Design of a Debridement Device Using Impinging Jets

Abstract

Chronic wound care is a significant burden on the healthcare system, affecting an estimated three to six million Americans, manifesting as ulcers associated with restricted blood flow, diabetes mellitus, or pressure. Treatment is frequently unsuccessful, with only an estimated 25–50% of venous and diabetic ulcers closing after 20 weeks of treatment. Debridement, the removal of necrotic tissue and foreign materials from the wounds, is a crucial component in the chronic wound care. While there exist many debridement techniques, the search for new and more effective methods is ongoing. The existing methods of debridement include surgical, the industry gold standard, as well as the mechanical, autolytic, enzymatic, and hydrosurgery (VersaJet™). The VersaJet™ uses a single high-speed jet directed parallel to the wound surface to remove soft necrotic tissue. This paper presents the design of a debridement device that uses two narrow, high-speed impinging fluid jets to excise necrotic tissue. The handheld device can be used to remove strips of necrotic tissue of a predetermined width and depth and was tested on samples of simulated slough, the soft necrotic tissue, and eschar, the hard, scablike necrotic tissue. The preliminary tests indicate that the technique removes necrotic tissue quickly and with good control, suggesting that, with further development, the technique may provide a time-saving alternative to surgical debridement. Further testing, however, is required to ensure that the jets do not damage the surrounding healthy tissues and to quantitatively analyze the effectiveness of the technique relative to other debridement strategies.