ttaggart19 Posted August 17, 2015 Share Posted August 17, 2015 Are there studies that have been done to evaluate the need for sterile technique for dirty procedures, such as I&Ds and suturing in the ED? Obviously central lines and lumbar punctures need to be done with sterile technique but I have worked in different settings where one place will advocate for sterile technique while suturing and another will not. I have been unable to find any data supporting either side. Thanks Link to comment Share on other sites More sharing options...
andersenpa Posted August 17, 2015 Share Posted August 17, 2015 Which "dirty" wounds are you suturing? Link to comment Share on other sites More sharing options...
JustinPA Posted August 17, 2015 Share Posted August 17, 2015 Sterile versus nonsterile gloves for repair of uncomplicated lacerations in the emergency department: a randomized controlled trial. http://www.ncbi.nlm.nih.gov/pubmed/14985664 Link to comment Share on other sites More sharing options...
medic25 Posted August 17, 2015 Share Posted August 17, 2015 You beat me to it with the Perelman sterile glove study. There is also literature showing no benefit to using sterile saline for wound irrigation over simple tap water. Here's a review from thennt.com (great site BTW) showing some of the literature, including a Cochran Review. http://www.thennt.com/nnt/tap-water-for-wound-irrigation/ Link to comment Share on other sites More sharing options...
cbrsmurf Posted August 17, 2015 Share Posted August 17, 2015 i like these threads: frequent clinical problem, addressed with good references Link to comment Share on other sites More sharing options...
ttaggart19 Posted August 17, 2015 Author Share Posted August 17, 2015 Which "dirty" wounds are you suturing? I didn't say anything about suturing dirty wounds Link to comment Share on other sites More sharing options...
ttaggart19 Posted August 17, 2015 Author Share Posted August 17, 2015 Thanks guys. Nothing better than having studies to back up what you're doing. Link to comment Share on other sites More sharing options...
Nonlegit Posted August 18, 2015 Share Posted August 18, 2015 You beat me to it with the Perelman sterile glove study. There is also literature showing no benefit to using sterile saline for wound irrigation over simple tap water. Here's a review from thennt.com (great site BTW) showing some of the literature, including a Cochran Review. http://www.thennt.com/nnt/tap-water-for-wound-irrigation/ Love this study, it validates so much. What did we do when we were kids? Mom made you go "rinse it off real good." Turns out it wasn't such a bad idea. I'm instructed to have a lot more of my people that check in rinsing thoroughly in the sink as opposed to soaking in saline and betadyne these days. Link to comment Share on other sites More sharing options...
andersenpa Posted August 18, 2015 Share Posted August 18, 2015 Are there studies that have been done to evaluate the need for sterile technique for dirty procedures, such as I&Ds and suturing in the ED? Obviously central lines and lumbar punctures need to be done with sterile technique but I have worked in different settings where one place will advocate for sterile technique while suturing and another will not. I have been unable to find any data supporting either side. Thanks That's how I read it Link to comment Share on other sites More sharing options...
winterallsummer Posted August 19, 2015 Share Posted August 19, 2015 As a student I was told in Europe they don't use sterile technique for laceration repair. I'm unsure if that's true or not. Is anyone actually doing I&D as a sterile procedure? Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted August 26, 2015 Share Posted August 26, 2015 My general approach to both suturing (unless very large or complicated wound) and abscess drainage is to enter the room with a bottle of chlorhexidene. After the assessment, I ask the patient (or their parent if a child) to wash the area while I get the supplies ready for the procedure. I&D's are a clean, not sterile procedure. I use sterile technique +/- draping depending on location for suturing. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 27, 2015 Moderator Share Posted August 27, 2015 I have always done stapling and I+Ds as a clean procedure and suturing as a sterile procedure. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted August 27, 2015 Share Posted August 27, 2015 I have always done stapling and I+Ds as a clean procedure and suturing as a sterile procedure. I as well, while always in the back of my mind asking myself "Can you infect pus?" Sent from my iPad using Tapatalk Link to comment Share on other sites More sharing options...
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