title: The use of detergent irrigation for musculoskeletal wounds.
abstract: The primary purpose of irrigation is to remove bacterial contaminants from the wound. Surfactants do that by disrupting the bonds of the organism to the surface. The use of this wound care strategy was studied in a series of investigations spanning several years. In vitro experiments revealed that surfactant irrigation was superior to saline or antibiotic solutions for removal of adherent bacteria from metallic surfaces, from bone, and from bovine muscle. An in vivo model of the complex orthopedic wound was developed. The superiority of surfactant irrigation over saline or antibiotic solution was demonstrated in animal wounds containing metal, bone injury, and soft tissue damage. Specificity of different surfactant irrigations for various bacterial species was demonstrated. A sequential surfactant irrigation protocol was developed and shown effective in the polymicrobial wound with established infection.
authors.affiliation: Department of Orthopaedic Surgery, University of Missouri Hospital, One Hospital Drive, MC213, Columbia, Missouri 65201, USA. AnglenJ@health.missouri.edu
authors.forename: J O
authors.initials: JO
authors.lastname: Anglen
authors.forename: B J
authors.initials: BJ
authors.lastname: Gainor
authors.forename: W A
authors.initials: WA
authors.lastname: Simpson
authors.forename: G
authors.initials: G
authors.lastname: Christensen
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003902:Detergents / Q000494:pharmacology*; D004195:Disease Models, Animal; D004866:Equipment Contamination; D008826:Microbial Sensitivity Tests; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods; D011336:Probability; D011549:Pseudomonas / Q000187:drug effects / Q000302:isolation & purification; D051381:Rats; D017207:Rats, Sprague-Dawley; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013501:Surface-Active Agents / Q000494:pharmacology; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000517:prevention & control*; D007507:Therapeutic Irrigation / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents; D003902:Detergents; D013501:Surface-Active Agents