High and Low Pressure Pulsatile Lavage of Contaminated Tibial Fractures: An In Vitro Study of Bacterial Adherence and Bone Damage

OBJECTIVE: This study was designed to examine the effect of pulsatile irrigation on microscopic bone architecture and its time-dependent efficacy in removing adherent slime-producing bacteria from cortical bone. DESIGN: Using an in vitro model, ten-millimeter transverse cut sections from five human tibiae were contaminated with Staphylococcus aureus and subjected to either high pressure pulsatile lavage (HPPL; seventy pounds per square inch, …