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VERSAJET

It is generally agreed that wound debridement helps to create a wound environment which is conducive to healing. Surgical debridement is quick and effective: sharp instruments such as scalpel, scissors or curette are used to remove devitalised tissue and bacterial contamination from the wound. Surgical debridement is normally carried out in an operating theatre under general anaesthetic.

A new technology (VERSAJET^◊) has recently been approved in the UK and US for the surgical debridement of wounds. It uses a fluid jet under high pressure (up to 15,000 psi) to cut and evacuate necrotic tissue. The new technology is safer and more selective than conventional instruments and offers greater precision. Compared with a scalpel, the fluid jet more completely removes devitalised tissue and at the same time spares collateral healthy tissue. The benefit to the patient is that the wound is expected to close more quickly and the quality of scarring is better.

The price of the new instrument is significantly higher than the price of conventional instruments. The price of a disposable VERSAJET^◊ handpiece is nearly 40 times the price of a scalpel blade. However, the greater precision of the instrument means that it is possible to prepare a wound for closure with fewer operative procedures. In a recent US evaluation, the median number of surgical debridements required was reduced from two per wound with conventional instruments to one with VERSAJET^◊. This difference was statistically significant¹.

In the US evaluation, the total cost of debridement was $4,571 per patient with VERSAJET^◊ compared with $6,448 with conventional instruments. Despite the fact that the new technology costs more initially, because it saves operating theatre, nurse and surgeon time, the overall cost of treatment was reduced by approximately $1,900 per patient.

Not all of this saving will be in cash, although there will be some cash saving. Most of the saving will be in the form of nursing, surgeon and operating theatre time. All of these resources have alternative uses, and releasing nursing and surgeon time makes it possible to treat more patients with the same capacity.