Document Detail

Wound irrigation in musculoskeletal injury.
MedLine Citation:
PMID:  11476531     Owner:  NLM     Status:  MEDLINE    
Wound irrigation to remove debris and lessen bacterial contamination is an essential component of open fracture care. However, considerable practice variation exists in the details of technique. Volume is an important factor; increased volume improves wound cleansing to a point, but the optimal volume is unknown. High-pressure flow has been shown to remove more bacteria and debris and to lower the rate of wound infection compared with low-pressure irrigation, although recent in vitro and animal studies suggest that it may also damage bone. Pulsatile flow has not been demonstrated to increase efficacy. Antiseptic additives can kill bacteria in the wound, but host-tissue toxicities limit their use. Animal and clinical studies of the use of antiseptics in contaminated wounds have yielded conflicting outcomes. Antibiotic irrigation has been effective in experimental studies in some types of animal wounds, but human clinical data are unconvincing due to poor study design. There are few animal or clinical studies of musculoskeletal wounds. Detergent irrigation aims to remove, rather than kill, bacteria and has shown promise in animal models of the complex contaminated musculoskeletal wound.
J O Anglen
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Journal of the American Academy of Orthopaedic Surgeons     Volume:  9     ISSN:  1067-151X     ISO Abbreviation:  J Am Acad Orthop Surg     Publication Date:    2001 Jul-Aug
Date Detail:
Created Date:  2001-07-30     Completed Date:  2001-10-11     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9417468     Medline TA:  J Am Acad Orthop Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  219-26     Citation Subset:  IM    
Orthopaedic Surgery, University of Missouri-Columbia, Columbia 65212, USA.
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MeSH Terms
Anti-Bacterial Agents / administration & dosage,  adverse effects
Anti-Infective Agents, Local / administration & dosage,  contraindications
Bacterial Infections / prevention & control
Drug Delivery Systems
Fractures, Open / surgery*
Irrigation* / adverse effects,  instrumentation,  methods
Surface-Active Agents / administration & dosage
Wound Infection / prevention & control
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Anti-Infective Agents, Local; 0/Surface-Active Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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