Efficacy of Power-pulsed Lavage in Lower Extremity Wound Infections: A Prospective Observational Study

Mote, Gregory A.; Malay, D. Scot

doi:10.1053/j.jfas.2009.10.004

Cited by 17 publications

(10 citation statements)

References 34 publications

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“…10 The male to female ratio was found to be 4.6:1. The youngest person was 20 years old and the oldest 44 years old.…”

Section: Discussionmentioning

confidence: 93%

Pulsatile lavage for wound debridement in compound fractures of leg: a randomized control trial

Shafeed¹,

Paul²

2016

Int J Res Orthop

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Background: Management of compound fractures is a real challenge to the orthopaedic surgeon. Thorough wound irrigation and debridement is necessary to get a good outcome. Power-pulsed lavage (PPL) is a method of wound irrigation that has been popularised as an adjuvant in wound debridement. Methods: 39 patients of 28 to 40 years with Gustilo Anderson Type II and Type III fractures were divided in to two groups randomly and given pulsatile lavage or continuous flow lavage. Both the groups were followed up from January 2014 to January 2016, microbiology of the swab collected, pre and post lavage, and various other factors influencing the outcome were studied. Results: Most of the successful outcome was in the age group of 25-29 years (46.7%) and in the male gender 66.7%. The success outcome rate was 73.3% in those with Type II Gustilo Anderson fracture compared to Type III (26.7%). All persons with successful outcome had Tscherne grade II fracture. Also a clean or clean contaminated wound (CDC classification) had more chance for successful outcome (86.7%) than contaminated or dirty wounds. Conclusions: Heavy growth in pre-lavage blood agar culture was the single most important factor that determines the persistence of infection in compound fracture of both bones of leg. Type of lavage did not affect the union of fracture because presence of radiological signs of union was comparable in pulsatile group (66.7%) and continuous flow group (61.9%).

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“…10 The male to female ratio was found to be 4.6:1. The youngest person was 20 years old and the oldest 44 years old.…”

Section: Discussionmentioning

confidence: 93%

Pulsatile lavage for wound debridement in compound fractures of leg: a randomized control trial

Shafeed¹,

Paul²

2016

Int J Res Orthop

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“…It was shown that post-irrigation hemograms (WBC, CRP, and ESR) were significantly more desirable than pre-irrigation hemograms, suggesting that irrigation can effectively restore the aberrant hemograms to normal levels [21]. There was no significant difference in the post-irrigation hemogram or the bacteria-positive rate among the 4 groups, suggesting that the 4 irrigation techniques might reduce the risk of infection effectively [4,6,22]. Moreover, PL, CD, and IL groups exhibited a lower positive rate of bacteria in muscular tissues than in the SL group, indicating that PL, CD, and IL promote wound healing more than SL [23].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, PL, CD, and IL groups exhibited a lower positive rate of bacteria in muscular tissues than in the SL group, indicating that PL, CD, and IL promote wound healing more than SL [23]. It has been documented that PL is much more effective and efficient in removal of bacteria in complicated musculoskeletal incisions than SL [6,24]. CD effectively prevents infection caused by PLIF incision, which may be correlated with improving microcirculation of the wound, clearance of dead tissues, and generation of new blood vessels [25,26].…”

Section: Discussionmentioning

confidence: 99%

“…The pulsed irrigator produces pulsed current under varied pressures to irrigate the wound so that microbes and foreign bodies are removed from the wound and infection can be effectively prevented [5]. In addition, PL promotes granulation tissue growth [6]. Compared with conventional irrigation techniques, PL is also advantageous in enhanced efficiency and economic usage of irrigating fluid.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Lavage Techniques for Preventing Incision Infection Following Posterior Lumbar Interbody Fusion

Fei

2017

Med Sci Monit

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BackgroundThe main purpose of this study was to compare the effects of various lavage techniques – traditional saline lavage (SL), pulse lavage (PL), closed drainage (CD), and iodine lavage (IL) – on preventing incision-related infection after posterior lumbar interbody fusion.Material/MethodsPatients with prolapsed lumbar (intervertebral) discs (PLID) undergoing posterior lumbar interbody fusion surgery (PLIF) over the course of 2 years were included and were randomly allocated into 4 groups: the SL group, the PL group, the CD group, and the IL group. Relevant data were recorded, including preoperative conditions, intraoperative lavage time, lavage fluid volume, incision outlook, pain perception, results of routine blood tests, and postoperative infection rate.ResultsThe PL, CD, and IL groups showed less intraoperative lavage time, lavage volume fluid, effusion, infection rate, and muscle and lower pain perception compared with the SL group (all P<0.05). Significant differences in white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were observed between preoperative and postoperative data in each group (P<0.01). No significant differences in clinical characteristics, postoperative temperature, suture removal time, incision characteristics, WBC, ESR, and CRP were observed among the PL, CD, IL, and SL groups (P>0.05).ConclusionsPL, CD, and IL all showed much better postoperative infection prevention in comparison to SL.

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“…In a level IV study, power-pulsed lavage showed a statistically significant decrease in bacterial contamination. 53 …”

Section: Intra-operative Factorsmentioning

confidence: 99%

Total knee arthroplasty and infection: how surgeons can reduce the risks

Ratto

Rosso³

et al. 2016

EFORT Open Reviews

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Total joint arthroplasty (TJA) is one of the most common orthopaedic procedures. Nevertheless, several complications can lead to implant failure.Peri-prosthetic joint infections (PJI) certainly represent a significant challenge in TJA, constituting a major cause of prosthetic revision. The surgeon may have an important role in reducing the PJI rate by limiting the impact of significant risk factors associated to either the patient, the operative environment or the post-operative care.In the pre-operative period, several preventive measures may be adopted to manage reversible medical comorbidities. Other recognised pre-operative risk factors are urinary tract infections, intra-articular corticosteroid injections and nasal colonisation with Staphylococcus (S.) aureus, particularly the methicillin-resistant strain (MRSA).In the intra-operative setting, protective measures for PJI include antibiotic prophylaxis, surgical-site antisepsis and use of pre-admission chlorhexidine washing and pulsed lavage during surgery. In this setting, the use of plastic adhesive drapes and sterile stockinette, as well as using personal protection systems, do not clearly reduce the risk of infection. On the contrary, using sterile theatre light handles and splash basins as well as an increased traffic in the operating room are all associated with an increased risk for PJI.In the post-operative period, other infections causing transient bacteraemia, blood transfusion and poor wound care are considered as risk factors for PJI.Cite this article: Ratto N, Arrigoni C, Rosso F, Bruzzone M, Dettoni F, Bonasia DE, Rossi R. Total knee arthroplasty and infection: how surgeons can reduce the risks. EFORT Open Rev 2016;1: 339-344 DOI: 10.1302/2058-5241.1.000032.

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Efficacy of Power-pulsed Lavage in Lower Extremity Wound Infections: A Prospective Observational Study

Cited by 17 publications

References 34 publications

Pulsatile lavage for wound debridement in compound fractures of leg: a randomized control trial

Pulsatile lavage for wound debridement in compound fractures of leg: a randomized control trial

Comparison of Lavage Techniques for Preventing Incision Infection Following Posterior Lumbar Interbody Fusion

Total knee arthroplasty and infection: how surgeons can reduce the risks

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