Pulse lavage is a medical technique using a pressurized, pulsating stream of sterile solution to clean wounds or surgical sites. It removes contaminants and prepares the area for optimal healing. It represents a specialized method of irrigation that effectively addresses various tissue and wound conditions.
What is Pulse Lavage
Pulse lavage is a medical procedure involving an electrically powered device that delivers an irrigating solution, typically sterile saline, in a pulsating manner. This system consists of a hand-held unit, a solution reservoir, and a mechanism for simultaneous suction. The device sprays sterile liquid onto the target area while simultaneously removing contaminated fluid and debris, maintaining a clean field. The concept behind this technique has evolved significantly since its initial adaptations from WaterPik units in the 1960s for combat wound irrigation.
How Pulse Lavage Cleans
Pulse lavage cleans by relying on the physical force of the pulsating stream. This intermittent pressure dislodges foreign materials, bacteria, and non-viable tissue from the wound surface, with the continuous flow then flushing contaminants away. The pulsating stream is effective because it creates alternating compression and decompression, loosening adherent debris more efficiently than a continuous stream. Controlled pressure and fluid flow allow for thorough cleaning, even in complex wound geometries, while minimizing the risk of pushing contaminants deeper into the tissue. An irrigation pressure between 4 and 15 pounds per square inch (psi) is generally recommended, as lower pressures may be ineffective and higher pressures could potentially cause tissue trauma or drive bacteria into the wound.
When Pulse Lavage is Used
Pulse lavage is used in various medical contexts to ensure thorough cleaning and reduce infection risk. In orthopedic surgeries, such as joint replacements or fracture repairs, it cleanses bone and surrounding tissues, removing debris or cement residues. For traumatic wounds, such as open fractures or deep lacerations, it aids in removing significant contamination. Chronic wounds, such as pressure ulcers or diabetic foot ulcers, also benefit from debridement, preparing the wound bed for healing. It is also applied in burn care to remove necrotic tissue and bacteria from burn wounds.
Patient Considerations and Safety
Patients undergoing pulse lavage often receive anesthesia or sedation for comfort. Post-procedure care involves wound dressing changes to support healing. Maintaining sterile technique is important to prevent new infections. Trained medical professionals carefully perform pulse lavage, adjusting pressure settings based on the wound’s sensitivity and the amount of debris present. Warming the saline solution to room temperature before use can help prevent the procedure from slowing down the wound healing process.