Splatter during jet irrigation cleansing of a wound model: A comparison of three inexpensive devices

Pigman, Edwin C.; Karch, Dieter; Scott, James

doi:10.1016/s0196-0644(05)81259-4

Cited by 18 publications

(6 citation statements)

References 6 publications

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“…Most studies recommend high pressure (25–35 psi) syringe irrigation. Standard water faucets deliver about 45 psi 1. Patients who self-irrigate in a sink would not need expensive delivery devices, and fewer personnel would be exposed to open wounds.…”

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confidence: 99%

Review: infection rates do not differ for wounds cleansed with water or saline

Ernst

2008

Evidence-Based Medicine

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Review: infection rates do not differ for wounds cleansed with water or saline QUESTION How does water compare with other solutions for cleansing wounds? REVIEW SCOPEIncluded studies compared water with other solutions for cleansing acute or chronic wounds or with no cleansing and reported objective outcome measures. Studies assessing cleansing solutions as part of dental procedures, prophylaxis, preoperative or operative procedures, and those of patients with burns or ulcers were excluded. Outcomes included wound infection and healing. REVIEW METHODSMedline, CINAHL, and EMBASE/Excerpta Medica (all to 2007); Cochrane Wounds Group Specialised Register; Cochrane Controlled Trials Register (Issue 3, 2007); 2 other databases; and reference lists were searched for randomised controlled trials (RCTs) or quasi-RCTs. Authors, experts, and companies were contacted. 5 RCTs and 6 quasi-RCTs (age range 2-95 y) met the selection criteria; duration of follow-up ranged from 1 to 6 weeks.

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confidence: 99%

Review: infection rates do not differ for wounds cleansed with water or saline

Ernst

2008

Evidence-Based Medicine

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“…In our experience, we have found that the cannula tends to bend and prevent irrigation. Although commercial plastic splash guards are available that effectively prevent splash exposure,10 our adaptation of the use of a gallipot is cheaper and more readily available in the National Health Service. However, to address this formally, a clinical trial should be undertaken to compare the complications of our technique with other methods of wound irrigation.…”

Section: Discussionmentioning

confidence: 99%

A simple, effective and cheap device for the safe irrigation of open traumatic wounds

Stevens

Gardner

Lee

2009

Emergency Medicine Journal

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This study reports the use of an overturned plastic gallipot from a sterile wound dressing pack as a splashguard during the irrigation of traumatic wounds with a device consisting of a 20 ml syringe and a 21F gauge hypodermic needle. This simple, effective and cheap device can be constructed from items readily available within the emergency department or operating theatre and minimises exposure to biologically hazardous material during wound irrigation.

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“…The pressure used for irrigation has repeatedly been shown to be an important variable in the infection rates of wounds. It has been demonstrated that using a bulb syringe or a bag of saline as low-pressure irrigation is not sufficient, 6 although sufficient pressure can be achieved with a proper syringe setup. 8 High-pressure irrigation (>8 psi) effectively removes small particulate matter and bacteria from wounds.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are several potential drawbacks to this method, including cost of supplies, clinician time, and risks associated with exposure to the splatter of body fluids. 6 Clinician time and the cost of supplies may be decreased with the use of tap water (TW). Additionally, in many cases, TW irrigation does not require the health care provider to be in such close proximity to the patient as is required with syringe irrigation.…”

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confidence: 99%

A Multicenter Comparison of Tap Water versus Sterile Saline for Wound Irrigation

Moscati

Mayrose

Reardon³

et al. 2007

Academic Emergency Medicine

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Objectives: To compare wound infection rates for irrigation with tap water versus sterile saline before closure of wounds in the emergency department. Methods:The study was a multicenter, prospective, randomized trial conducted at two Level 1 urban hospitals and a suburban community hospital. Subjects were a convenience sample of adults presenting with acute simple lacerations requiring sutures or staples. Subjects were randomized to irrigation in a sink with tap water or with normal saline using a sterile syringe. Wounds were closed in the standard fashion. Subjects were asked to return to the emergency department for suture removal. Those who did not return were contacted by telephone. Wounds were considered infected if there was early removal of sutures or staples, if there was irrigation and drainage of the wound, or if the subject needed to be placed on antibiotics. Equivalence of the groups was met if there was less than a doubling of the infection rate.Results: A total of 715 subjects were enrolled in the study. Follow-up data were obtained on 634 (88%) of enrolled subjects. Twelve (4%) of the 300 subjects in the tap water group had wound infections, compared with 11 (3.3%) of the 334 subjects in the saline group. The relative risk was 1.21 (95% confidence interval = 0.5 to 2.7).Conclusions: Equivalent rates of wound infection were found using either irrigant. The results of this multicenter trial evaluating tap water as an irrigant agree with those from previous single institution trials. 1 Wound infection, while infrequent, is the most common complication of treating these lacerations, occurring in 3%-5% of cases.2 Standard care requires adequate decontamination of lacerations before skin closure to reduce wound infection rates. High-pressure irrigation (>8 psi) with sterile saline (SS) is more efficacious in removing debris and bacteria than is cleaning with antibacterial solutions. 3-5The current standard of care for simple skin lacerations is irrigation with SS using a syringe and splash shield. However, there are several potential drawbacks to this method, including cost of supplies, clinician time, and risks associated with exposure to the splatter of body fluids.6 Clinician time and the cost of supplies may be decreased with the use of tap water (TW). Additionally, in many cases, TW irrigation does not require the health care provider to be in such close proximity to the patient as is required with syringe irrigation. The ability to have a larger distance between the health care provider and the wound therefore reduces the risk of body fluid contamination due to splatter.It has been shown that 35-mL and 65-mL syringes with a 19-gauge needle are able to achieve pressures of 25-35 psi for irrigation.7 A standard water faucet has also been shown to provide sufficient pressure (about 45 psi) for adequate wound irrigation. 8 We previously compared TW with SS in an animal model and determined that bacterial decontamination of simple lacerations was not compromised and was actually improved with ...

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Splatter during jet irrigation cleansing of a wound model: A comparison of three inexpensive devices

Cited by 18 publications

References 6 publications

Review: infection rates do not differ for wounds cleansed with water or saline

Review: infection rates do not differ for wounds cleansed with water or saline

A simple, effective and cheap device for the safe irrigation of open traumatic wounds

A Multicenter Comparison of Tap Water versus Sterile Saline for Wound Irrigation

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