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Figure  5: After complete healing with JFT and split skin graft. JFT: jet
          Figure 4: JFT procedure. JFT: jet force technology  force technology
          and providing buoyancy and gentle limb resistance for   hydro jet is the  Venturi  effect. A  jet  of saline,  propelled
          physical therapy.  However, whirlpool treatments have   by a power console, travels across the operating window
                        [10]
          fallen out of favor secondary to the risk of nosocomial   of a hand‑held piece, and then into a suction collector.
          contamination and transmission of virulent infections. [11,12]    This pressurized saline stream functions like a knife. The
          Wound cleansing involves the process of selection of both   saline beam is aimed parallel to the wound, allowing the
          a wound cleansing  solution and a mechanical means  for   cutting mechanism to perform a highly controlled form of
          delivering that solution to the wound. The methods for   tangential  excision.   It  is  also used as  pulsed lavage  in
                                                                               [18]
          wound irrigation can be broadly classified into two types,   wound cleansing. [19]
          including continuous and pulsed irrigation.  The  delivery
          of an uninterrupted stream  of irrigant  to the  wound’s   JFT is a type of hydrotherapy which uses a disposable
          surface  is  termed  “continuous  irrigation”.  The  system   cannula  (Israel), saline, and oxygen under pressure to
          of intermittent  or interrupted delivery of irrigant  to the   mechanically remove mechanically  debris and bacteria.
          wound’s surface is referred to as the “pulsed irrigation”   Utilizing a unique triple nozzle, JFT is one of the simplest,
          technique.  Recently, the use of pulsed lavage has   most efficient,  and effective methods of achieving fast
          begun to replace whirlpool therapy. Mechanical forces are   and virtually  painless  debridement  when  compared
          used to rid the wound of bacteria  and other particulate   to  other  mechanical debridement  methods.  JFT  is  the
          matter retained on the wound surface by adhesive forces.   comprehensive innovation for cleansing and debridement.
          Under most circumstances, debridement alone will reduce   By using compressed oxygen combined with a minimal
          bacterial load with the added benefit of removing necrotic   amount of saline solution, JFT quickly and effectively
          tissue  which would otherwise  increase  inflammation  and   debrides  wounds without  the  mess  of traditional
          delay healing.  If cleansing is required, an appropriate   methods. JFT supersedes other equipment which is more
                      [13]
          solution should be  selected to optimize  the  healing   complicated  to operate and replaces more expensive
          process and minimize  the risk of damage to viable   methods of debridement. It is ideal for use at the bedside
          tissue.  The recommendation for irrigation pressure   without  the  need  for anesthesia  in  patients  who are
               [14]
          ranges from 4 to 15 PSI. When pressures < 4 PSI are used   not medically stable for anesthesia or who have refused
          there is insufficient pressure to remove surface pathogens   surgery.  In  our  study,  it  was  useful  in  both  groups of
          and debris.  Irrigation  pressures  > 15 PSI  have been   patients.  The  current  study’s  limitations  include its  small
          noted to cause wound trauma and drive bacteria into   sample size,  the lack of statistical analysis, the absence
          wounds.   It  is  thought  that  pulsed lavage  encourages   of controls, and the lack  of testing utility against other
                 [15]
          the growth of healthy, granulating tissue.  The goal is to   infectious organisms  including like fungi, anaerobes and
                                             [16]
          remove  unwanted tissue  without disturbing  the  healthy   biofilms.
          tissue.  The forces holding bacterial particles on the
          wound’s surface are capillary, molecular and electrostatic.   In conclusion, hydrotherapy with JFT helps to remove
          Madden  et  al.  proposed three  types  of forces that   contaminants,  debris,  and microbial  colonization of
                       [17]
          could  be used to remove bacteria from the wound’s   the wound leading to spontaneous wound healing or
          surface: direct mechanical contact (e.g.  scrubbing),   facilitating wound bed preparation for wound coverage by
          inertial forces and fluid dynamic forces. Fluid dynamic   a skin graft or flap.
          forces are the effective forces in wound irrigation  using   Financial support and sponsorship
          pulsed  lavage. The high‑powered water jet is a unique   The department  of Plastic Surgery, JIPMER, Pondicherry,
          device when  compared to the  pulse irrigator,  which is   India.
          a low‑energy water jet.  The advantage is the ability  to
          focus a high‑powered stream of water into a high‑energy   Conflicts of interest
          cutting implement.  The mechanism  of action of this   There are no conflicts of interest.

           280                                                           Plast Aesthet Res || Vol 2 || Issue 5 || Sep 15, 2015
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