[Application effects of the hydrosurgical debridement system in eschar excision and debridement in ex vivo porcine skin burn wound models].

Objective: To investigate the application effects of the hydrosurgical debridement system (hereinafter referred to as the hydrosurgery system) in eschar excision and debridement in ex vivo porcine skin burn wound models. Methods: This was a basic research study using grouped design. On November 21st, 2024, 23 young surgeons (20 males and 3 females, aged 30-43 years) participated in the 2024 Zhejiang Provincial Burn Surgery Clinical Skills Competition in Ningbo city. Each surgeon used the hydrosurgery system and convetional instruments to perform eschar excision (using the hydrosurgery system and roller dermatome) and debridement (using the hydrosurgery system and conventional scalpel) on ex vivo porcine skin burn wound models featuring both early-stage eschar and late-stage liquefied eschar (both with an area of 12 cm×8 cm), respectively. The operative time (assessing speed) and amount of removed tissue (assessing precision) were recorded for both instruments in both procedures. Results: The operative time for eschar excision was not statistically different between the hydrosurgery system (122 (96, 145) s) and traditional instrument (125 (56, 233) s), P>0.05; however, the amount of removed tissue by the hydrosurgery system (2.88±0.27) g was significantly less than that (13.81±1.93) g by traditional instrument (t=-5.44, P<0.05). The operative time for debridement by the hydrosurgery system ((121±9) s) was significantly shorter than that ((368±33) s) by traditional instrument (t=-7.00, P<0.05); however, the amount of removed tissue by the hydrosurgery system ((30.85±1.98) g) was significantly greater than that ((21.48±1.45) g) by traditional instrument (t=4.00, P<0.05). Conclusions: Compared with traditional instruments, the hydrosurgery system allows more precise removal of necrotic tissue and minimize damage to healthy tissue in early-stage eschar excision in ex vivo porcine skin burn wounds; however, while it significantly accelerates debridement during late-stage debridement of liquefied eschar, it may remove excessive normal tissue.