Today I saw a patient who would have benefitted incredibly from ultrasonic debridement. She has cutaneous calcinosis, terrible pain and her wounds are horribly colonized with nasty drainage like a lava flow. Last year I had an ultrasonic debriding machine on loan for a while as a trial. The patients loved it and so did I. However, administration decided that the cost of the machine was too much given the limited reimbursement for debridement services. It is certain that debridement with the device was less painful and likely that it was a more thorough way to debride devitalized tissue. It is also possible that wound outcomes would have been better if I had used it long term although I don’t know that since I couldn’t keep it that long. The sad fact is that right now I don’t get paid on the basis of either patient satisfaction or wound outcomes. So, no ultrasonic debridement machine for me. Now, there’s a great argument for outpatient payment reform. I want my ultrasonic debriding machine back.

Caroline Fife, MD