A Hydrosurgery System (Versajet) with and without Hydrogen Peroxide Solutions for the Debridement of Subacute and Chronic Wounds

Irkoren, Saime; Sivrioğlu, Nazan

doi:10.1097/01.asw.0000443898.56886.66

Cited by 8 publications

(5 citation statements)

References 14 publications

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“…At the level of observational studies, [18][19][20][21][22][23][24][25] the quality of the evidence is low to moderate and the conclusions of some of them are not sufficiently supported by the results report. 23 Effectiveness of debridement is mainly supported by the evolution of healing and graft success, and not by the biopsy study.…”

Section: Resultsmentioning

confidence: 92%

Hydrosurgery for Wound Debridement: Overview of Systematic Reviews

Bolaos-Daz¹,

Alfaro²

2019

IJMP

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Hydrosurgery system (Versajet®) has been applied for more than 20 years and exerts its action based on the principle of the Venturi effect, in which a thin and cutting tangential fluid (tangential hydrojet) is generated and is propelled at high speed generating excision mainly on non-viable tissue. Objective: To determine the effectiveness and safety regarding the use of hydrosurgery in the debridement of acute or chronic wounds. Findings: Five systematic reviews (SRs) were selected according to the AMSTAR criteria and 2 SRs were excluded. Kakagia et al selected 20 articles, of which 3 were randomized clinical trials (RCTs). Two were RCTs that exclusively included burn injuries and 1 RCT included acute injuries in general. Edmondson et al reviewed the evidence for various burn debridement techniques. He sought to determine if scalpel excision should remain the standard of comparison. He selected 18 studies, of which 3 were RCTs. Bekara et al selected 7 studies for hydrosurgery and only 2 were RCTs. Kwa et al compared surgical and non-surgical burn techniques and included 8 studies with hydrosurgery, of which 2 were RCTs. Elraiyah et al reviewed the evidence regarding techniques for diabetic foot ulcers. He selected 1 RCT with hydrosurgery. Conclusion: Hydrosurgery seems to reduce the number of debridements as well as favor a greater preservation of the underlying dermis and precision of debridement at the level of difficult contours. The evidence is still scarce and of low statistical power with moderate risk of bias in the study designs.

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Section: Resultsmentioning

confidence: 92%

Hydrosurgery for Wound Debridement: Overview of Systematic Reviews

Bolaos-Daz¹,

Alfaro²

2019

IJMP

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“…Mohammadi et al in a randomized clinical trial of chronic colonized burn wounds showed that 2% hydrogen peroxide wound cleansing significantly improved skin graft take rates 41. Another trial by Irkoren demonstrated that hydrosurgery with hydrogen peroxide was superior to controls without hydrogen peroxide for infected wounds, resulting in shorter hospital stay and enhanced graft viability 42.…”

Section: Clinical Resultsmentioning

confidence: 99%

Hydrogen Peroxide Wound Irrigation in Orthopaedic Surgery

Lü

Hansen

2017

J. Bone Joint Infect.

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As the burden of deep hardware infections continues to rise in orthopaedics, there is increasing interest in strategies for more effective debridement of colonized tissues and biofilm. Hydrogen peroxide has been used medically for almost a century, but its applications in orthopaedic surgery have yet to be fully determined. The basic science and clinical research on the antiseptic efficacy of hydrogen peroxide have demonstrated its efficacy against bacteria, and it has demonstrated potential synergy with other irrigation solutions such as chlorhexidine and povidone-iodine. While hydrogen peroxide is effective in infection reduction, there are concerns with wound healing, cytotoxicity, and embolic phenomena, and we recommend against hydrogen peroxide usage in the treatment of partial knee replacements, hemiarthroplasties, or native joints. Additionally, due to the potential for oxygen gas formation, hydrogen peroxide should not be used in cases of dural compromise, when pressurizing medullary canals, or when irrigating smaller closed spaces to avoid the possibility of air embolism. Finally, we present our protocol for irrigation and debridement and exchange of modular components in total joint arthroplasty, incorporating hydrogen peroxide in combination with povidone-iodine and chlorhexidine.

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“…It has been shown that the use of each of them alone exerts a bacteriostatic effect, but their combination has a bactericidal effect 17–19 . In addition to the fact that hydrogen peroxide has micro debridement properties by producing O 2 when acted upon by catalase enzyme 20 . These unique properties encouraged their combined use in orthopedic surgery and plastic surgery 21,22 .…”

Section: Discussionmentioning

confidence: 99%

Low‐budget, single‐session elimination of CIED pocket infection

Roshdy

Seaoud

Elbelbesy

2020

Pacing Clinical Electrophis

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Background The dramatic increase in the use of cardiovascular implantable electronic devices (CIED) was associated with an increased rate of CIED infection, which has a high management cost. Aim of the Study To test the safety and efficacy of a single‐session protocol, aiming to reuse the infected pocket side and the same device and leads in patients with CIED pocket infection. Patients and Methods We included patients with isolated pocket infection between January 2015 and November 2019. The Patient was prepared by taking a swab for culture and sensitivity before the procedure. The pocket was debrided and the capsule was removed, the pocket was rinsed with povidone‐iodine and hydrogen peroxide mixture, then packed with gauze sponge soaked with povidone‐iodine. The device was debrided using ultrasonic irrigation and sterilized using gas plasma. The device was reimplanted and the wound was closed in layers. Results During the period of the study, we had 12 patients with isolated pocket infection. Nine presented with erosion, two with impending erosion, and one with a chronic sinus. Patient's age was 61.5 ± 7.64 years. The infection was diagnosed 14.2 ± 8.22 weeks post device implantation. They were admitted for 7.6 ± 1.54 days postprocedure. The follow‐up duration was 26.5 ± 15 (1.7–52) months. Only one patient (8%) had a recurrence of the infection after 50 days of the procedure. Conclusion Our protocol was successful in treating 92% of device‐related pocket infection without the need to replace the device or the pocket side.

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A Hydrosurgery System (Versajet) with and without Hydrogen Peroxide Solutions for the Debridement of Subacute and Chronic Wounds

Cited by 8 publications

References 14 publications

Hydrosurgery for Wound Debridement: Overview of Systematic Reviews

Hydrosurgery for Wound Debridement: Overview of Systematic Reviews

Hydrogen Peroxide Wound Irrigation in Orthopaedic Surgery

Low‐budget, single‐session elimination of CIED pocket infection

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