• M Bhandari, K Thompson, A Adili, and S G Shaughnessy.
• Hamilton Civic Hospitals Research Centre, McMaster University Hamilton, Ontario, Canada. bhandari@netinc.ca
• Int. J. Surg. Investig. 2000 Jan 1;2(3):179-82.

BackgroundIrrigation and debridement are essential in the initial management of traumatic wounds. The relative efficicacy of low pressure irrigation compared with high pressure irrigation remains unclear.AimsThe purpose of this study was to examine the time dependent efficacy of both high and low pressure lavage in removing adherent bacteria from traumatic wounds with exposed bone.MethodsUsing an in-vivo model, we created bilateral Staphylococcus aureus contaminated femoral wounds in 30 mice. The wounds were incubated for 1 to 10 hours and lavaged with either high (70 psi) or low pressure lavage (1-2 psi). The mean colony forming units of bacteria were compared between groups at each time point.ResultsHigh and low pressure lavage were effective in removing adherent bacteria from contaminated wounds up to 8 hours and 4 hours, respectively. High pressure lavage was more effective than low pressure at every time point.ConclusionThe efficacy of low pressure lavage in wounds with exposed bone is questionable when irrigation is delayed beyond 4 hours.

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