Use Of Pulsatile Lavage Research Articles

A rare and uncommon complication after use of hydrogen peroxide (H2O2): A review of use of H2O2in orthopaedics

Hydrogen peroxide (H2O2) is a commonly used chemical agent in orthopaedic practice for antisepsis, haemostasis and preparation of bone bed for cementation. However, the associated risks of H2O2usage are not widely known. We report a case of suspected air embolism after use of H2O2during drainage of a septic arthritis of the shoulder.Upon our literature review, we were able to demonstrate H2O2to be beneficial in antisepsis and care of chronic wounds. However, it has not been proven to be superior to other antiseptics commonly used in orthopaedic surgery. Regarding its use in cementation, there is evidence to show it is more effective than saline however, the use of pulsatile lavage appears to be the most important factor affecting the quality of cementation. H2O2has not been shown to be helpful with haemostasis. Prior to the use of H2O2, one should be cautious and understand its associated risks and precautions.

Wound Irrigation for Open Fractures.

» The optimal regimen for wound irrigation in the setting of an open fracture has been a subject of debate. Basic science evidence as well as results from a recent prospective clinical trial have shed new light on this controversial topic. » While normal saline solution appears to be the optimal irrigation agent, the optimal timing and volume often are determined by the surgeon. Future clinical trials are needed to determine the optimal timing for debridement and irrigation, as well as the ideal volume of irrigant. » Irrigation pressure and the use of pulsatile lavage do not appear to have an effect on outcomes.

Moderatorsʼ Summary: Amputee Care

Moderatorsʼ Summary: Amputee Care

Heterotopic ossification about the hip after intramedullary nailing for fractures of the femur.

A prospective study of 100 consecutive unilateral fractures of the shaft of the femur was performed to delineate the incidence of, and the factors predisposing to, heterotopic ossification about the hip after intramedullary nailing. Bone debris from reaming of the endosteal canal is deposited in the soft tissues surrounding the site of insertion of the nail, and we postulated that this debris may stimulate the formation of heterotopic bone and that decreasing the amount of debris left in the tissues after nailing may decrease the amount of heterotopic ossification. To test this theory, the patients were treated with routine intramedullary nailing and were randomly divided into two groups. In Group I, the operative incision was irrigated with 250 milliliters of normal saline solution with use of a bulb syringe before the wound was closed, and in Group II, the incision was irrigated with 3000 milliliters of normal saline solution with use of pulsatile lavage. The two groups were similar in all other respects. Eighty patients (eighty fractures; forty in Group I and forty in Group II) were available for follow-up and were evaluated in a blind fashion after the fracture had united. A grading system that was based on the length of the heterotopic ossification, as measured on antero-posterior radiographs of the hip, was used. In thirty-two of the patients (40 per cent), no heterotopic ossification developed, whereas minimum or mild ossification developed in twenty-seven patients (34 per cent). Moderate ossification developed in twelve patients (15 per cent) and severe ossification, in nine patients (11 per cent).(ABSTRACT TRUNCATED AT 250 WORDS)