Using a goat survival model with quantifiable luminescent Pseudomonas aeruginosa, this study compares four irrigation solutions (saline, bacitracin, castile soap, benzalkonium chloride) and two delivery devices (bulb syringe vs. pulsatile lavage at 19 psi) in contaminated complex musculoskeletal wounds, measuring both immediate bacterial reduction and 48-hour bacterial rebound.
When irrigating an open fracture or contaminated musculoskeletal wound, use saline with a bulb syringe (or low-pressure device) rather than antiseptic additives or pulsatile lavage — more aggressive solutions and higher-pressure delivery produce better immediate bacterial counts but worse bacterial burden at 48 hours, the time of typical second-look débridement.
This evidence provided early in vivo support for the FLOW trial's eventual recommendation of saline over soap solutions.
Using a goat survival model with quantifiable luminescent Pseudomonas aeruginosa, this study compares four irrigation solutions (saline, bacitracin, castile soap, benzalkonium chloride) and two delivery devices (bulb syringe vs. pulsatile lavage at 19 psi) in contaminated complex musculoskeletal wounds, measuring both immediate bacterial reduction and 48-hour bacterial rebound.
When irrigating an open fracture or contaminated musculoskeletal wound, use saline with a bulb syringe (or low-pressure device) rather than antiseptic additives or pulsatile lavage — more aggressive solutions and higher-pressure delivery produce better immediate bacterial counts but worse bacterial burden at 48 hours, the time of typical second-look débridement.
This evidence provided early in vivo support for the FLOW trial's eventual recommendation of saline over soap solutions.