Wound irrigation

Wound irrigation may have one or several of the following aims:

• removal of foreign bodies
• reduction of pathogen numbers
• removal of blood, clot and dead tissue
• removal of free cancer cells
• moistening of tissue

The solution used to irrigate may be:

• physiological saline; its low osmolarity may aid in free tumour cell lysis
• topical antiseptic, e.g. chlorhexidine and iodine; both may cause undesirable cell death of host tissue. Alternatives include spraying dry povidone-iodine spray onto the wound - this has been shown to reduce infection rates - or local injection of antibiotic peroperatively.

If an antiseptic is chosen, it must not stain the skin. Irrigation may be carried out with a rubber bulb syringe, low pressure or high pressure systems. Evidence suggests that a simple high pressure system, e.g. a fine jet of fluid from a needle attached to a large syringe, is far superior to low pressure alternatives (1).

Reference:

• Edlich, R.F., Thacker, J.G. (1994). Wound irrigation. Annals of Emergency Medicine; 24: 88-90