SPLATTER DURING JET IRRIGATION CLEANSING OF A WOUND MODEL - A COMPARISON OF 3 INEXPENSIVE DEVICES

Study objective: Pressurized jet irrigation is commonly used to cleans e traumatic wounds but results in splatter of blood, a biohazard. Thre e inexpensive irrigation devices were compared to assess the degree of splatter produced: a 1.25-in. 18-gauge angiocath, an Irrijet Irrigati on System with a 12.7-cm splash shield, and a Zerowet Splashield held directly against the wound (Zerowet-C) and held 4 to 10 cm from the wo und, an incorrect technique (Zerowet-I). Design: A standard laceration was created in pieces of beef. This wound model was placed 1 m from t he floor. Paper grid sheets were placed on the irrigator's face and ch est. Six grid sheets were suspended at the 9:00, 12:00, and 3:00 posit ions 1 m from the wound model and 1 and 1.5 m from the floor to simula te exposure to nearby individuals. Two grid sheets were placed flat on the floor, at the 10:30 and 1:30 positions, 1 m from the base of the wound model stand. The study area was contained in a 3 x 2 x 2 m plast ic sheet enclosure to prevent air drafts. Intervention: Ten irrigation s were performed with the angio-cath, Irrijet, Zerowet-I, and Zerowet- C. Each run used 200 mL methylene blue solution delivered with a 50-mL syringe by one-hand pressure. The methylene blue splatter on each of the grids was counted by size (diameter, less than 1 mm, more than 1 m m and less than 5 mm, more than 5 mm and less than 10 mm, and more tha n 10 mm). Results: There was significantly less splatter onto the irri gator's face and chest with Irrijet, Zerowet-I, and Zerowet-C. No faci al splatter occurred with Zerowet-C. There was significantly less spla tter at the 9:00 and 12:00 positions at both heights, and on the floor with Irrijet, Zerowet-I, and Zerowet-C. Less significant splatter dif ference was noted at the 3:00 position. Conclusion: Irrijet, Zerowet-I , and Zerowet-C were superior to the angiocath in preventing splatter during this wound model irrigation. The correct use of Zerowet (Zerowe t-C) was particularly effective in preventing splatter onto the irriga tor's face.