Authors (including presenting author) :
Chung SP(1), Chris Chong HM(2), Deng Y(1)
Affiliation :
(1) Wound Care Team, New Territories West Cluster (2) Department of Surgery, New Territories West Cluster
Keyword 1: :
Hydromechanical debridement
Keyword 2: :
Wound Debridement
Keyword 5: :
Community care
Introduction :
Complex abscess wounds with deep undermining, slough, and biofilm present a challenge for effective debridement while preserving viable tissue. Low-pressure hydromechanical irrigation is an established modality that utilizes saline delivered at approximately 15 psi, a pressure benchmarked to remove pathogenic burden without causing tissue trauma. Its selective hydro-mechanical action targets non-viable material and can provide micro-massage to stimulate perfusion and granulation.
Objectives :
To evaluate the clinical outcomes of a disposable hydromechanical irrigation system in managing a complex abscess and to assess its operational feasibility for general ward staff without specialized wound care training.
Methodology :
A 47-year-old female with poorly controlled Type 2 Diabetes (HbA1c 14.7%) presented with a refractory lower extremity abscess (15x8 cm) featuring deep undermining, exposure of necrotic tendon, and polymicrobial infection (MRSA and Pseudomonas aeruginosa). Adjunctive to sharp debridement and antimicrobial dressings, a disposable hydromechanical irrigation system was employed from November 2025. The irrigation therapy was administered at a frequency of 2 to 4 times per week, specifically consisting of four sessions per week for the initial two weeks, followed by two sessions per week. The device was operated by trainee nurses under structured guidance, demonstrating its usability by non-specialist staff. Irrigation was delivered via a closed-circuit collection bag to minimize aerosolization and cross-contamination.
Result & Outcome :
Hydromechanical irrigation effectively facilitated the clearance of deep, undermined slough. Over four weeks, the wound bed transitioned to healthy granulation tissue and systemic infection was controlled. The procedure was well-tolerated with no iatrogenic complications or damage to exposed structures. Critically, it was safely and effectively administered, confirming the device's operational simplicity and low specialty training requirement. This case demonstrates that low-pressure hydromechanical irrigation is an effective and safe adjunct for selective debridement in complex abscess management, even in wounds with exposed deep structures such as tendon. Its practical utility is enhanced by an intuitive and portable design that is simple to use. This combination of efficacy, safety, and ease of use makes it a viable and accessible treatment option not only in hospital settings but also in community and outpatient care environments, offering a widely applicable solution to enhance wound care delivery.
