Universität zu Köln

Werra, Ursula Elisabeth Maria, Zinser, Max and Dorweiler, Bernhard (2022). Physical interventions as an alternative/addition to surgical debridement Ultrasound, coldplasma and LASER/photobiomodulation. Gefasschirurgie, 27 (2). S. 129 - 135. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1434-3932

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Abstract

Background: In Germany the treatment of patients with chronic wounds costs 8 billion Euros annually. Often, surgical debridement is indicated. But if critical structures are directly adjacent or the patient has only a limited ability to undergo anaesthesia, the possible applications can be limited. Furthermore, for financial reasons, the possibility of delegation is always of interest. Objectives: We present alternative and additional methods to surgical debridement from the portfolio of physical interventions. Materials and methods: Ultrasound-assisted wound debridement (UAW), cold plasma and photobiomodulation are based on interesting principles with great potential for development. The respective mechanisms, the current evidence, as well as financial aspects, are presented. Results: Overall, mainly because of the heterogeneity of the data the current evidence is weak. Also, some aspects of the treatment modalities have not yet been fully clarified. UAW represents a real alternative. It is highly acceptable to patients and can be performed in an outpatient setting. The effectiveness of cold plasma or photobiomodulation still cannot be assessed conclusively. However, several positive clinical results have been shown. Conclusions: Surgical debridement as such (still) cannot be completely replaced. However, the alternative methods such as UAW can offer an additional benefit. Wounds may be treated in an outpatient setting earlier (with corresponding savings). Another important strength is moreover the effectiveness regarding multidrug-resistant germs. There is a need for further clinical studies to be initiated, as the current data show that there are still many unanswered questions.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Werra, Ursula Elisabeth Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Zinser, Max UNSPECIFIED UNSPECIFIED UNSPECIFIED Dorweiler, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-563726
DOI:	10.1007/s00772-021-00854-1
Journal or Publication Title:	Gefasschirurgie
Volume:	27
Number:	2
Page Range:	S. 129 - 135
Date:	2022
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1434-3932
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ATMOSPHERIC ARGON PLASMA; DIABETIC FOOT ULCERS; CHRONIC WOUNDS; PHOTOBIOMODULATION; THERAPY; CARE Multiple languages Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56372