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Randomized Controlled Trial
. 2018 Jan;100-B(1):88-94.
doi: 10.1302/0301-620X.100B1.BJJ-2017-0955.R1.

Wound irrigation does not affect health-related quality of life after open fractures: results of a randomized controlled trial

S Sprague  1 , B Petrisor  1 , K Jeray  2 , P McKay  1 , D Heels-Ansdell  1 , E Schemitsch  3 , S Liew  4 , G Guyatt  1 , S D Walter  1 , M Bhandari  1 ; FLOW Investigators
Collaborators, Affiliations
Randomized Controlled Trial

Wound irrigation does not affect health-related quality of life after open fractures: results of a randomized controlled trial

S Sprague et al. Bone Joint J. 2018 Jan.

Abstract

Aims: The Fluid Lavage in Open Fracture Wounds (FLOW) trial was a multicentre, blinded, randomized controlled trial that used a 2 × 3 factorial design to evaluate the effect of irrigation solution (soap versus normal saline) and irrigation pressure (very low versus low versus high) on health-related quality of life (HRQL) in patients with open fractures. In this study, we used this dataset to ascertain whether these factors affect whether HRQL returns to pre-injury levels at 12-months post-injury.

Patients and methods: Participants completed the Short Form-12 (SF-12) and the EuroQol-5 Dimensions (EQ-5D) at baseline (pre-injury recall), at two and six weeks, and at three, six, nine and 12-months post-fracture. We calculated the Physical Component Score (PCS) and the Mental Component Score (MCS) of the SF-12 and the EQ-5D utility score, conducted an analysis using a multi-level generalized linear model, and compared differences between the baseline and 12-month scores.

Results: We found no clinically important differences between irrigating solutions or pressures for the SF-12 PCS, SF-12 MCS and EQ-5D. Irrespective of treatment, participants had not returned to their pre-injury function at 12-months for any of the three outcomes (p < 0.001).

Conclusion: Neither the composition of the irrigation solution nor irrigation pressure applied had an effect on HRQL. Irrespective of treatment, patients had not returned to their pre-injury HRQL at 12 months post-fracture. Cite this article: Bone Joint J 2018;100-B:88-94.

Keywords: Health-related quality of life; Irrigation pressure; Irrigation solution; Open fractures.

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Figures

Fig. 1
Fig. 1
Short Form (SF)-12 scores (physical component score (PCS) and mental component score (MCS)) over time by solution.
Fig. 2
Fig. 2
Short Form (SF)-12 scores (physical component score (PCS) and mental component score (MCS)) over time by pressure.
Fig. 3
Fig. 3
EuroQol-5 Dimensions (EQ-5D) utility scores over time by solution and by pressure.
See this image and copyright information in PMC

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