VERSAJET General Technology Overview Features/Benefits Summary
of Evidence
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A revolutionary wound excision technology from Smith &
Nephew Wound Management. Uses Hydrosurgery technology (water
cutting) similar to that used in the cutting of materials during
mining and manufacturing. Consists of a powered console and single
use disposable hand pieces. FDA cleared and launched in the United
States in 2002. The VERSAJET II Hydrosurgery System
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VERSAJET II benefits
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VERSAJET Hydrosurgery System Venturi Effect The design of the
VERSAJET is such that the high velocity fluid jet passes across the
operating window and into the evacuation collector creating a
localized vacuum to hold and excise targeted tissue while
aspirating debris from the site. Tissue Excision Additional design
attributes allow the user to finely control excision. Orienting the
operating window parallel to the tissue optimizes the VERSAJETs
performance for tissue excision aspiration. Contaminant Evacuation
Alternatively, orienting the operating window obliquely to the
tissue optimizes the VERSAJETs performance for contaminant removal
irrigation and vacuuming.
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The VERSAJET II Hydrosurgery System The VERSAJET II system
enables a surgeon to precisely select, excise and evacuate
nonviable tissue, bacteria and contaminants from wounds, burns and
soft tissue injuries using a tissue-sparing technique 1-2,4-5
Advanced hydrosurgery technology helps reduce time to closure,
which may reduce overall treatment cost. 1,2,3
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Precision to preserve
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Principles of Hydrosurgical Debridement Complete removal of
undesirable tissue Maximum preservation of collateral tissue Wound
closure Courtesy of Dr. Jeff Nelson Courtesy of Dr. Jeff
Nelson
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The Clinical Benefits of Debridement Removes necrotic tissue
that impairs wound healing Creates bacterial balance in the wound
Results in controlled bleeding that stimulates the production of
blood- borne growth factors Removes the senescent fibroblasts
leaving younger, more viable cells Removes the hyperproliferative,
non-migratory wound edge that slows healing Thorough debridement is
paramount for the wound repair process.
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Classic Methods of Debridement Radical excision is required for
complex wounds Scalpels are non-selective Limitation exist for
pulse lavage Other invasive modalities cause collateral injury
Courtesy of Dr. Mark Granick
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CLEAN, FAST, and PRECISE Tangentially removes tissue Operation
is clearly visible No thermal effects Time and cost savings
Improves patient outcomes
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Surgical Debridement Literature Improves host defense
mechanisms and reduces active infection (Elek 1956) May enhance
chronic wound healing (Steed et al 1996) Reduces dysfunctional cell
populations (Hasan et al 1997, Vande Berg et al 1998) Promotes
release of tissue cytokines and growth factors (Enoch & Harding
2003)
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VERSAJET Features and Benefits FeaturesBenefitsEconomic Impact
Precision Completely removes non-viable tissue and particulate
contaminants Allows maximal preservation of viable tissue ~40% to
60% faster procedural time than conventional techniques Fewer
surgical procedures required to close the wound Less complex
procedure required to close the wound allowing for closure during
the same encounter Shorter healing time and reduced length of stay
Faster operating room turnover Safety Alleviates sharps injuries
Minimizes need for pulse lavage devices less risk of splash back
exposure and cross contamination Reduced blood loss Reduced costs
of sharps injuries and contamination Reduced risks to medical and
nursing staff Reduced risks to patients
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VERSAJET Summary of Evidence Clinical StudyWound TypeOutcome
Granick, 2006 Wound Repair and Regeneration; 14:394-396 VERSAJET
[n=45] vs conventional debridement [n=22] In the O.R. Chronic and
Acute wounds Fewer excision procedures required to close the wound
[mean=1.2 Versajet vs- 1.9 conventional] Net saving of $1900 per
patient Mosti, 2006 Wounds; 18(8): 227-237 VERSAJET debridement
[n=142] vs conventional debridemen [moist wound dressings, n=327]
at bedside Chronic (hard to heal) leg ulcers 76% of patients
achieved complete debridement with a single procedure. Pain was
well tolerated with local anesthetic Shorter time to clean wound
bed (1.3 days vs- 4.3 days) Reduced hospital length of stay
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VERSAJET Summary of Evidence Clinical StudyWound TypeOutcome
Dalla Paola, 2005 (poster at Turin) VERSAJET [N=12] vs historical
controls with conventional excision in the O.R Diabetic patients
with amputation stub dehiscence. VERSAJET group had fewer
subsequent amputations [2 vs 4], quicker healing [46 days vs 58
