Improved wound bed preparation using a mono-use disposable hydrodebridement  tool - case studies

Elena Toma; Renzi Erika

Elena Toma Registered Nurse, Clinical Specialist in Wound Care, Clinical Specialist in Ostomy Care, Independent tissue viability consultant, Rome, Italy
Renzi Erika Registered Nurse, Dipartimento di Sanità Pubblica e Malattie Infettive, “Sapienza” Università di Roma , Rome, Italy

Keywords: Debridement, Hydro-debridement, Détersion mécanique, Desbridación mecánica, Desbridamiento de herida, Wound bed preparation

Abstract

Background
Wound preparation and cleanliness represent the first steps towards effective healing.
Debridement can be the most traumatic procedure for the patient when wound dressing is being carried out.
It is important to choose appropriate techniques that aid the selective removal of non-viable tissue thereby reducing patients’ physical and psychological trauma.
Hydrodebridement with oxygenated saline solution is a selective mechanical debridement procedure, that exploits oxygen pressure in order to deliver a micro jet of solution which cleanses the wound bed and removes devitalized tissue.

Subjects and Methods: The Jetox^TM-HDC system was teamed with a sterile saline solution (0.9%) and compressed medical oxygen with adjustable flow (9-15 L/min). The device is sterile, latex free, and simultaneously sucks up tissue residues.
Three skin lesions with different etiology in two clinical cases were treated: Case 1 (male, age 55, diabetic) with one(1) ischemic lesion (20x11cm); Case 2 (female, age 87, diabetic, and bedridden) with two(2) pressure ulcers, (10x10cm and 4x7cm).
We gauged any improvement in tissue oxygenation locally around the wound by monitoring the trans-cutaneous tissue oxygen pressure (TcPO₂) before and during hydro-debridement.

Conclusions: The procedure was easy to use and generally well tolerated by patients. The device was suitable for outpatient treatment as well as for homecare. The debridement was capable of selectively removing of non-viable tissue and did not cause other vital tissue damage.
In addition to improved wound bed preparation and better overall decongestion of the injured area, the use of the system was associated with an overall improvement in tissue oxygenation in the surrounding wound area. (TcPO2-30mmHg, start of hydro-debridement – TcPO2-44mmHg, end of hydro-debridement). This technique could be advantageous in the treatment of both ischemic wounds and pressure ulcers.
The extent of tissue oxygenation produced by this procedure deserves further investigation in a statistically more relevant number of studies.