New techniques for wound management: A systematic review of their role in the
management of chronic wounds
#MMPMID29506339
Bekara F
; Vitse J
; Fluieraru S
; Masson R
; Runz A
; Georgescu V
; Bressy G
; Labbé JL
; Chaput B
; Herlin C
Arch Plast Surg
2018[Mar]; 45
(2
): 102-110
PMID29506339
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Debridement is a crucial component of wound management. Recent technologies such
as hydrosurgery (Versajet), ultrasound therapy (the MIST therapy device), or
plasma-mediated bipolar radio-frequency ablation therapy (Coblation) seem to
represent interesting alternatives for wound debridement. The purpose of this
systematic review was to describe, evaluate, and compare these three recently
developed methods for the management of chronic wounds. In January 2016, an
electronic database search was conducted of MEDLINE, PubMed Central, and Embase
for articles concerning these three innovative methods for the management of
chronic wounds. A total of 389 references were identified by our search strategy,
and 15 articles were included. We extracted data regarding the number and age of
patients, indications, operating time, number of procedures, costs, wound healing
time, decrease in exudation, perioperative blood loss, bacterial load, and the
occurrence of complications. The 15 articles included studies that involved 563
patients who underwent hydrosurgery (7 studies), ultrasound therapy (6 studies),
or Coblation (2 studies). Six randomized controlled trials were included that
compared the use of a scalpel or curette to hydrosurgery (2 studies) or
ultrasound therapy (6 studies). Hydrosurgery, in addition to being a very precise
and selective tool, allows significantly faster debridement. Ultrasound therapy
provides a significant reduction of exudation, and improves the wound healing
time. No comparative study dedicated to Coblation was identified. Despite the
obvious clinical interest of the topic, our review of the current literature
revealed a lack of prospective randomized studies comparing these devices with
each other or with standard techniques, particularly for Coblation and
hydrosurgery.
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