Irrigations wounds

Bartlett JG, Condon RE, Gorbach SL, Clarke JS, Nichols RL, Ochi S Veterans Administration Cooperative Study on Bowel Preparation for Elective Colorectal Operations Impact of oral antibiotic regimen on colonic flora, wound irrigation cultures and bacteriology of septic complications. Ann Surg 1978,188 249-254. 

Debridement can be accomplished by surgical or mechanical means (wet-to-dry dressing changes). Other effective therapies are hydrotherapy, wound irrigation, and dextranomers. Pressure sores should be cleaned with normal saline. 

Bishop ME, Garcia RL. Iododerma from wound irrigation with povidone-iodine. JAMA 1978 240(3) 249-50. 

A 65-year-old man undergoing elective sternal debridement and rewiring was given a prophylactic infusion of vancomycin 1 g preoperatively. Anesthesia was induced with thiopental, suxamethonium, and fentanyl, and maintained with fentanyl, vecuronium, and isoflurane. A few minutes after wound irrigation with bacitracin (about 25U/ml), his blood pressure fell precipitously, necessitating intravenous fluids and adrenaline. His face and arms were flushed. Afterwards, he reported having had a rash several years before after the use of an over-the-counter ointment composed of polymyxin B, bacitracin, and neomycin. 

Chlorhexidine has broad-spectrum antibacterial activity hut is not active against acid-fast bacteria, spores, or viruses. It has been used for such topical uses as preoperative. skin disinfection, wound irrigation, mouthwashes, and general sanitiration. Chlorhexidine is not absorbed through skin or mucous membranes and docs not cause systemic toxicity. 

THERAP CAT (VET) Essential nutrient factor. May be given orally as emetic, stomachic, laxative or to stimulate thirst (preveution of calculi). Intravenously as isotonic solution to raise blood volume, to combat dehydration. Locally as wound Irrigant, recta] douche. 

Plutonium-239 DTPA (see p 439) chelator. Dose 1 g in 250 mLD5W IV over 30-60 min daily. Wounds Irrigate with 1 g DTPA in 250 mL water. EDTA (see p 440) may also be effective if DTPA is not immediately available. Aluminum-containing antacids may bind plutonium in Gl tract. 

As a result of this work, we were able to replace the Army s favoured deep-yellow wound irrigant, proflavine (3,6-diaminoacridine), by the more selective and non-staining analogue, aminacrine (9-aminoacridine). 

Kelly DR, Nilo ER, Berggren RB (1969) Brief recording deafness after topical neomycin wound irrigation. N Engl J Med 280 1338-1339... 

Wound irrigations have to be iso-hydric (pH 7.4) or should have a very low buffer capacity. For irrigations for the bladder larger limits are allowed, but at pH < 3 irritation may occur [5]. Irrigations for dissolving bladder stones often contain citric acid as the active substance (pH 3.5 ). 

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