American Association of Plastic Surgeons

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Hydromechanical Therapy Improves Cutaneous Wound Healing Through Tissue Regeneration and Bioburden Reduction
Helen S Quinn, MD, Quynh Anh Phan, BS, Bin Chen, MD, PhD, Lifei Guo, MD, PhD
Lahey Hospital and Medical Center, Burlington, MA, USA

PURPOSE: Chronic wounds are difficult to treat, costly, and pose a significant burden on patient quality of life. The aim of this study is to evaluate the effect of hydromechanical therapy (WaterPik device) on wound healing and bacterial burden in a pig model.
METHODS: Ten full-thickness square wounds were created on experimental pigs and infected with Pseudomonas aeruginosa. On postoperative day 2, wounds either underwent WaterPik irrigation therapy at 25 psi for 2 minutes or dry dressing changes twice daily until postoperative day 28. Wound size, approximate bacterial burden, biofilm formation under electron microscopy and gene transcription using qPCR were measured and evaluated.
RESULTS: The WaterPik treatment group displayed significantly accelerated wound closure beginning at postoperative day 7. On postoperative day 28, the WaterPik group exhibited 99% closure compared to 83% in the control group. A significantly lower bacterial burden was observed at postoperative day 10, and unlike the control, no biofilm was observed under electron microscopy. Real-time qPCR analysis revealed that growth factors VEGF-A (p=0.02), bFGF (p=0.04), and KGF (p=0.01) were up-regulated in the WaterPik group on day 10. IL-1 mRNA was significantly downregulated (p=0.03). Collagen Iα (p=0.01) and α-SMA gene expression (p= 0.04) was increased.
CONCLUSION: WaterPik hydromechanical therapy may accelerate wound healing through enhanced angiogenesis, dermal and epidermal regeneration, and biofilm disruption. As such, this therapy provides a promising low-cost, yet effective and easily accessible modality to augment chronic wound healing.


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