title: Treatment of field water with sodium hypochlorite for surgical irrigation.
abstract: BACKGROUND
  Early irrigation and surgical debridement of high-energy wounds and open fractures effectively prevents infection. Rapid wound care has been maximized by the United States military's "forward surgical teams." However, the volume of sterile irrigant required to treat multiple patients with multiple wounds presents a significant logistical burden. Using ground-derived field water could eliminate this burden.
  
  
  METHODS
  We collected 100 water samples from five sources. An initial bacterial count (CFU/mL) was determined before treatment. 5% sodium hypochlorite was then added to each sample to derive a concentration of 0.025%. After treatment, a final bacterial colony count was performed.
  
  
  RESULTS
  We found no bacterial growth in 99/100 samples. One post-treatment sample grew a single colony of a Bacillus species not present in the pretreatment culture and was determined to be an air contaminant.
  
  
  CONCLUSIONS
  Our field-expedient modification of Dakin's solution could substitute for sterile irrigation fluid when it is neither available nor logistically feasible.
authors.affiliation: Department of Orthopaedic Surgery, 59th Medical Wing, Lackland Air Force Base, Texas, USA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Cyr
authors.forename: Donna
authors.initials: D
authors.lastname: Hensley
authors.forename: Gary E
authors.initials: GE
authors.lastname: Benedetti
mesh_terms: D000391:Air Microbiology; D015169:Colony Count, Microbial; D003646:Debridement; D004202:Disinfectants / Q000627:therapeutic use*; D004340:Drug Contamination; D004353:Drug Evaluation, Preclinical; D005618:Fresh Water / Q000382:microbiology*; D013502:General Surgery; D006801:Humans; D017053:Infection Control; D008887:Military Medicine / Q000379:methods* / Q000592:standards; D008889:Military Personnel; D012973:Sodium Hypochlorite / Q000627:therapeutic use*; D012996:Solutions; D007507:Therapeutic Irrigation / Q000379:methods* / Q000592:standards; D013997:Time Factors; D014481:United States; D014857:Warfare; D014871:Water Microbiology; D014881:Water Supply; D014946:Wound Infection / Q000209:etiology / Q000517:prevention & control; D014947:Wounds and Injuries / Q000150:complications / Q000601:surgery*
chemical_list: D004202:Disinfectants; D012996:Solutions; D012973:Sodium Hypochlorite