II. Protocol: Irrigation

  1. Personal Protection Equipment
    1. Wear a mask with eye shield during irrigation
  2. Saline is as effective as antiseptics (e.g. 1% Betadine) for irrigation
    1. Antseptics should be avoided inside the wound due to tissue injury
  3. Tap water is as safe and effective as saline for irrigation (and more plentiful)
    1. Fernandez (2012) Cochrane Database Syst Rev (2): CD003861 +PMID:22336796 [PubMed]
    2. Weiss (2013) BMJ Open 3(1) +PMID:23325896 [PubMed]
  4. Moderate pressure irrigation is the key
    1. Irrigation with syringe provides approximately 5-8 psi
  5. Irrigate with minimum of 250 to 500 cc, or 50-100 ml/cm wound length (use 1000 cc or more if contaminated)
    1. Normal Saline irrigation, compressible plastic bottles (250-500 cc) with plastic adapter OR
    2. Syringe 30-60 ml syringe (requires multiple refills) OR
    3. Placing wound under Running tap water
  6. Avoid irrigation with tissue destructive agents
    1. Hydrogen Peroxide (weak germacide)
    2. Betadine at stock concentration (9%)
      1. Always dilute Betadine (1:10)

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