Wound Irrigation for Open Fractures.

JBJS Rev · Jan 2020 · Review

Heckmann N, Simcox T, Kelley D, Marecek GS

Department of Orthopedics, Keck Medical Center of USC, Los Angeles, California

Orthopaedic Trauma

SUMMARY — THE REDUCTIONNormal saline irrigation appears optimal for open fractures; timing, volume, pressure, and pulsatile lavage remain debated with ongoing clinical trial evaluation needed.
Abstract, as published

» The optimal regimen for wound irrigation in the setting of an open fracture has been a subject of debate. Basic science evidence as well as results from a recent prospective clinical trial have shed new light on this controversial topic. » While normal saline solution appears to be the optimal irrigation agent, the optimal timing and volume often are determined by the surgeon. Future clinical trials are needed to determine the optimal timing for debridement and irrigation, as well as the ideal volume of irrigant. » Irrigation pressure and the use of pulsatile lavage do not appear to have an effect on outcomes.

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