Hydrosurgical Debridement Use Associated With Decreased Surgical Site-Related Readmissions

A Retrospective Analysis

Crystal Valerie James, MD; Munir Patel, MD; Nicole Ilonzo, MD; Kojo Wallace, MD; Jani Lee, MD; Mabel Chan, MD; Scott Ellis, MD; John C. Lantis II, MD

Disclosures

Wounds. 2021;33(6):139-142. 

In This Article

Materials and Methods

This was a retrospective analysis of 190 patients who underwent wound debridement. Current Procedural Terminology (CPT) codes 11042 and 11043, debridement to subcutaneous tissue and debridement to muscle and/or fascia, respectively, were used to identify 289 unique patients treated for lower extremity wounds of all types that were cared for by the vascular surgery service at a large tertiary care wound program from January 2016 to June 2018. This represented care provided by 3 physicians board-certified in both general surgery and vascular surgery.

Chart review was completed for each patient, and interventions—including debridement, types of dressings used, and skin substitute placement—were mapped out for each of the wounds. Outcomes such as wound infection, readmissions, and amputations also were recorded. All data were gathered and entered into Microsoft Excel (Microsoft Corporation); all patient identifiers were excluded.

The initial data from the 289 patients were examined, and 99 patients were removed due to lack of debridement during their wound care course or incomplete data. The remaining 190 patients had undergone mechanical debridement in the operating room. These patients were separated into 3 groups based on the tool used for debridement: (1) standard sharp soft tissue excision with scalpel and/or scissors, (2) standard sharp soft tissue excision with pulse irrigation, or (3) tangential hydrosurgical debridement (VERSAJET II Hydrosurgery System; Smith+Nephew).

These data sets were then imported into SAS University Edition (SAS Institute) to perform statistical analysis. Logistic regression was performed with the aforementioned debridement methods and subsequent surgical site infection (SSI) hospital admission as the dependent variable.

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