days] and fewer surgical procedures [2 vs. 3.5] Klein, 2005- J Burn
Care Rehabil ; 32(1): 64-69 VERSAJET excision of burn wounds
[n=44]. Non-comparative Burn wounds. Removal of eschar to eyelids,
fingers, web spaces More effective excision in difficult areas [cf
Goulian and Watson knives] No patient required re-excision. No
graft loss. Caputo, 2008 Int wound J 5(2): 288-294 Randomized trial
of VERSAJET vs conventional debridement in the O.R [n=41] Leg and
foot ulcers Shorter procedure time in the O.R (39% quicker) Saving
on pulse lavage (not required with VERSAJET) Saving on instrument
sets required ($500 instead of $21,000
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Other Hospitals Using VERSAJET Cleveland Clinic Foundation
Cleveland, Ohio The Ohio State University Medical Center Columbus,
Ohio Akron Childrens Akron, Ohio University of California San
Francisco (UCSF) University of California, San Diego (UCSD) Wishard
Memorial Hospital Indiana West Pennsylvania Hospital Pennsylvania
Duke University Health System North Carolina Lehigh Valley Hospital
- Pennsylvania Washington Hospital Center Washington, DC University
of Medicine and Dentistry in New Jersey Mercer Medical Center
Hospital New Jersey Clara Maass Medical Center New Jersey Methodist
Hospital Minnesota Johns Hopkins Maryland Mayo Clinic Minnesota
University of Illinois Medical Center Illinois Long Island Jewish
Medical Center New Hyde Park, New York Stony Brook University
Hospital Stony Brook, New York
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VERSAJET Financial Impact Debridement for certain patients
(e.g. Medicare) is typically not profitable for hospitals This is
because patients typically require multiple operative procedures
VERSAJET has the potential to: Free-up operating room time, which
frees resource to treat more profitable cases In the Granick study
the saving was equivalent to 45 minutes per patient Reduce resource
costs per patient and offset the cost of the handpiece in the
Granick study: Net saving $1900 per patient, including $127
reduction in materials spend 1.9 and 1.2 debridements per patient
mean the following: The group of 10 patients may require 19 or 12
debridement procedures on average for traditional debridement
approach and VERSAJET respectively The first debridement is
unavoidable; however, VERSAJET decreases the number of second
debridement procedures Thus, VERSAJET saves 7 out of 9 second or
repeated debridement procedures
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Economic Model Disclaimer The amount of savings is based on a
peer-reviewed article entitled, Efficacy and cost-effectiveness of
a high-powered parallel waterjet for wound debridement. Granick MS,
Posnett J, Jacoby M, Noruthun S, Ganchi PA, Datiashvili RO. Wound
Repair Regen. 2006 Jul-Aug; 14(4): 394-7. The savings are estimated
for hospital operating expenses. To the bes of our abilities, we
estimate the budget impact using available public and proprietary
data and disclose all pertinent assumptions. The new technology
(VERSAJET) may trigger changes in coding (i.e. excisional
debridement 86.22 non-excisional debridement 86.28). This may
result in a lower reimbursed amount from either public or
commercial payers. Under no circumstances should this presentation
be used by a health care provider for coding, payment or
verification purposes AND Smith & Nephew is not responsible for
any overpayment for health care services that may result from the
use of this presentation. The Corporate Reimbursement Disclaimer
provided at the end of the presentation prevails.
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Corporate Reimbursement Disclaimer The information provided
with this notice is general reimbursement information only. It is
not legal advice, nor is it advice about how to code, complete or
submit any particular claim for payment. Although we supply this
information to the best of our current knowledge, it is always the
providers responsibility to determine and submit appropriate codes,
charges, modifiers, and bills for services rendered. The coding and
reimbursement information is subject to change without notice.
Payers or their local branches may have their own coding and
reimbursement requirements and policies. Before filing any claims,
providers should verify current requirements and policies with the
payer.
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References 1.Granick MS, Posnett J, et al. Efficacy and
cost-effectiveness of a high-powered parallel waterjet for wound
debridement. Wound Rep Reg 2006a;14:394-397 2.Granick MS, Boykin,
Gamelli R, et al. Toward a common language: surgical would bed
preparation and debridement. Wound Rep Reg 2006; 14 S1-S10
3.Cubison TCS, Pape SA, Jeffery SLA. Dermal preservation using the
VERSAJET hydrosurgery system for debridement of paediatric burns.
Burns 2006;32:714-720 4.Duteille F. et al. Management of 2 nd
-degree facial burns using the VERSAJET hydrosurgery system and
xenograft: A prospective evaluation of 20 cases. BURNS.
2012;38(5):724-9. 5.Matsumura H. et al. The estimation of Tissue
Loss During Tangential Hydrosurgical Debridement. Annals of Plastic
Surgery. 2012:69(5):521-525