Evaluation of fluid pressures of common wound-flushing techniques

Abstract

Solution bottles of any size and needle gauge do not meet the requirement for satisfactory flushing pressure of 7 to 8 psi. Use of a 35-mL syringe can produce pressure substantially > 7 to 8 psi, which could damage tissues. The most consistent delivery method to generate 7 to 8 psi was use of a 1-L plastic bag within a cuff pressurized to 300 mm Hg.

Retrospective evaluation of coyote attacks in dogs: 154 cases (1997–2012)

“…Disinfecting and irrigating the clipped skin around the wound is warranted regardless of location or species receiving or causing the wound. This can be safely achieved by flushing the wound with sterile lactated Ringer's solution to a pressure of 7 to 8 psi with use of a 1 L LRS bag within a pressure infusion bag pressurized to 300 mm Hg . Bandages are often provided for patients with superficial wounds to prevent contamination and devitalized tissue after disinfection, decrease dead space, and absorb drainage until definitive surgical treatment can occur …”

Local wound management: A review of modern techniques and products

“…If a fluid bag is not available, the use of a 35 mL syringe with an 18-gauge needle may be considered, however caution should be used to not create excessive pressure. 30 There is no evidence that pulsatile flow confers any additional benefit over constant pressure. 31 The most commonly used fluids for irrigation are sterile isotonic fluid bags.…”

Wound healing in animals: a review of physiology and clinical evaluation

“…Additionally, wound cleansing and lavage can remove superficial contaminants and contaminated exudates, while wound debridement removes necrotic tissues that promote inflammation and act as foci of infection. [101][102][103] Wound lavage and debridement are discussed in more detail elsewhere. 7,58,59,99,101 Negative pressure wound therapy (NPWT) often is considered to be an important treatment modality in this category as it is thought to loosen necrotic debris to improve ease of debridement, as well as to facilitate the removal of exuand infectious materials.…”

“…[101][102][103] Wound lavage and debridement are discussed in more detail elsewhere. 7,58,59,99,101 Negative pressure wound therapy (NPWT) often is considered to be an important treatment modality in this category as it is thought to loosen necrotic debris to improve ease of debridement, as well as to facilitate the removal of exuand infectious materials. 58,99 There is wide use of NPWT in human medicine, and it is gaining popularity in veterinary medicine, although the published veterinary literature on this modality is not extensive.…”

“…Wound dressings can leave behind films or exudate specific to the materials used on the wound bed or periwound skin, and wound cleansing or lavage can be used to remove this. Additionally, wound cleansing and lavage can remove superficial contaminants and contaminated exudates, while wound debridement removes necrotic tissues that promote inflammation and act as foci of infection 101–103 . Wound lavage and debridement are discussed in more detail elsewhere 7,58,59,99,101 .…”