Bahrs C, Schnabel M, Frank T, Zapf C, Mutters R, von Garrel T. Lavage of contaminated surfaces: an in vitro evaluation of the effectiveness of different systems. J Surg Res. 2003 Jun 1. 112(1):26-30. [QxMD MEDLINE Link].

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Longmire AW, Broom LA, Burch J. Wound infection following high-pressure syringe and needle irrigation. Am J Emerg Med. 1987 Mar. 5(2):179-81. [QxMD MEDLINE Link].Lu M, Hansen EN. Hydrogen Peroxide Wound Irrigation in Orthopaedic Surgery. J Bone Jt Infect. 2017. 2 (1):3-9. [QxMD MEDLINE Link]. Suspected foreign bodies can often be identified using ultrasonography Ultrasonography In ultrasonography, a signal generator is combined with a transducer. Piezoelectric crystals in the signal generator convert electricity into high-frequency sound waves, which are sent into... read more . Gabriel A, Shores J, Heinrich C, et al. Negative pressure wound therapy with instillation: a pilot study describing a new method for treating infected wounds. Int Wound J. 2008 Jun. 5(3):399-413. [QxMD MEDLINE Link]. Chisholm CD, Cordell WH, Rogers K, Woods JR. Comparison of a new pressurized saline canister versus syringe irrigation for laceration cleansing in the emergency department. Ann Emerg Med. 1992 Nov. 21(11):1364-7. [QxMD MEDLINE Link].

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Some foreign bodies (eg, small fragments of glass or metal in a puncture wound) may be allowed to remain in a wound if removal would incur additional tissue damage and further impair healing. Patients should be told that a retained foreign body is possible and given wound care instructions that include watching for signs of infection. Brown LL, Shelton HT, Bornside GH, Cohn I Jr. Evaluation of wound irrigation by pulsatile jet and conventional methods. Ann Surg. 1978 Feb. 187(2):170-3. [QxMD MEDLINE Link]. [Full Text]. Irrigation and instillation of wounds, hollow spaces or hollow organs in combination with adequate medical devices. Allen Gabriel, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, California Medical Association

Hair removal is generally not recommended, except when closure using adhesive strips is anticipated. To remove hair, clip rather than shave it. Eyebrows must remain intact to achieve accurate alignment of wound edges during suturing. The medical device is indicated and designed for the connection to non-Luer connections such as nasogastric tubes or for irrigation procedures, including manual aspiration and dispensing of water. Normal wound healing is characterized by 3 interrelated phases: inflammatory, proliferative or fibroplastic, and remodeling. In normal wound healing, infectious microorganisms, foreign debris, and necrotic tissue are removed from the wound during the inflammatory phase due to vascular and cellular responses to trauma. However, weaknesses in the body’s inflammatory response can cause deficits in its ability to overpower surface microorganisms. This can lead to delayed angiogenesis and granulation tissue formation, as well as infection. Contaminating microorganisms can upset collagen synthesis and modify matrix metalloproteinases, leading to anoxia and impeding neutrophil and macrophage function. Irrigation syringes are hypodermic 3-piece syringes with catheter tip. The single-use devices are intended to be used for the following purposes:

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Owens BD, White DW, Wenke JC. Comparison of irrigation solutions and devices in a contaminated musculoskeletal wound survival model. J Bone Joint Surg Am. 2009 Jan. 91(1):92-8. [QxMD MEDLINE Link]. Anglen JO. Wound irrigation in musculoskeletal injury. J Am Acad Orthop Surg. 2001 Jul-Aug. 9(4):219-26. [QxMD MEDLINE Link]. Gross A, Cutright DE, Bhaskar SN. Effectiveness of pulsating water jet lavage in treatment of contaminated crushed wounds. Am J Surg. 1972 Sep. 124(3):373-7. [QxMD MEDLINE Link].Bernstein BH, Tam H. Combination of subatmospheric pressure dressing and gravity feed antibiotic instillation in the treatment of post-surgical diabetic foot wounds: A case series. Wounds. 2005. 17(2):37-48. Tetanus vaccination and immune globulin may be needed depending on the wound type and patient's vaccination history (see table Tetanus Prophylaxis in Routine Wound Management Tetanus Prophylaxis in Routine Wound Management ). Chan MC, Cheung K, Leung P. Tap Water Versus Sterile Normal Saline in Wound Swabbing: A Double-Blind Randomized Controlled Trial. J Wound Ostomy Continence Nurs. 2016 Mar-Apr. 43 (2):140-7. [QxMD MEDLINE Link].

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Gurunluoglu R. Experiences with waterjet hydrosurgery system in wound debridement. World J Emerg Surg. 2007 May 2. 2:10. [QxMD MEDLINE Link]. [Full Text]. Owens BD, Wenke JC. Early wound irrigation improves the ability to remove bacteria. J Bone Joint Surg Am. 2007 Aug. 89(8):1723-6. [QxMD MEDLINE Link]. Skin cleansing: Proceed from the wound edges outward, wiping in concentric circles with chlorhexidine or povidone-iodine solution followed by alcohol solution. Do not introduce a cleansing agent directly into the wound because many are toxic to tissues and may interfere with wound healing.The barrel of the syringe is transparent, allowing for easy visualization of the contents and ensuring accurate dosing. Debride all devitalized and necrotic tissue: Stabilize the wound edge with forceps, then cut away the devitalized tissue with a scalpel or iris scissors. Make the cuts perpendicular to the skin surface, not on an angle (to maximize dermal apposition during closure). Wolcott RD, Rumbaugh KP, James G, et al. Biofilm maturity studies indicate sharp debridement opens a time- dependent therapeutic window. J Wound Care. 2010 Aug. 19(8):320-8. [QxMD MEDLINE Link]. The irrigation syringes with measurement function are intended to be used for manual aspiration and dispensing of fluids. Drug admixture for the indications mentioned above shall be done according to the respective SmPCs of the drugs. Clean the peri-wound area with normal saline solution; wipe intact skin with skin protectant wipe. Gently pat dry the wound’s edges, unless the wound should be covered with a wet-to-dry dressing (dry only surrounding skin). Work from cleanest to most contaminated part of wound.