Fluid lavage of open wounds (FLOW): A multicenter, blinded, factorial pilot trial comparing alternative irrigating solutions and pressures in patients with open fractures

Journal of Trauma - Injury, Infection and Critical Care

Volumn 71, Issue 3, 2011, Pages 596-606

  Bhandari, Mohit ^a  

^a MCMASTER UNIVERSITY   (Canada)

Author keywords

Factorial design; Irrigation pressures; Irrigation solutions; Open fractures; Pilot study; Randomized control trial

Indexed keywords

ANTIBIOTIC AGENT; CASTILE SOAP; SOAP; SODIUM CHLORIDE; UNCLASSIFIED DRUG;

ADULT; ARTICLE; CONTROLLED STUDY; FEMALE; FRACTURE NONUNION; HUMAN; LAVAGE; MAJOR CLINICAL STUDY; MALE; MULTICENTER STUDY; OPEN FRACTURE; POSTOPERATIVE COMPLICATION; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; REOPERATION; TREATMENT OUTCOME; WOUND HEALING; WOUND INFECTION; WOUND IRRIGATION;

ADULT; COHORT STUDIES; DOUBLE-BLIND METHOD; FEASIBILITY STUDIES; FEMALE; FRACTURE HEALING; FRACTURES, OPEN; HUMANS; MALE; MIDDLE AGED; PILOT PROJECTS; REOPERATION; SOAPS; THERAPEUTIC IRRIGATION; TREATMENT OUTCOME;

EID: 80052761797     PISSN: 00225282     EISSN: 15298809     Source Type: Journal    
DOI: 10.1097/TA.0b013e3181f6f2e8     Document Type: Article

References (27)

1. Dormans JP, Fisher RC, Pill SG. Orthopaedics in the developing world: present and future concerns. J Am Acad Orthop Surg. 2001;9:289-296.
2. Court-Brown C, McQueen M, Tornetta P III. Trauma. 1st ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2006.
3. Anglen JO. Wound irrigation in musculoskeletal injury. J Am Acad Orthop Surg. 2001;9:219-226.
4. Khatod M, Botte MJ, Hoyt DB, Meyer RS, Smith JM, Akeson WH. Outcomes in open tibia fractures: relationship between delay in treatment and infection. J Trauma. 2003;55:949-954. (Pubitemid 38004670)
5. Bhandari M, Guyatt GH, Swiontkowski MF, Schemitsch EH. Treatment of open fractures of the shaft of the tibia. J Bone Joint Surg Br. 2001;83:62-68. (Pubitemid 32170963)
6. Bhandari M, Tornetta P III, Sprague S, et al. Predictors of reoperation following operative management of fractures of the tibial shaft. J Orthop Trauma. 2003;17:353-361. (Pubitemid 36701599)
7. Spencer J, Smith A, Woods D. The effect of time delay on infection in open long-bone fractures: a 5-year prospective audit from a district general hospital. Ann R Coll Surg Engl. 2004;86:108-112. (Pubitemid 38332231)
8. Anglen JO. Comparison of soap and antibiotic solutions for irrigation of lower-limb open fracture wounds. A prospective, randomized study. J Bone Joint Surg Am. 2005;87:1415-1422. (Pubitemid 40917739)
9. Burd T, Christensen GD, Anglen JO, Gainor BJ, Conroy BP, Simpson WA. Sequential irrigation with common detergents: a promising new method for decontaminating orthopedic wounds. Am J Orthop (Belle Mead NJ). 1999;28:156-160.
10. Petrisor B, Jeray K, Schemitsch E, et al; FLOW Investigators. Fluid lavage in patients with open fracture wounds (FLOW): an international survey of 984 surgeons. BMC Musculoskelet Disord. 2008;9:7.
11. Anglen J, Apostoles PS, Christensen G, Gainor B, Lane J. Removal of surface bacteria by irrigation. J Orthop Res. 1996;14:251-254. (Pubitemid 26145996)
12. Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220-233. (Pubitemid 126433231)
13. Brooks R, Rabin RE, de Charro F. The Measurement and Valuation of Health Status Using EQ-5D: A European Perspective. Dordrecht: Kluwer Academic Publishers; 2003.
14. Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001;33:337-343. (Pubitemid 32675374)
15. Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol. 1992;13:606-608.
16. Owens BD, White DW, Wenke JC. Comparison of irrigation solutions and devices in a contaminated musculoskeletal wound survival model. J Bone Joint Surg Am. 2009;91:92-98.
17. Bhandari M, Adili A, Schemitsch EH. The efficacy of low-pressure lavage with different irrigating solutions to remove adherent bacteria from bone. J Bone Joint Surg Am. 2001;83:412-419. (Pubitemid 32221572)
18. Anglen JO, Gainor BJ, Simpson WA, Christensen G. The use of detergent irrigation for musculoskeletal wounds. Int Orthop. 2003;27:40-46. (Pubitemid 36692851)
19. Anglen JO, Apostoles S, Christensen G, Gainor B. The efficacy of various irrigation solutions in removing slime-producing Staphylococcus. J Orthop Trauma. 1994;8:390-396.
20. Malten KE, den Arend JA. Irritant contact dermatitis. Traumiterative and cumulative impairment by cosmetics, climate, and other daily loads. Derm Beruf Umwelt. 1985;33:125-132. (Pubitemid 15011201)
21. Strube DD, Nicoll G. The irritancy of soaps and syndets. Cutis. 1987; 39:544-545. (Pubitemid 17089150)
22. Simion FA, Rhein LD, Morrison BM Jr, et al. Self-perceived sensory responses to soap and synthetic detergent bars correlate with clinical signs of irritation. J Am Acad Dermatol. 1995;32:205-211.
23. Bhandari M, Adili A, Lachowski RJ. High pressure pulsatile lavage of contaminated human tibiae: an in vitro study. J Orthop Trauma. 1998; 12:479-484. (Pubitemid 128454968)
24. Bhandari M, Schemitsch EH, Adili A, Lachowski RJ, Shaughnessy SG. High and low pressure pulsatile lavage of contaminated tibial fractures: an in vitro study of bacterial adherence and bone damage. J Orthop Trauma. 1999;13:526-533.
25. Dirschl DR, Duff GP, Dahners LE, Edin M, Rahn BA, Miclau T. High pressure pulsatile lavage irrigation of intraarticular fractures: effects on fracture healing. J Orthop Trauma. 1998;12:460-463. (Pubitemid 128454964)
26. Bhandari M, Schemitsch EH. High-pressure irrigation increases adipocyte-like cells at the expense of osteoblasts in vitro. J Bone Joint Surg Br. 2002;84:1054-1061.
27. Adili A, Bhandari M, Schemitsch EH. The biomechanical effect of high-pressure irrigation on diaphyseal fracture healing in vivo. J Orthop Trauma. 2002;16:413-417. (Pubitemid 34785159)