Irrigation Fluids Used for the Prevention and Treatment of Orthopaedic Infections

➤ Intrawound irrigation is a mainstay in the prevention and treatment of surgical site infections. ➤ There are 3 components of irrigation: delivery method, volume, and type of solution (with and without additives). ➤ A low-pressure delivery system for a 1 to 9-L volume of solution should be used to irrigate wounds, with a greater volume indicated in the setting of contaminated or infected wounds. ➤ Operative irrigation solutions are frequently supplemented with the addition of surfactants, antibiotics, or antiseptics. ➤ There is limited evidence with regard to the optimal antiseptic or whether antiseptics confer any advantage. Current literature suggests that surfactants and antibiotics should be avoided. ➤ To date, most studies on irrigation solutions in orthopaedics are retrospective, necessitating the organization of prospective randomized controlled trials to guide future evidence-based decisions.