Hydrosurgical and conventional debridement of burns: randomized clinical trial

HyCon Study Group

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Tangential excision of burned tissue followed by skin grafting is the cornerstone of burn surgery. Hydrosurgery has become popular for tangential excision, with the hypothesis that enhanced preservation of vital dermal tissue reduces scarring. The aim of this trial was to compare scar quality after hydrosurgical versus conventional debridement before split-skin grafting.

METHODS: A double-blind randomized within-patient multicentre controlled trial was conducted in patients with burns that required split-skin grafting. One wound area was randomized to hydrosurgical debridement and the other to Weck knife debridement. The primary outcome was scar quality at 12 months, assessed with the observer part of the Patient and Observer Scar Assessment Scale (POSAS). Secondary outcomes included complications, scar quality, colour, pliability, and histological dermal preservation.

RESULTS: Some 137 patients were randomized. At 12 months, scars of the hydrosurgical debrided wounds had a lower POSAS observer total item score (mean 2.42 (95 per cent c.i. 2.26 to 2.59) versus 2.54 (95 per cent c.i. 2.36 to 2.72; P = 0.023)) and overall opinion score (mean 3.08 (95 per cent c.i. 2.88 to 3.28) versus 3.30 (95 per cent c.i. 3.09-3.51); P = 0.006). Patient-reported scar quality and pliability measurements were significantly better for the hydrosurgically debrided wounds. Complication rates did not differ between both treatments. Histologically, significantly more dermis was preserved with hydrosurgery (P < 0.001).

CONCLUSION: One year after surgery scar quality and pliability was better for hydrosurgically debrided burns, probably owing to enhanced histological preservation of dermis.

Original languageEnglish
Pages (from-to)332-339
Number of pages8
JournalThe British journal of surgery
Volume109
Issue number4
DOIs
Publication statusPublished - 3 Mar 2022

Keywords

  • burns/pathology
  • cicatrix/etiology
  • debridement
  • humans
  • skin/pathology
  • skin transplantation/adverse effects

Fingerprint

Dive into the research topics of 'Hydrosurgical and conventional debridement of burns: randomized clinical trial'. Together they form a unique fingerprint.

Cite this