VERSAJET usage algorithmsDr. Jeffrey M Nelson MD FACS – St. Mary’s Burn Centre, Tucson, AZ USA

VERSAJET usage algorithm: general power level settings

1-3 3-4 4-5 5-6 6-7 7-8 8-10

• Tenuous tissue

• Gentle resurfacing

• Weak tissue• Debride

superficial eschar

• Common settings

• Medium quality tissue

• “Get a feel for the wound”

• Common settings• Medium quality

tissue• Deeper necrosis

• Youthful tissue

• Firm induration

• Palmer or plantar skin

• Robust or rigid tissue

• Chronic fibrosis• Deep tissue necrosis

• Pump priming

• Major tissue necrosis

IntroductionAlgorithms for the usage of VERSAJET Hydrosurgery System in complex wound management cases are presented:

VERSAJET usage algorithm: power level ranges by skin type/integrity

Minor surface debridement post biologic dressings:

INTEGRATM

ALLOGRAFTTM

XENOGRAFTTM

Post-enzymaticdebridement:

COLLAGENASE™

Attenuated skin:

Long-term steroidsAged skin

Robust tissue quality:

Young burn

Chronic indurated wound

Pressure ulcer

Thick tissue:

Scalp

Glaborous skin

Calciphylaxis

Deep tissueinjury:

Pressure ulcer

Coumadin necrosis

Necrotising fascitis

Very deep tissue injury:

Coumadin necrosis

Necrotising fascitis

Power level:

2-3Power level:

3-4Power level:

4-5Power level:

5-6Power level:

6-7Power level:

7-9Power level:

8-10

• Pyoderma- gangrenosum

• Pemphygus (Bulous disorders)

• Stevens-Johnson Syndrome/TEN

• Systemic lupus

• Vasculitis

• Coumadin necrosis

• Wegner’s granulomatosis

• Human/animal bites

• Insect/brown recluse

• Abrasions/road rash

• Burns, thermal

• Burns, chemical

• Crush injury

• Post-surgical

• Necrotizing fascitis

• Synergistic gangrene

• Fournier’s gangrene

• Post-surgical

• Abscesses

• Arterial ulcers

• Venous stasis ulcers

• Neuropathic ulcers

• Pressure ulcers

• Necrobiosislipoidica-diabeticorum

• Radiation injury

• Calciphylaxis

• Gout

• Cryoglobulinemia

• Tumor necrosis

VERSAJET™ usage algorithm: power level ranges by wound classification

• Scalp

• Chest/back (not nipple or areola

• Flanks

• Abdomen

• Buttocks

• Thighs

• Calves

• Palms

• Soles

• Face

• Neck

• Popliteal fossa

• Dorsal foot

• Anticubital fossa

• Medial malleolus

• Perineum

• Anterior tibia

• Dorsal hand

• Medial/Lateral digits

• Elbow

• Deep wound femoral triangle

• Radial artery at wrist

• Eyes

• Deep wounds of neck

• Post auricular region

VERSAJET usage algorithm: power level ranges by anatomic location

Presented at the 2006 John A. Boswick, MD Burn and Wound Healing Symposium, Maui, Hawaii and also at the 2005 North American Burn Society meeting, MT, USA

Immunologic(2-8)

Traumatic(3-7)

Infectious(4-8)

Physiologic(4-8)

Safe zones(5-8)

Careful zones(3-6)

Alert zones(1-4)

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VJEE-02-0811-USE

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