Comparing a Hydrosurgery System* to Conventional Debridement Techniques for the Treatment of Delayed Healing Wounds: A Prospective, Randomized Clinical Trial to Investigate Clinical Efficacy and Cost-Effectiveness

Wounds that undergo delayed healing present a significant clinical problem and create a major financial impact on the health care system.  While surgical debridement procedures have conventionally been performed with scalpels and electrocautery, alternative techniques, such as hydrosurgery, are becoming more widespread. This prospective, open label, randomized study compared procedures using the hydrosurgery system with conventional methods of debridement in order to assess clinical efficacy and cost-effectiveness when treating subjects with chronic wounds.  Wounds were debrided with conventional techniques or hydrosurgery. 40 subjects were recruited into the study: 21 subjects in the hydrosurgery excision group and 19 in the conventional debridement group.  The time taken for the first excision procedure was significantly faster using the hydrosurgery system when compared to conventional debridement (p<0.001).  The total excision time for all procedures was significantly less for the hydrosurgery group than for the conventional group (p=0.005). Also, the hydro surgery group demonstrated significantly less intraoperative blood loss than conventional group for all procedures (p=0.003).  In this study, although there were no differences in time to stable wound closure or bacterial reduction between the hydrosurgery system and conventional debridement, the hydrosurgery system did offer advantages in terms of operative times and intraoperative blood loss and was cost-neutral, despite the handpiece cost. It is hoped that studies of this type will allow for enhanced clinician education, patient safety and prove beneficial to facilities.