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Pulsatile lavage systems and their potential to penetrate soft tissue
Kevin Knappe1,2, Andre Lunz3,4, Matthias Bülhoff3,4
1Department of Orthopedic Surgery, Heidelberg University, Heidelberg, Germany. kevin.knappe@med.uni-heidelberg.de.
Summary
Pulsatile lavage systems used in surgery show significant differences in impact pressure and flow rate. Higher impact pressure in these systems leads to deeper tissue penetration, potentially transferring bacteria to deeper layers.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Biomedical Engineering
Background:
- Pulsatile lavage systems are crucial for cleaning soft tissue in orthopedic and trauma surgeries, particularly for septic conditions or contaminated wounds.
- While effective in reducing bacterial contamination and removing debris, these systems pose risks like bacterial seeding, tissue damage, and air embolism.
Purpose of the Study:
- To compare impact pressure and flow rate across three distinct pulsatile lavage systems.
- To investigate if these parameters influence the systems' ability to penetrate deeper soft tissue layers.
Main Methods:
- An in vitro study using muscle tissue flushed with contrast medium.
- Computed tomography (CT) scanning to analyze fluid penetration depth and volume.
Main Results:
- Significant variations in impact pressure and flow rate were observed among the tested pulsatile lavage systems.
- No significant differences in total penetration volume were found, but penetration depth varied significantly between devices.
Conclusions:
- Higher impact pressure directly correlates with increased penetration depth in soft tissues.
- This deeper penetration capability raises concerns about the potential for bacteria to be transferred to deeper tissue layers during surgical procedures.
