Authors (including presenting author) :
Shit KYF (1), Tong SY (1), Lam MY (1), Cheung KWA (1), Mak HN (1), Leung YY (1), Yu HY (1), Wong YK (1), Lau SM (3), Tong MH (2), Chim CK (2)
Affiliation :
(1) NTEC Wound Services Team, Department of Surgery, Prince of Wales Hospital
(2) NTEC COST Team
(3) Department of Surgery, North District Hospital
Introduction :
Devitalized or infected tissue over wound is a medium for bacterial growth which can delay wound healing and prolong hospital stay. Effective wound debridement with aerosol controlled is crucial for managing those hard-to-heal wounds in both hospitals & community settings.
Objectives :
To provide selective hydro-mechanical debridement to chronic non-healing wounds with minimal pain or discomfort by safe Pulsar debridement system.
Methodology :
Pulsar II (AWI) system has been introduced for direct localized hydrotherapy to remove necrotic tissue and biofilm over wounds. The no touch and no suction techniques can reduce bacterial bioburden, promote bio-stimulation without harming the normal wound bed tissue. Suitable cases were recruited under standardized study protocol by both Wound Team & COST Team. Application instructions and training has been arranged for all concerned staff. Treatment regime of Pulsar therapy and EZ Debride brush (1st visit only) every day for 4 days consecutively or 4 times in any 7 days period with 3 liters of normal saline for each case was designed. Wound assessment and evaluation were performed by 3D Wound Measurement System with wound size (L,W,D) and percentage of granulation tissue analysis.
Result & Outcome :
Total 23 cases / wounds (16 patients in Hospital A and 7 patients in COST) were recruited into the project. Each case has received 4 sessions in 1 week.
Wound size was improved as measured by 3D camera: 56.5% in length, 43.5% in width and 43.5% in depth; by wound ruler: 65.2% in length; 65.2% in width and 43.5% in depth. Total 88 sessions were done for 23 wounds, post Pulsar irrigation with increased % of granulating tissue was noted in 63 sessions (71.59%). Pain assessment was done before, during and after the procedure. 76 sessions of pain scores during the procedure were obtained (3 cases with 12 sessions were un-assessable) and average pain score was 2.47 (NRS 0/10). A patient satisfaction survey was conducted after completion of treatment. The average score was 5.42 (6/6). Patient revealed that the treatment can promote their wound healing (5.41) and there has no discomfort during the procedure (5.47).
The pulsar debridement system was successfully provided a hydro-mechanical debridement to chronic non-healing wounds and aided in improving the wound bed by increasing the granulating tissues. Besides, patients experienced minimal pain during the procedure and overall satisfied with the whole process.
