunction with sterile saline and standard waste receptacle. The purpose of this paper is to report our experiences with this instrument in debridement of a variety of wounds prior to final reconstructive surgery. Technical details and pitfalls are discussed to facilitate clinical use. Results: Efficient, safe and fast debridement was achieved in all patients using the hydrosurgery system. The actual time the hydrosurgery system was used for debridement averaged as 15.5 minutes. In ten patients, an adequately debrided wound bed was achieved with a single operative procedure, in four patients; two stages were required prior to reconstructive surgery. In one patient with recurrent sacral-iscial pressure sore, two debridements were carried out followed by long term vacuum assisted closure. The postoperative course was uneventful in all patients, but in three with a minor breakdown of the skin graft, which eventually healed with no surgical intervention. Conclusion: As a result of our clinical experience, the Versajet™ enables surgeon to precisely target damaged and necrotic tissue and spare viable tissue. This modality may be a useful alternative tool for soft tissue debridement in certain cases. However, further studies are required to investigate its cost-effectiveness in wound management.