Some Important Lessons Regarding Wound Irrigation

By Donna Cook

Wounds come about upon physical injury which could occur in many ways. Among the common ways that people sustain wounds is through motor vehicle accidents and gun shot injuries. Severe soft tissue injury can also be as a result of burns. Wound irrigation is one of the initial steps that are undertaken in the treatment process. It is important that this is done judiciously to ensure that they heal in the best way possible.

In the ideal situation, solutions meant for cleaning wounds should be transparent to facilitate accurate and thorough wound cleansing. They also need to be inexpensive and nontoxic to the injured. Normal saline fits this description just right. It is the typical solution for cleansing. It is an isotonic solution with no toxic contents. One major drawback to its use is the fact that it may not kill any harmful microbes that may be present. Povidone iodine, potable water and sodium hypochlorite are additional options that can be used.

Equipment used for irrigation include syringes, pressure canisters and traditional containers modified for cleaning under pressure. Canisters could be of the piston type or bulbous. They have the advantage of being simple, cheap and efficient.

Irrigation can be said to either be continuous or pulsed. Pulsed irrigation is done with periods of rest, perhaps to confirm whether the wound has been fully cleansed. Studies, however, reveal that the outcome is the same, regardless of what method has been used. Pressure during cleaning ensures that all the debris has been done away with.

Irrigation can be quite messy sometimes. Due to high pressures, one can get splashed on by infected fluid. Both the patient and the doctor should protect themselves from getting infected. The eyes, being the most vulnerable, should be protected by wearing goggles. The caregiver should also wear a special gown and gloves to ensure the skin is protected. Any intravenous lines present on the patient should be carefully covered to keep them from getting splashed onto.

Irrigation is indicated for all types of wounds, initially and after every dressing. Care should be taken when irrigating wounds that are actively bleeding because this stands a risk of dislodging any existing clots. It may also be unwise to actively cleanse tissues in cases where bone, nerves and vessels are exposed.

Sustaining severe physical injury is often very traumatic to the patient. Subjecting them to further trauma is not fair at all. It is only noble that sufficient anesthesia is provided to ensure that they do not complain of pain during the procedure. Depending on how severe the damage is, either general or local anesthesia can be utilized.

Once cleansing is deemed satisfactory, the wound should be dressed using sterile gauze and other appropriate dressing material. Closing up the area primarily with stitches depends on the size of the wound and whether there is an infection or not. Every step should be put down in writing including the type of solution, volume of solution used and irrigation pressures employed.

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