Saline solution reduces reoperation compared to soap in irrigation of open fractures

Study Type:Randomized Trial

OE Level Evidence:1

Journal Level of Evidence:N/A

A Trial of Wound Irrigation in Initial Management of Open Fracture Wounds

N Engl J Med. 2015 Dec 31;373(27):2629-41

Contributing Authors: FLOW Investigators Bhandari M KJ Jeray B Petrisor PJ Devereaux D Heels-Ansdell E Schemitsch J Anglen GJ Della Rocca C Jones H Krefer S Liew P Mckay S Papp P Sancheti S Sprague TB Stone SL Tanner P Tornetta T Tufescu S Walter G Guyatt

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OE EXCLUSIVE

Dr. Mohit Bhandari discusses the FLOW trial and the necessity for large randomized controlled trials in medicine.

Synopsis

2551 patients with an open fracture of the extremity were included in this randomized, 2 by 3 factorial design trial to investigate the effects of irrigation pressure and solution on reoperation rates. The patients were randomized to receive irrigation with either soap or saline at high, low, or very low pressure. After a 12 month follow-up period, the results indicated that the use of saline was ...