Davis Kathryn E, Moquin Kenneth J, Lavery Lawrence A
Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Plastic Surgery, Henry Ford Hospital, Detroit, MI, USA.
Int Wound J. 2016 Aug;13(4):469-74. doi: 10.1111/iwj.12456. Epub 2015 May 12.
Saline irrigation has been shown to be both experimentally and clinically efficacious in decreasing bacterial contamination as well as decreasing infection rates. The dynamics of irrigation delivery fall into two primary categories: simultaneous and intermittent irrigation. An important component to irrigation therapy is distribution of irrigation solution to hard-to-reach areas of a wound bed, including undermining and fissure-like structures. Here we test the effectiveness of simultaneous irrigation to fill the irregular structures of a wound bed. In order to visualise the dynamic movement of irrigation solution, three-dimensional wound models were constructed using clear synthetic ballistic gel. Wounds with the aforementioned characteristics were carved into the ballistic gel with varying area, depth and volume. All three wounds were dressed as per manufacturer's instructions. Data demonstrate that simultaneous irrigation is effective in reaching all parts of a wound bed in wound models that have both undermining and tunnelling, and irrigation effectively saturates bridged wounds. Finally, this study shows that there is constant turnover of irrigation solution in the wound that is driven more by administration volume and less by flow rate. These data show that simultaneous irrigation is an effective technique for delivering irrigation solution to both simple and complex wounds.
生理盐水冲洗已在实验和临床中被证明在减少细菌污染以及降低感染率方面是有效的。冲洗给药的动力学主要分为两类：同步冲洗和间歇冲洗。冲洗治疗的一个重要组成部分是将冲洗液分布到伤口床难以到达的区域，包括潜行和裂隙样结构。在此，我们测试同步冲洗填充伤口床不规则结构的有效性。为了可视化冲洗液的动态运动，使用透明合成弹道凝胶构建了三维伤口模型。将具有上述特征的伤口刻入弹道凝胶中，其面积、深度和体积各不相同。所有三个伤口均按照制造商的说明进行包扎。数据表明，在既有潜行又有隧道的伤口模型中，同步冲洗能够有效到达伤口床的所有部位，并且冲洗能有效使桥接伤口饱和。最后，本研究表明伤口中冲洗液不断更新，其更多地由给药量驱动，而较少受流速影响。这些数据表明，同步冲洗是一种向简单和复杂伤口输送冲洗液的有效技术。
