مرکز منطقه ای اطلاع رساني علوم و فناوري - A comparison between three irrigation methods in the debridement of contaminated bovine cancellous bone and the effect of duration of irrigation on the efficiency of debridement

Latin Abstract :

Objectives: Irrigation and debridement constitute an important part of treatment of open fractures. We investigated the effi¬ciency of different irrigation methods and durations in cleansing contaminated bovine femur cancellous bone samples and the extent of tissue damage associated with irrigation. Methods: A total of 72 samples of 4x4x1 cm size were obtained from fresh frozen bovine distal femoral cancellous bone. The top surface of the samples were sawed to a 2-mm depth to cre¬ate four squares equal in size. All the samples were contami¬nated with construction sand using the same method and were then randomized to three irrigation groups (bulb syringe irriga¬tion, high-pressure pulsatile lavage, and low-pressure pulsatile lavage), each consisting of 24 samples. The duration of irriga¬tion was set as 3, 6, or 9 minutes for every eight samples of each group. After the irrigation procedure, the images were trans¬ferred to a computer screen with a video-microscope camera and the number of sand particles on the samples were counted and irrigation-related macroscopic bone damage was assessed. Results: The lowest number of sand particles was found on the samples irrigated by high-pressure pulsatile lavage (p<0.001). The duration of irrigation did not affect the efficiency of cleansing in all the groups (p>0.05). The least irrigation-related bone dam¬age was observed in samples irrigated by low-pressure pulsatile lavage for 3 minutes (p<0.01). The amount of bone damage was similar in all groups after irrigations beyond 3 minutes (p>0.05). Conclusion: Our findings showed that the most efficient method of cleansing contaminated bone samples was high-pressure pul¬satile lavage and that prolonged irrigations did not enhance the efficiency of the irrigation method; however, high-pressure irriga¬tion of 3 minute duration resulted in the greatest bone damage.