FOCUS ON THE AUSTRIAN W UND ASSOCIATION - EWMA

Science, Practice and Education
Figure 1: The first degree of tissue damage
(straight edge without any cracks)
Figure 3: The third wound trauma degree (deep crack) Figure 4: The third wound trauma degree (disrupted tissue)
First, we analysed the distribution of TDD in the whole
observation. We found a statistically significant difference
between the TDD I, II and III (p = 0.0000) and also between
the group with minimal tissue damage (TDD I) and
the rest of the cohort (p = 0,00023) and between the maximum
damage grade (TDD III) and the rest (0,00001), see
table and graph 3a, 3b. Each group is unique and can be
used to describe the properties of the whole group.
The best results (the lowest occurrence of trauma
markers), are achieved with the water-jet hydrosurgery
technique (69%) and scalpel debridement (47%). In contrast,
the greatest incidence of grade III trauma (the most
severe signs of tissue trauma) were found in the group of
tissue samples treated with scissors, method N (47%). A
statistically significant difference in results was confirmed
between the groups “V” and “N” (p=0.00005), “V” and
“E” (P=0.00112), “N” and “S” (p=0.00049) and “N” and
“E” (p=0.00035). Statistical analysis didn’t prove the statistically
significant difference in wound trauma between
the group “E” versus “S” (p=0.17404) and “V” versus “S”
(p=0.17404).
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Figure 2: The second wound trauma degree (small fissure)
To establish a ranking of all the tested techniques we
can calculate the average TDD (ATDD ) score, which
takes into account not only the layout in each of the
stages I-III, but also the significance of histopathological
changes when assessing the impact of the relevant debridement
technology on wound healing. According to this
ATDD score, the best results (the least severe trauma) were
achieved by group “V”, followed by groups “S” and “E”.
The worst results (the heaviest histopathological changes
on the surface due to wound trauma) were observed in
group “N” (see table and graph No. 4).
DISCUSSION
We observed 64 soft tissue specimens debrided with 4
different surgical techniques in our experimental study.
When planning the study we decided to make 2 independent
histological sections from each tissue block to utilize
the clinical material effectively. Thanks to this, we were
able to increase the number of histological findings in
EWMA Journal 2012 vol 12 no 1