Role of hydrosurgery in the management of diabetic foot disease- new application of an age-old technique

Background: The lifetime risk of diabetic foot ulcer (DFU) may be as high as 25%. The primary aim in a case of DFU is to obtain wound closure as expeditiously as possible. Hydrosurgery debridement is a recent and new novel approach for debridement. Methods: The study was an observational prospective comparative study between hydrosurgery system and surgical debridement for assessment of hydrosurgery as a tool for debridement of DFUs carried out at tertiary care centre on patients presenting to or referred to the hospital. Study was being conducted on 60 patients of diabetic foot disease. They were divided into two groups of 30 each. Randomization was done by computer generated numbers. Results: Mean diabetes duration was lower in hydrosurgery group as compared to surgical debridement group (11.53 and 14.63 years respectively). Deformity was present in 43.3% and 33.3% of patients in hydrosurgery and surgical debridement groups respectively. On culture sensitivity of tissue/pus, Klebsiella (23.3%) was dominantly found in hydrosurgery group whereas Klebsiella and Pseudomonas were found equally in Surgical debridement group (20% each). Mean operative time was less in hydrosurgery group as compared to Surgical debridement (15.30 and 23.67 minutes respectively). Conclusions: Hydrosurgery system showed significant advantages over standard surgical scalpel debridement with lesser debridements required, reduced operative time and in hospital stay. It permitted adequate debridement of the diabetic foot wounds without much collateral damage which usually happens with standard scalpel debridement, preserving more viable tissues to promote rapid healing.