Experimental evidence has suggested that irrigation
pressures of less than 10 psi are ineffective
in removing soil contaminants from contaminated
open wounds.5 Experimental studies have also
shown that high-pressure irrigation is more effective
than low-pressure irrigation in the removal of
bacteria, especially when the time to irrigation
was delayed beyond 6 hours.36 In contrast, some
experimental studies have shown complications
from high-pressure irrigation, including increased
damage to fractured bone,37 bacterial propagation
into soft tissues and the intramedullary canal of
the fractured bone,11,37 promotion of stem-cell differentiation
from bone-forming cells (osteoblasts)
toward the adipocyte cell type,38 and impairment
of in vivo fracture healing.12 Our results suggest
that findings from experimental studies do not
always translate into differences in patient-important
outcomes in clinical practice.