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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