Fluid lavage in patients with open fracture wounds FLOW: an international survey of 984 surgeonsReport as inadecuate




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BMC Musculoskeletal Disorders

, 9:7

First Online: 23 January 2008Received: 03 October 2007Accepted: 23 January 2008

Abstract

BackgroundAlthough surgeons acknowledge the importance of irrigating open fracture wounds, the choice of irrigating fluid and delivery pressure remains controversial. Our objective was to clarify current opinion with regard to the irrigation of open fracture wounds.

MethodsWe used a cross-sectional survey and a sample-to-redundancy strategy to examine surgeons- preferences in the initial management of open fracture wounds. We mailed this survey to members of the Canadian Orthopaedic Association and delivered it to attendees of an international fracture course AO, Davos, Switzerland.

ResultsOf the 1,764 surgeons who received the questionnaire, 984 55.8% responded. In the management of open wounds, the majority of surgeons surveyed, 676 70.5%, favoured normal saline alone. Bacitracin solution was used routinely by only 161 surgeons 16.8%. The majority of surgeons, 695 71% used low pressures when delivering the irrigating solution to the wound. There was, however considerable variation in what pressures constituted high versus low pressure lavage. The overwhelming majority of surgeons, 889 94.2%, reported they would change their practice if a large randomized controlled trial showed a clear benefit of an irrigating solution – especially if it was different from the solution they used.

ConclusionThe majority of surgeons favour both normal saline and low pressure lavage for the initial management of open fracture wounds. However, opinions varied as regards the comparative efficacy of different solutions, the use of additives and high versus low pressure. Surgeons have expressed considerable support for a trial evaluating both irrigating solutions and pressures.

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Author: Brad Petrisor - Kyle Jeray - Emil Schemitsch - Beate Hanson - Sheila Sprague - David Sanders - Mohit Bhandari - the FLOW In

Source: https://link.springer.com/







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