• Kevin Knappe, Andre Lunz, Matthias Bülhoff, Mareike Schonhoff, Tobias Renkawitz, Jan Philippe Kretzer, and Sebastian Jaeger.
• Department of Orthopedic Surgery, Heidelberg University, Heidelberg, Germany. kevin.knappe@med.uni-heidelberg.de.
• Eur J Trauma Emerg Surg. 2023 Feb 1; 49 (1): 327333327-333.

BackgroundIn orthopedic and trauma surgery, pulsatile lavage systems are used to clean soft tissue. This may be necessary in septic surgeries or in case of contaminated wounds after trauma. Positive features such as reduction of bacterial contamination and removal of foreign particles are counterbalanced by negative aspects such as bacterial seeding in deeper tissue layers, damage to various tissues and even cases of air embolism.PurposeThe aim of this prospective experimental in vitro study was to compare impact pressure and flow rate in three different pulsatile lavage systems and to determine, whether these parameters alter their ability to reach deeper soft tissue layers.MethodsTo test the penetration of soft tissue, the muscle tissue was flushed with contrast medium instead of saline fluid and afterwards scanned by computed tomography.ResultsImpact pressure and flow rate showed significant differences between the different systems. There were no significant differences between the three devices in terms of total penetration volume, but there were significant differences in penetration depth.ConclusionIn this study, we found that higher impact pressure leads to deeper penetration and therefore bacteria are likely to be transferred to deeper tissue layers.© 2022. The Author(s).

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