he initial management of open
fractures requires thorough irrigation and
débridement1-4 to prevent infection and
promote wound and bone healing.2,4 Clinicians
accomplish débridement by removing all visible
debris and necrotic tissue and by providing copious
irrigation of the wound.
Controversy exists regarding the choice of irrigation
pressure and solution.4-13 High pressure
may be more effective than low pressure in removing
particulate matter and bacteria7-10 but at
the expense of bone damage8,11 and a resultant
delay in bone healing.12 Low pressure may avoid
bone damage and delayed healing but at the possible
cost of less effective removal of foreign
matter and bacteria.