Document Detail

High-pressure pulsatile lavage causes soft tissue damage.
MedLine Citation:
PMID:  15552129     Owner:  NLM     Status:  MEDLINE    
Irrigation and debridement can be a source of iatrogenic injury in open fracture treatment. Although high-pressure pulsatile lavage has been shown to cause considerable damage to bone, little has been written about its effects on soft tissue. The purpose of this study is to quantify and compare the damages on soft tissue caused by high-pressure pulsatile lavage and low-pressure lavage. Forty specimens of fresh ovine muscle were collected and subjected to high-pressure pulsatile lavage or low-pressure lavage, with the delivery orientation being across or in line with the muscle fibers. Ten additional specimens were used as controls. The results show that high-pressure pulsatile lavage causes considerable soft tissue penetration of particulate markers (across, 4.7 mm; in line, 15.6 mm) when compared with low-pressure lavage (across, 0.5 mm; in line, 0.7 mm). Furthermore, all specimens subjected to high-pressure pulsatile lavage showed gross tissue disruption. Fifteen additional samples were obtained to measure cellular death. This was observed at a deeper level for high-pressure pulsatile lavage (median depths: across, 1210 microm; in line, 1335 microm), which was approximately twice that of low-pressure lavage (across, 485 microm; in line, 682 microm). These results show that high-pressure pulsatile lavage penetrates and disrupts soft tissue to a deeper level than low-pressure lavage, causing considerable gross and microscopic tissue disruption.
James Ivy Boyd; Montri Daniel Wongworawat
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  -     ISSN:  0009-921X     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-11-19     Completed Date:  2005-01-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  13-7     Citation Subset:  AIM; IM    
Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
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MeSH Terms
Irrigation / adverse effects*,  methods
Muscle, Skeletal / injuries,  pathology
Pulsatile Flow
Soft Tissue Injuries / etiology*

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