An Experimental Study On The Effect Of Water Jet Technology On The Debridement Of Infected Wounds

Objective:To explore the effect of water jet on the debridement of infected wounds,and provides experimental basis and theoretical basis for the clinical application of water jet on infected wounds’ debridement.Methods:72 Wistar rats were separated into two groups randomly.The full-thickness skin on the back of the rats of 3cm × 3cm was resected under sterile condition.Pseudomonas aeruginosa and Staphylococcus aureus were inoculated to the wound to make the infection model respectively.Then,each group was treated with different debridement method(Hydrodynamic debridement system,traditional debridement method(scalpel + pulse flushing),simple pulse washing)and different rinse medium(physiological saline,chlorhexidine),The quantitative bacterial analysis and histopathological analysis of the local muscle tissue were performed before and after debridement.Results:1.Animal modeling and general appearance:all rats were modeling success with no animal deaths.Open the dressing to observe the wound 48 hours after modeling.There is a lot of green exudate on the Pseudomonas aeruginosa infected wounds and dressing surface,with the soft tissue edema and easily bleeding.On the Staphylococcus aureus infected wounds and dressings,we could find lots of yellow and white purulent secretions,also with the soft tissue edema and easily bleeding.are prompted infection model modeling success.These results suggest that the infected model is successfully established.2.Bacteriological count:There was no statistically significant between the group of same bacterial infected wounds before debridement(P>0.05).When the saline was used as the rinse medium to debride the Pseudomonas aeruginosa infected wound,theamount of bacteria in tissue was(19 ± 0.27)× 108CFU/g after debridement of water jet,which was significantly smaller than that of the traditional debridement group(1.61 ± 0.60)× 108CFU/g(P<0.05)and that of the pulse washing group(6.67±4.34)×108 CFU/g(P<0.05).When the chlorhexidine was used as the rinse medium to debride the Pseudomonas aeruginosa infected wound,the amount of bacteria in tissue was(1.29 ± 0.24)× 108CFU/g after debridement of water jet,which was significantly smaller than that of the traditional debridement group(1.77 ± 0.56)× 108CFU/g(P<0.05)and that of the pulse washing group(5.42 ± 3.73)× 108CFU/g(P<0.05).When the saline was used as the rinse medium to debride the Staphylococcus aureus infected wound,the amount of bacteria in tissue was(1.61 ± 0.50)× 106CFU/g after debridement of water jet,which was significantly smaller than that of the traditional debridement group(2.59 ± 1.35)× 106CFU/g(P<0.05)and that of the pulse washing group(5.93 ± 2.51)× 106CFU/g(P<0.05).When the chlorhexidine was used as the rinse medium to debride the Staphylococcus aureus infected wound,the amount of bacteria in tissue was(1.58±0.57)× 106CFU/g after debridement of water jet,which was significantly smaller than that of the traditional debridement group(2.72 ± 1.59)× 106CFU/g(P<0.05)and that of the pulse washing group(6.87 ± 3.68)×106CFU/g(P<0.05).3.Histopathological examination:When the debridement of Pseudomonas aeruginosa infected wound and Staphylococcus aureus infected wound was performed respectively,whether it was treated with saline or chlorhexidine as the rinse medium,the results of HE staining of each debridement group were as follows:the water jet debridement group see a small amount of inflammatory cell infiltration,the traditional debridement group see part of the inflammatory cell infiltration,pure pulse flushing group see a lot of inflammatory cell infiltration,and the tissue destruction of water jet debridement group slighter than the traditional debriment group.Conclusion:When the debridement of different kinds of bacteria infected wound was performed,whether it was treated with saline or chlorhexidine as the rinse medium,the effect of debridement with waterjet is better than the traditional debridement method and pulse flushing.