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 REDUCTIONThis review of open fracture wound irrigation finds normal saline to be the optimal agent, with pressure and pulsatile lavage not affecting outcomes, while ideal timing and volume still need clinical trials.
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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