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Hydrodebridement of wounds: effectiveness in reducing wound bacterial contamination and potential for air bacterial contamination

Frank L Bowling, Daryl S Stickings, Valerie Edwards-Jones, David G Armstrong, Andrew JM Boulton

Journal of Foot and Ankle Research 2009, 2:13 (8 May 2009)

Abstract

Background
The purpose of this study was to assess the level of air contamination with bacteria after surgical hydrodebridement and to determine the effectiveness of hydro surgery on bacterial reduction of a simulated infected wound.

Methods
Four porcine samples were scored then infected with a broth culture containing a variety of organisms and incubated at 37degreesC for 24 hours. The infected samples were then debrided with the hydro surgery tool (Versajet, Smith and Nephew, Largo, Florida, USA). Samples were taken for microbiology, histology and scanning electron microscopy pre-infection, post infection and post debridement. Air bacterial contamination was evaluated before, during and after debridement by using active and passive methods; for active sampling the SAS-Super 90 air sampler was used, for passive sampling settle plates were located at set distances around the clinic room.

Results
There was no statistically significant reduction in bacterial contamination of the porcine samples post Hydrodebridement. Analysis of the passive sampling showed a significant (p<0.001) increase in microbial counts post Hydrodebridement. Levels ranging from 950 colony forming units per meter cubed (CFUs/m3) to 16780 CFUs/m3 were observed with active sampling of the air whilst using hydro surgery equipment compared with a basal count of 582 CFUs/m3. During removal of the wound dressing, a significant increase was observed relative to basal counts (p<0.05). Microbial load of the air samples was still significantly raised 1 hour post-therapy.

Conclusions
The results suggest a significant increase in bacterial air contamination both by active sampling and passive sampling. We believe that action might be taken to mitigate fallout in the settings in which this technique is used.