Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo, Japan.
Int Wound J. 2021 Jun;18(3):269-278. doi: 10.1111/iwj.13528. Epub 2021 Mar 23.
Studies demonstrating the effectiveness of hydrosurgery for chronic wounds are extremely limited. This systematic review aimed to evaluate the efficacy of hydrosurgery compared with conventional debridement in chronic wounds, skin ulcers, and non-acute wounds. This PROSPERO-registered review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A systematic search was performed in PubMed, Scopus, and Cochrane Library databases. Abstracts of all studies were screened independently by two reviewers. The bias of prospective randomised controlled studies was assessed using the Cochrane Collaboration's tool for assessing the risk of bias and RevMan 5.4 software, whereas the bias of retrospective comparative studies was evaluated using the Risk of Bias Assessment Tool for Non-randomised Studies. Two prospective randomised controlled trials, two retrospective comparative studies, and three prospective non-comparative studies were included. Hydrosurgery enabled rapid debridement. The Versajet Hydrosurgery System saved 8.87 minutes compared with the conventional methods. Similarly, the debridement quality was high with this system. The debridement number needed to achieve adequate wound beds was fewer in the hydrosurgery group than in the conventional group. These superiorities lead to subsequent success and cost-effectiveness. As there were only two prospective randomised controlled studies, and much information was missing, the risk of bias was unclear. This review confirmed that hydrosurgery is useful for the debridement of chronic wounds, considering the procedural speed and quality.
研究表明水刀疗法治疗慢性伤口的效果非常有限。本系统评价旨在评估水刀疗法与传统清创术在慢性伤口、皮肤溃疡和非急性伤口方面的疗效。本 PROSPERO 注册的综述是按照系统评价和荟萃分析的首选报告项目进行的。在 PubMed、Scopus 和 Cochrane Library 数据库中进行了系统搜索。由两位评审员独立筛选所有研究的摘要。使用 Cochrane 协作风险偏倚评估工具和 RevMan 5.4 软件评估前瞻性随机对照研究的偏倚,使用非随机研究风险偏倚评估工具评估回顾性比较研究的偏倚。纳入了两项前瞻性随机对照试验、两项回顾性比较研究和三项前瞻性非比较研究。水刀疗法可以快速清创。Versajet 水刀系统与传统方法相比节省了 8.87 分钟。同样,该系统的清创质量也很高。水刀组达到足够的创面床所需的清创次数少于传统组。这些优势导致后续的成功和成本效益。由于只有两项前瞻性随机对照试验,而且有很多信息缺失,因此偏倚风险尚不清楚。本综述证实,考虑到操作速度和质量,水刀疗法对慢性伤口的清创是有用的。