Jeany Thalia Hartono, Rosalyn Devina Santoso, Fanny Evasari Lesmanawati
Turkish Journal of Plastic Surgery - 2026;34(3):99-106
Context: The clinical benefits of hydrosurgical debridement over conventional debridement in burn patients are not well established. Aim: We aimed to compare healing time and postoperative infection rates between the two methods in acute burn injuries. Methods and Statistical Analysis Used: This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four databases were searched for studies involving burn patients of any age and burn depth undergoing surgical debridement. The included studies directly compared hydrosurgical and conventional debridement techniques using scalpel-based methods. The primary outcome was healing time following burn injury or skin grafting. Secondary outcomes included operative time, scar quality, dermal preservation, and infection rates. Pooled estimates were calculated using a random-effects model, and heterogeneity was assessed using the I² statistic. Results: Six studies were included, including 445 participants with partial- to full-thickness burns. Four studies were included in the meta-analysis of healing time. The pooled analysis demonstrated a mean difference of -10.12 days (95% confidence interval [CI]: -16.72 to -3.52; P = 0.003; I² = 97%), in favor of hydrosurgical debridement. Infection rates from three studies showed no significant difference (relative risk: 1.06; 95% CI: 0.66-1.69; P = 0.82). Two randomized controlled trials demonstrated significantly greater dermal preservation with hydrosurgery. Findings regarding scar quality were mixed. Conclusion: Hydrosurgery may better preserve viable dermis and reduce healing time; however, these findings are based on a limited number of studies with substantial heterogeneity. Therefore, its use may not be generalizable to all patients and should be considered on a case-by-case basis.
