ADVANCES IN HYDROSURGERY FOR WOUND DEBRIDEMENT: AN IN-DEPTH REVIEW

Abstract

Effective wound bed preparation is essential to facilitate subsequent reepithelization by eliminating barriers that impede the healing process. These barriers include necrotic tissues, bacterial colonization, moisture imbalances, and compromised wound margins. Therefore, achieving optimal ulcer bed debridement is critical in addressing these challenges. Traditional methods of wound bed preparation, such as scalpel excision, have been the gold standard; however, emerging techniques offer enhanced efficiency and safety. These include autolytic, enzymatic, mechanical (negative pressure), biological (larvae), and hydro surgery-based approaches. Despite the promise of these innovative technologies, further research with robust experimental designs is needed to build upon initial observations. In this context, hydro surgery systems, like Versajet®, have been in use for over two decades. They operate on the Venturi effect principle, with pressurized saline or sterile water passing through a nozzle in a handheld device. This pressurization generates a high-speed, cutting fluid (tangential hydro jet) and creates localized vacuum forces, effectively removing non-viable tissue by suction and transporting it to an external collection system. This review aims to explore the potential of hydro surgery in wound bed preparation and its contribution to improved clinical outcomes.