Extract
To The Editor:I read the article entitled "Comparison of Soap and Antibiotic
Solutions for Irrigation of Lower-Limb Open Fracture Wounds. A Prospective,
Randomized Study" (2005;87:
1415-22), by Anglen, with great
interest. The topic is of interest to all orthopaedic surgeons who deal with
open fractures in their practice.We have used a number of different solutions, including saline solution,
soap, antibiotic, chlorhexidine, Betadine, and hydrogen peroxide. The most
important factor, in my view, is the use of copious pulse lavage, which
mechanically removes the debris and bacteria from an open wound. It has been
suggested that at least a few liters of saline solution (rather than hydrogen
peroxide) should be used for irrigation because in some open wounds, debris is
driven deep into tissues with the foaming action of hydrogen peroxide.