Daily Bolus of LR: Wound irrigation

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February 22, 2011 by dailybolusoflr

Wound irrigation is an important step in wound management which has been shown to decrease the likelihood of resultant infection.

 

Wounds become infected when the bacterial load in a wound reaches a certain threshold.  Literature shows that an effective way to decrease the bacterial contamination in a wound is to irrigate it.

 

The optimal pressure is between 5-8 psi. 

 

The following are commonly used acceptable methods of irrigation:

·         19G needle and 35 or 65 cc syringe

·         Tap water faucet

·         Commercial irrigation devices

 

The following are NOT considered acceptable:

·         Piercing saline bottles

·         Piercing saline IV bags

 

Pearls:

·         Optimal solutions are NS or 1% povidone iodine.  Higher concentrations of povidone iodine are toxic to wounds.

 

·         Soaking increased bacterial load of the wound and should be avoided.

 

·         Tap water irrigation is an acceptable method to irrigate wounds in low risk extremity wounds.

 

 

 

Regan, L. “When irrigating a wound, don’t consider all methods to be equal”. In Mattu A, Chanmugam A et al, eds. Avoiding Common Errors in the Emergency Department. Lippincott Williams & Wilkins; 2010

 

Linda Regan, MD FACEP

Program Director, Emergency Medicine Residency

Johns Hopkins Medical Institutions

 

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