Written by Kim O’Brien Root —
[dropcap]It’s sometimes called a liquid scalpel—a device that cuts away bad tissue, but doesn’t use a knife.[/dropcap]Instead, Versajet uses a high-pressure water stream that effectively removes dead, damaged or infected tissue from a wound. Used regularly in wound care, the surgical tool has been shown to be more sterile and precise than a regular scalpel, and it can also help speed along healing.
Care of large wounds or burns can be a nasty ordeal, and requires debridement—a process to remove bad tissue. Doing so—sometimes multiple times—helps improve the healing potential of the remaining healthy tissue.
Versajet debuted in the early 2000s as the next step in wound care, using water and a vacuum system to suck away unwanted tissue. Sentara Williamsburg Regional Medical Center introduced the Versajet Hydrosurgery System about a year ago, and the devices are located at most Sentara hospitals and surgery centers in Hampton Roads. Versajet devices are also being used at Naval Medical Center Portsmouth and at Chesapeake Regional Medical Center.
Dr. Joseph Testa, a general surgeon at Sentara Williamsburg who also works in the Sentara Wound Healing Center, says he prefers using Versajet over a scalpel for surgical debridements.
“It’s actually much nicer to use and more precise than a knife,” says Testa, who requested that Sentara Williamsburg acquire the equipment after being introduced to it during his residency with the Henry Ford Health System in Detroit, Mich. “It’s a nice technology to offer patients.”
The idea behind wound debridement, Testa says, is that open wounds attract bacteria. By physically scraping the bacteria off, the bacteria can no longer get oxygen from the bloodstream. Debridement can be done by surgical, chemical, mechanical or autolytic—using the body’s own enzymes—methods.
Stronger than a high-pressure carwash, the hand-held Versajet shoots streams of water across the surface of a wound and quickly collects it again, along with unwanted tissue, in a vacuum that’s part of the hand piece. And it’s not messy: Versajet operates on the Venturi effect of fluid dynamics, propelling sterile saline through a constricted opening with a corresponding decrease in pressure.
Doctors say that using Versajet over a scalpel for surgical debridement reduces the amount of bleeding, so it reduces the need for cauterization. They also say it creates cleaner edges that can be especially helpful if a wound requires a skin graft or closure, and also decreases damage of good tissue around the wound.
“Even in the best of hands, meticulous knife debridement often leads to an uneven wound surface and more removal of more tissue than necessary,” according to a study done at Brigham and Women’s Hospital in Boston, Mass. “With the Versajet Hydrology System, wounds can be debrided in a safer, more controlled manner.”
Another study suggests that Versajet reduces debridement procedure times by about 14 percent and results in 40 percent fewer procedures per patient, according to Smith & Nephew, the London-based medical technology company that makes Versajet.
Some wounds can be debrided in an outpatient wound clinic. Versajet is done in an operating room. Testa uses it on large wounds that have had multiple treatments prior, or for a troublesome wound that has trouble healing. It’s been shown to be beneficial for very painful wounds as well.
A type of wound that Versajet is good for is a venous ulcer on the leg, a chronic wound caused by improper functioning of venous valves. Testa treated one patient who had multiple debridements done in the outpatient wound clinic. Versajet—which often requires a local anesthetic but usually not full anesthesia—improved healing of the wound and reduced the healing time, he says.
Versajet gets a lot of attention because of the science behind it, and also because people are fascinated just to watch it work, says Edward Armstrong, vice president of marketing for Smith & Nephew’s Advanced Wound Devices division. The company is continually working to improve the device’s technology, introducing the newest version two years ago.
Still, Versajet isn’t considered a replacement for the surgical blade. Rather, Armstrong says, it’s a complement.
Testa agrees.
“Wound care is a multiple-dimensional process,” Testa says. “Even though we use this technology to heal the wound, it’s not the only thing we use. It’s one piece of the puzzle to wound care.”