The bacteria-removal efficiency of mechanical lavage and rubber-bulb syringe irrigation in contaminated avulsive wounds

Stewart, Jack L.; Carlson, Harvey C.; Briggs, Robert L.; Green, Vernon A.

doi:10.1016/0030-4220(71)90145-9

Cited by 14 publications

(5 citation statements)

References 2 publications

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“…[51][52][53] Also, as damaging the wound surface may lead to a delay of wound healing, the wound surface must be treated protectively. While bacteria and residual materials can be removed by lavaging with pressure, [54][55][56][57][58] caution is needed as excessive pressure damages granulation tissue on the wound surface. It is recommended to warm lavage fluid nearly to the body temperature.…”

Section: Significance Of Lavage and Points Of Cautionmentioning

confidence: 99%

The wound/burn guidelines – 1: Wounds in general

Inoue

Hasegawa

Maekawa

et al. 2016

The Journal of Dermatology

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Section: Significance Of Lavage and Points Of Cautionmentioning

confidence: 99%

The wound/burn guidelines – 1: Wounds in general

Inoue

Hasegawa

Maekawa

et al. 2016

The Journal of Dermatology

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“…Numerous studies have since reported on the application of pulse lavage systems in the civilian wound management setting. Both positive and negative reports on the merits of the civilian application of mechanical pulse lavage fluid for wound washing can be found in the medical literature since that time [5,7,10,16,18,19,24,27,30,31,33]. These electric powered pumps have now been collectively referred to as High-Pressure Pulse Lavage (HPPL) systems.…”

Section: Introductionmentioning

confidence: 99%

In Vitro Characterization of Lavage Splash and Effectiveness of Lavage Shield

Nishiyama

Hillock²

2015

ReconRev

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BACKGROUND: Utilization of fluid to remove debris from surgical wounds has been a standard of medical care for centuries. Electrically powered pulse lavage systems are now regularly used to flush wounds in the operating room. This study aims to characterize splash patterns and contamination generated by different irrigation techniques commonly used in the treatment of surgical wounds.METHODS: 4 different irrigation scenarios: gravity flow (GF), asepto bulb syringe (ABS), high pressure pulsatile lavage without splash shield (HPPL), and high pressure pulsatile lavage with splash shielding (HPPL-S) were conducted on a Sawbone® knee model anchored to a standard operating table in a fully operational operating room of a community hospital. Normal saline supplemented with Fluorescein dye was utilized as the fluid. The OR was divided into 4 quadrants and surveyed with a UV light source to characterize the presence of fluorescent fluid/droplets and radius of droplet displacement.RESULTS: The HPPL trials contaminated the entire room with droplets that were too numerous to count. The HPPL-S trials reduced the number of droplets in quadrants outside of the “head right” quadrants, to a range of 0-12 droplets. In addition, the HPPL-S trial reduced the droplet distance to levels comparable to or below the GF and ABS droplet distance.DISCUSSION: This is the first study to characterize splash patterns seen with different irrigation systems. The addition of an inexpensive splashguard during high-pressure irrigation drastically reduced splash displacement. Decreased splash displacement theoretically reduces OR contamination and the resultant risk of nosocomial contamination.

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“…It suggests that irrigation pressures <4 psi may be insufficient to remove surface pathogens and debris and that irrigation pressures >15 psi may cause wound trauma and drive bacteria into wounds. These pressure range recommendations were derived from studies conducted by Brown et al (3), Rodeheaver et al (4,5), Wheeler et al (6) and Stewart et al (7,8). Commonly used wound irrigation methods include the use of pour or squeeze bottles, bulb syringes, piston syringes (a 35 ml syringe attached to a 19 gauge needle or angiocatheter), pulse lavage irrigation systems, whirlpool agitation and a whirlpool hose sprayer attachment (9).…”

Section: Introductionmentioning

confidence: 99%

Suction assisted pulse lavage: randomised controlled studies comparing its efficacy with conventional dressings in healing of chronic wounds

Shetty

Barreto

Paul

2012

International Wound Journal

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Chronic, open, non-healing wounds pose a continual challenge in medicine as the treatment is variable and there are no documented consistent responses. Although wound aetiologies vary and there are a number of factors that affect chronic wound pathogenesis, wound ischaemia and bacterial colonisation of wounds are the chief concerns among them. Conventionally, pulse lavage has been used primarily as a wound debriding device. To address both the critical factors of wound ischaemia and bacterial burden, a couple of technical points were proposed and applied in this study. The objective of our study was to evaluate pulse lavage therapy's ability to improve the healing rate of chronic wounds compared to that of the traditional saline-wet-to-moist dressings. The study period was from 1 August 2010 to 31 January 2012 and was conducted in our institution. Thirty patients with 31 chronic, non-healing wounds were enrolled in the study after obtaining proper consent. Subjects were randomised (15 patients each) to the pulse lavage group and the control group. Patients in the test group were subjected to irrigation of their wounds with pulsed lavage at 10 to 15 psi pressure. In the control group, wound was closed by applying moist betadine saline gauze dressings after cleaning with saline. Wounds treated with pulse lavage system significantly reduced in size, had better control of bacterial contamination and had overall faster healing rates. Efficacy of pulse lavage can be increased by correct method of administration of the irrigant.

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The bacteria-removal efficiency of mechanical lavage and rubber-bulb syringe irrigation in contaminated avulsive wounds

Cited by 14 publications

References 2 publications

The wound/burn guidelines – 1: Wounds in general

The wound/burn guidelines – 1: Wounds in general

In Vitro Characterization of Lavage Splash and Effectiveness of Lavage Shield

Suction assisted pulse lavage: randomised controlled studies comparing its efficacy with conventional dressings in healing of chronic wounds

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