Differences in Decreasing Bacteria Colonization Wound Irrigation using 0.9% Nacl Compared with Wound Irrigation using Active Ingredients Polyhexanide 0.1% and 0.1% Betaine in Open Fractures of Long Bone

Abstract

BACKGROUND: An open fracture is an emergency case that must be treated quickly to prevent infection. The use of an irrigation solution containing 0.1% of the antimicrobial polyhexanide and 0.1% of the surfactant betaine has been associated with more satisfactory wound healing.

AIM: This study was comparing irrigation with polyhexanide 0.1% and betaine 0.1% (P + B) in reducing bacterial colonization of open fractures compared to using 0.9% natrium chloride (NaCl) solution.

METHODS: This study uses a pre- and post-control group design. Sampling was carried out in the operation room of the emergency care installation, inpatient installation, and outpatient installation of prof. Hospital. Dr. I.G.N.G Ngoerah Denpasar, between September and  November  2022. From a sample population suffering from open fractures of the lower extremities, samples of patients were taken who were irrigated with 0.9% NaCl solution with a mixture of polyhexanide 0.1% and betaine 0.1%. The presence or absence of bacterial colonization was examined using a surgical wound base swab with the Levine technique.

RESULTS: In the 30 patients in this study, there was a significant decrease in bacterial levels (Log colony-forming unit [CFU]/g) after irrigation, both from irrigation with NaCl (p = 0.04) and NaCl + P + B (p < 0.001). The reduction in bacterial levels was more significant with NaCl + P + B compared with NaCl alone, at post-irrigation (p < 0.001), H+3 (p = 0.003), and H + 7 (p < 0.001).

CONCLUSION: Wound irrigation using a combination of 0.9% NaCl, 0.1% polyhexanide, and 0.1% betaine reduced bacterial colonization more than using 0.9% NaCl-only solution in open fractures of long bones.