Matsumura Hajime, Nozaki Motohiro, Watanabe Katsueki, Sakurai Hiroyuki, Kawakami Shigehiko, Nakazawa Hiroaki, Matsumura Izumi, Katahira Jiro, Inokuchi Sadaki, Ichioka Shigeru, Ikeda Hiroto, Mole Trevor, Smith Jennifer, Martin Robin, Aikawa Naoki
Department of Plastic Surgery, Tokyo Medical University Hospital, Tokyo, Japan.
Ann Plast Surg. 2012 Nov;69(5):521-5. doi: 10.1097/SAP.0b013e31826d2961.
The preservation of healthy tissue during surgical debridement is desirable as this may improve clinical outcomes. This study has estimated for the first time the amount of tissue lost during debridement using the VERSAJET system of tangential hydrosurgery. A multicenter, prospective case series was carried out on 47 patients with mixed wound types: 21 (45%) burns, 13 (28%) chronic wounds, and 13 (28%) acute wounds. Overall, 44 (94%) of 47 patients achieved appropriate debridement after a single debridement procedure as verified by an independent photographic assessment. The percentage of necrotic tissue reduced from a median of 50% to 0% (P < 0.001). Median wound area and depth increased by only 0.3 cm (6.8%) and 0.5 mm (25%), respectively. Notably, 43 (91%) of 47 wounds did not progress into a deeper compartment, indicating a high degree of tissue preservation.
在手术清创过程中保留健康组织是可取的，因为这可能会改善临床结果。本研究首次使用VERSAJET切线水刀系统估计了清创过程中损失的组织量。对47例混合伤口类型的患者进行了一项多中心前瞻性病例系列研究：21例（45%）烧伤，13例（28%）慢性伤口，13例（28%）急性伤口。总体而言，47例患者中有44例（94%）在单次清创手术后通过独立的照片评估证实达到了适当的清创效果。坏死组织的百分比从中位数50%降至0%（P<0.001）。伤口面积和深度的中位数仅分别增加了0.3厘米（6.8%）和0.5毫米（25%）。值得注意的是，47个伤口中有43个（91%）没有进展到更深的腔隙，表明组织保留程度很高。
