Efficacy of Hydromechanical Therapy in Nonhealing, Chronic Wounds as a Cost- and Clinically Effective Wound Care Modality

Introduction. Chronic wounds pose a widespread challenge to health care, with many new, costly wound care modalities introduced in recent years with varying degrees of success. Bacterial biofilms have been postulated as one of the main culprits of the stagnation of chronic wound healing. For years, surgical fields have used pressurized irrigation for cleansing surgical wounds, but its utility in managing nonhealing chronic wounds has often been overlooked. Objective. In this case series, the authors aimed to demonstrate that hydromechanical therapy with pressurized irrigation can be a cost-effective and clinically effective wound care modality. Materials and Methods. The authors present 6 clinical cases of difficult nonhealing wounds managed with hydromechanical therapy with pressurized irrigation, a follow-up from the initial case report. Other, often more expensive modalities, had previously failed. In all 6 cases, irrigation was performed using tap water or saline either at home or long-term care facilities. Literature that focused on the mechanism of healing from hydromechanical therapy was reviewed. Results. All chronic wounds in the series reached stable healing. The authors speculate that such healing was achieved through biofilm disruption and tissue stimulation with a mechanical impact. Literature supporting this hypothesis is presented. Conclusions. The current clinical results offer a new perspective on the role of a traditional surgical modality of hydromechanical therapy in chronic wound care and on the associated opportunity of potential cost savings.