Evaluation of the quality and cost-effectiveness of Versajet hydrosurgery

Judicious resource allocation to maximise benefits is essential to health care decision-making, particularly with increasingly expensive treatments and rising populations. Accurate wound debridement is important, and while many methods exist, surgical debridement is currently the gold standard with material costs at approximately pound 140. Versajet, a hydrosurgical device, is suggested by some to have facilitated a paradigm shift in wound management by allowing debridement of undesirable tissue while accurately preserving viable structures. Its proponents claim that it minimises surgical duration, length of hospital admission, improves wound healing and may be deployed at the bedside or in the community. Consoles and single-use hand-units cost pound 6000- pound 7000 and pound 220- pound 240, respectively. Some propose that hydrosurgery may provide an efficacious, efficient and cost-effective alterative to surgical debridement. However, the evidence available is largely based on expert opinion. Methodological flaws of such descriptive studies include the lack of control groups, selection bias and lack of blinding. Hence, these claims need to be interpreted cautiously. This opinion review examines the available evidence as to whether Versajet hydrosurgery provides quality and cost-effective care.