Surgical Wound Dehiscence Clinical Trial
Official title:
A Study to Investigate the Time to Closure of Delayed Healing Dehisced Incisions, Delayed Healing Traumatic Wounds or Chronic Cutaneous Defects Surgically Excised With VERSAJET Compared Conventional Operating Room Techniques
It is increasingly recognised that the debridement of devitalised, bacterially contaminated
or senescent tissue is an essential component of the effective treatment of delayed healing
wounds.
Whilst surgical debridement procedures have conventionally been performed with scalpels and
other sharp instrumentation, alternative techniques such as the VERSAJET Hydrosurgery System
are becoming more widespread.
To increase the adoption of this new technology, it is essential that clinical improvements
are assessed alongside the potential impact on the costs of debridement and the net financial
impact on the hospital.
It is hypothesised that a decrease in the time to achieve stable wound closure will not only
lead to a patient benefit, but also a potential reduction in the cost of treatment due to
e.g. repeat procedures, longer hospital stay, infection etc. The purpose of this study is to
investigate the difference in time to closure of wounds surgically excised with VERSAJET
Hydrosurgery System and those surgically excised using conventional operating room
techniques.
It is increasingly recognised that the debridement of devitalised, bacterially contaminated
or senescent tissue is an essential component of the effective treatment of delayed healing
wounds. Whilst passive autolytic or enzymatic debridement procedures have their place, where
patients are unable to tolerate any surgical procedure, the judicious use of surgical
debridement to rapidly remove necrotic, contaminated tissue and slough has been shown to
offer many advantages in returning a wound to a healing trajectory.
Whilst surgical debridement procedures have conventionally been performed with scalpels and
other sharp instrumentation, alternative techniques such as the VERSAJET Hydrosurgery System
are becoming more widespread.
To increase the adoption of this new technology, it is essential that clinical improvements
are assessed alongside the potential impact on the costs of debridement and the net financial
impact on the hospital. In fiscal year 2004, there were more than 57,000 discharges under DRG
code 217 ('wound debridement and skin graft except hand) in the United States. Mean length of
stay (all payers) was 11 days and mean charges were $52,800. In 2005, Medicare funded 15,800
discharges under this code. Average charges for these patients were $56,500 and average
reimbursement was $18,2654. In this context it is particularly important that the potential
patient benefit and cost impact of new technology is fully assessed.
It is hypothesised that a decrease in the time to achieve stable wound closure will not only
lead to a patient benefit, but also a potential reduction in the cost of treatment due to
e.g. repeat procedures, longer hospital stay, infection etc. The purpose of this study is to
investigate the difference in time to closure of wounds surgically excised with VERSAJET
Hydrosurgery System and those surgically excised using conventional operating room
techniques.
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