Does Bacteremia Occur During High Pressure Lavage of Contaminated Wounds?

Tabor, Owen B.; Bosse, Michael J.; Hudson, Michael; Greene, K. G.; Nousiainen, Markku; Meyer, Ralph A.; Sims, Stephen H.; Kellam, James F

doi:10.1097/00003086-199802000-00014

Cited by 19 publications

(14 citation statements)

References 7 publications

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“…Local treatment led to the reduction in bacterial level, and it is possible that, had a low concentration of bacteria been used to contaminate the wound, local treatment may have prevented infection. The 30fold reduction in bacterial levels following wound lavage reported here is consistent with results from other authors [24]. It would be interesting to assess the effects of lavage and antibiotics in this model when commenced at different times, e.g.…”

Section: Discussionsupporting

confidence: 91%

Early intramedullary nailing in an animal model of a heavily contaminated fracture of the tibia

Hill

Clasper

Parker

et al. 2002

Journal Orthopaedic Research

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An ovine model was developed to study the outcome following intramedullary nailing of a heavily contaminated fracture. Animals in the control group received no treatment directed at controlling infection, whereas those in the treatment group received wound debridement, lavage and the use of appropriate systemic antibiotics. Despite this, infection developed at the osteotomy site and along the entire length of the implant in all animals in both groups. It was felt that standard methods of wound management might be inadequate when applied at the time of intramedullary nailing since the spread of contamination following the use of reamers was demonstrated in all animals. Results from this study support the clinical impression that heavily contaminated fractures should not be treated by primary intramedullary nailing.

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Section: Discussionsupporting

confidence: 91%

Early intramedullary nailing in an animal model of a heavily contaminated fracture of the tibia

Hill

Clasper

Parker

et al. 2002

Journal Orthopaedic Research

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“…However, more recent reports have favored a classification of pressures in the range of 35 to 70 psi as high pressure and 1 to 15 psi as low pressure 9,13,14,22 . Bahrs et al referred to pressures in the range of 10 to 30 psi as medium pressure 25 , and Tabor et al defined high pressure as 28 psi 26 . A recent study by Draeger and Dahners used a device that generated 6 to 19 psi and labeled it as high pressure 12 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of Irrigation Solutions and Devices in a Contaminated Musculoskeletal Wound Survival Model

Owens

White

Wenke

2009

The Journal of Bone and Joint Surgery-American Volume

133

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“…41 Table III summarises the available studies focusing on soft tissue damage. [33][34][35]40,41,[43][44][45][46]…”

Section: The Effect Of Pressurementioning

confidence: 99%

Irrigation of the wounds in open fractures

Crowley

Kanakaris

Giannoudis

2007

The Journal of Bone and Joint Surgery. British volume

135

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Modern principles for the treatment of open fractures include stabilisation of the bone and management of the soft tissues. Wound debridement and irrigation is thought to be the mainstay in reducing the incidence of infection. Although numerous studies on animals and humans have focused on the type of irrigation performed, little is known of the factors which influence irrigation. This paper evaluates the evidence, particularly with regard to additives and the mode of delivery of irrigation fluid. Normal saline should be used and although many antiseptics and antibiotics have been employed, no consensus has been reached as to the ideal additive. Despite the advocates of high-pressure methods highlighting the improved dilutional ability of such techniques, the results are inconclusive and these irrigation systems are not without complications. New systems for debridement are currently being investigated, and an ideal method has yet to be determined.

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Does Bacteremia Occur During High Pressure Lavage of Contaminated Wounds?

Cited by 19 publications

References 7 publications

Early intramedullary nailing in an animal model of a heavily contaminated fracture of the tibia

Early intramedullary nailing in an animal model of a heavily contaminated fracture of the tibia

Comparison of Irrigation Solutions and Devices in a Contaminated Musculoskeletal Wound Survival Model

Irrigation of the wounds in open fractures

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