METHODS
In this study with a 2-by-3 factorial design, conducted at 41 clinical centers, we
randomly assigned patients who had an open fracture of an extremity to undergo
irrigation with one of three irrigation pressures (high pressure [>20 psi], low pressure
[5 to 10 psi], or very low pressure [1 to 2 psi]) and one of two irrigation solutions
(castile soap or normal saline). The primary end point was reoperation
within 12 months after the index surgery for promotion of wound or bone healing
or treatment of a wound infection.