Strategies to Address Infection Prevention and Treatment in the Reduced Inflammatory Milieu of Irrigated Open Wound
Abstract
Open fractures require irrigation and debridement to prevent potential infection. Irrigation and debridement, however, removes the body's first healing response, such as fracture hematoma. We implemented an irrigated radius defect model intended to represent the open fracture setting with bone loss. We evaluated feasibility to investigate the role of platelet rich plasma (PRP) to restore healing response. We completed the hypothesis development protocol evaluating the separate and combined roles of irrigation and PRP augmentation in a rabbit radius defect model. Irrigation was with commercially available pulse lavage. PRP was manually prepared with centrifugation and separation. Platelet concentration was compared to whole blood platelet concentration. PRP was combined with thrombin prior to insertion in the defect. Healing was assessed radiographically, histologically and with microCT. Intended power was not achieved due to animal loss (ulnar fracture and due to unrelated intestinal causes). Platelet concentration exhibited variability across all rabbits, from 2x to 8x. Histologic scoring and radiographic evaluation did not confirm that irrigation reduced healing potential, at 3 and 6 weeks, but sample number was compromised and results were not definitive. Future work will evaluate one time point, fibrinogen will be used to avoid quick activation of thrombin, and the ulnar defect will be considered to avoid inadvertent forearm fracture.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 2012
- Accession Number
- ADA581722
Entities
People
- Dean Tsukayama
- Joan Bechtold
Organizations
- Hennepin Healthcare Research Institute