Wound cleaning in orthopedic debridement is an important part of wound management. Pulse flushing (PL) is a flushing method that uses the principle of high-frequency pulses to form a high-speed jet of water with a certain pulse frequency to improve the debridement effect.
Normal wound healing needs to go through three overlapping stages, namely the inflammatory reaction stage, the hyperplasia or fibrosis stage and the reconstruction stage. In the inflammatory response phase of trauma, the blood vessel and cell responses can remove pathogenic microorganisms, foreign bodies and necrotic tissue in the wound; while in the proliferative phase, granulation growth and re-epithelialization of the wound occur; in the reconstruction phase, collagen fibers are deposited in the dermis, Make the wound surface stronger. If the body's inflammatory response is not enough to eliminate the pathogenic microorganisms in the wound, the wound will be infected, and the regeneration of blood vessels and the formation of granulation tissue will be delayed. Therefore, the purpose of orthopedic debridement includes removing all substances that may prevent wound healing (debridement or debridement), so that wound healing can progress from the inflammatory response phase to the hyperplasia or fibrosis phase as soon as possible.
The pulsating water flow of PL is generated by the electric water pump system. The first time this technology was applied to wound cleaning was in the 1960s. The US military created PL technology and conducted related research when dealing with a large number of war wounds. With the development of science and technology , This technology has been rapidly promoted in daily medical treatment. At present, many medical device companies have produced pulse irrigators, which are usually connected with suction devices to ensure that the irrigating fluid is absorbed while generating pulsed water flow in the wound area. Irrigation pressure is the most important factor affecting the effect of wound cleaning. The ability of PL less than 1psi to remove bacteria and debris is very limited and has no clinical value; PL between 5 and 10psi has the best effect on removing loose necrotic tissue and debris from the wound; The cleaning effect is better.
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