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Annotation: D. J. Crowley, N. K. Kanakaris, and P. V. Giannoudis Irrigation of the wounds in open fractures J Bone Joint Surg Br 2007; 89-B: 580-585 [Abstract] [Full text] [PDF]

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Irrigation of the wounds in open fractures

KC Kong   (8 June 2007)

Irrigation of the wounds in open fractures 8 June 2007
KC Kong, Consultant Orthopaedic Surgeon King George Hospital, Ilford, IG3 8YB Send letter to journal: Re: Irrigation of the wounds in open fractures kck{at}doctors.org.uk KC Kong	Sir, I read this paper with interest. The authors have reviewed several publications that looked at the use of various antiseptic solutions which included povidone iodine, chlorhexidine gluconate, hydrogen peroxide and sodium hypochlorite. The use of aqueous chlorhexidine in 4% and in 0.05% concentrations have been studied by Goebel et al1 and Taylor et al,2 and the authors have found them effective in clearing bacterial contamination in in-vivo and in-vitro models of wound contamination. Taylor et al have reviewed the effectiveness and toxic effects and found chlorhexidine gluconate in 0.05% to be effective in clearing bacterial contamination and non toxic to soft tissues and wound healing. They recommended chlorhexidine should not be used on the brain, meninges, middle ear and articular surfaces. The use of aqueous chlorhexidine gluconate or acetate (0.05%) in irrigating open fractures (not involving a joint) followed by isotonic saline needs consideration. K.C. Kong, Consultant Orthopaedic Surgeon, King George Hospital, Ilford, UK. 1. Goebel ME, Drez D, Heck SB, Stoma MK. Contaminated rabbit patellar tendon grafts. In vivo analysis of disinfecting methods. Am J Sports Med 1994;22:387-91. 2. Taylor GJ, Leeming JP, Bannister GC. Effect of antiseptics, ultraviolet light and lavage on airborne bacteria in a model wound. J Bone Joint Surg [Br] 1993;75-B:724-30.