Does bacteremia occur during high pressure lavage of contaminated wounds?
The risk of bacteremia secondary to high pressure lavage of contaminated wounds was assessed. Twenty canines were divided randomly into four treatment groups. A 10-cm incision was made over the left shoulder of each dog. The deltoideus muscle was disrupted and traumatized. Groups A and B (n = 8) had wound contamination with 1.4 x 10(9) Staphylococcus aureus followed 75 minutes later by high pressure lavage or bulb syringe irrigation, respectively. Groups C and D (n = 2) had no contamination, followed by the same treatment. Bacterial counts were obtained before and after wound irrigation. Blood cultures were obtained before, during, and 15 minutes after irrigation. Positive control cultures were obtained during injection of bacteria into the antecubital vein. A detectable bacteremia did not occur during or after high pressure lavage or bulb syringe irrigation of acute contaminated wounds but did occur in 18 of 20 positive controls. Bacterial levels were reduced by an average of 70% +/- 10% by high pressure lavage and 44% +/- 50% by bulb irrigation. Reduction of wound bacteria was achieved more consistently with high pressure lavage than with bulb syringe irrigation.
Tabor
O B
OB
Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, NC 28232, USA.
Bosse
M J
MJ
Hudson
M C
MC
Greene
K G
KG
Nousiainen
M T
MT
Meyer
R A
RA
Sims
S H
SH
Kellam
J F
JF
D000818:Animals; D016470:Bacteremia / Q000209:etiology*; D004195:Disease Models, Animal; D004285:Dogs; D005069:Evaluation Studies as Topic; D011312:Pressure; D011897:Random Allocation; D007507:Therapeutic Irrigation / Q000009:adverse effects* / Q000379:methods; D014946:Wound Infection / Q000150:complications / Q000628:therapy*