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PubMed2006

[Effects of different irrigation modes on biological characteristics and water use efficiency of paddy rice].

With hybrid rice cultivar Liangyou Peijiu as test material, this paper studied its biological characteristics and water use efficiency under effects of four irrigation modes. Compared with continuous flooding irrigation, intermittent irrigation increased the leaf area index, photosynthetic rate and water use efficiency, and decreased the leaf transpiration rate. Semi-dry cultivation increased the leaf water use efficiency, while dry cultivation decreased the leaf area index, photosynthetic rate, and water use efficiency, and induced the leaf senescence in later growth period. Under intermittent irrigation, semi-dry cultivation and dry cultivation, the water consumption of paddy rice was 8. 75% , 17. 96% and 29. 69% lower, and its grain yield was 24. 02% higher but 5. 07% and 38. 93% lower than that under continuous flooding irrigation, respectively. The water use efficiency was the highest under intermittent irrigation, relatively high under semi-dry cultivation, but relatively low under continuous flooding irrigation and dry cultivation. Compared with other irrigation modes, intermittent irrigation increased the milled rice rate, head rice rate and grain length, while decreased the chalky rice and chalkiness. With the reduction of water consumption, the amylose content of rice grain decreased, but the gel consistency and protein content increased. Intermittent irrigation could be a favorable irrigation mode for the paddy rice planting in Southern China.

Agriculture↗
PubMed2003

Evaluation of canal cleanliness and smear layer removal after the use of the Quantec-E irrigation system and syringe: a comparative scanning electron microscope study.

OBJECTIVE: The purpose of this study was to evaluate canal cleanliness and smear layer removal after use of the Quantec-E irrigation system and to compare the system with traditional irrigation. STUDY DESIGN: Forty anterior teeth were randomly assigned to 4 groups. Group A consisted of 15 teeth that were instrumented with .12, .10, .08, .06 and .04 tapered rotaries while simultaneously irrigated via the Quantec-E irrigation pump with 12 mL of 5.25% NaOCl, followed by 6 mL EDTA 17% in crown-down fashion, with a final flush with 4 mL 5.25% NaOCl. Group B consisted of 15 teeth that were instrumented with the same instrument sequence, and irrigated with the same volumes via traditional needle and syringe. Group C consisted of 5 teeth that were sectioned and examined under a scanning electron microscope (SEM) without any instrumentation and served as a negative control. Group D consisted of 5 teeth that were instrumented dry, without any irrigation, and served as a positive control. All teeth were sectioned buccolingually and examined with SEM at 700x magnification in the apical, middle, and coronal portions of the canals. Analysis of SEM images was performed by 5 independent examiners using a 4-point scoring system. RESULTS: Irrigation with the Quantec-E irrigation pump resulted in cleaner canal walls, less debris, and more complete removal of the smear layer within the coronal one third, when compared with syringe irrigation. However, no difference was observed in the middle and apical one thirds of the root canal. CONCLUSION: There was no significant difference between the 2 irrigation systems.

Dental Pulp Cavity↗
PubMed2004

The effectiveness of syringe irrigation and ultrasonics to remove debris from simulated irregularities within prepared root canal walls.

AIM: To compare the ability of syringe irrigation and ultrasonic irrigation to remove artificially placed dentine debris from simulated canal irregularities within prepared root canals. METHODOLOGY: After canal enlargement, twelve canines were split longitudinally into two halves. On the wall of one half of each root canal a standard groove of 4 mm in length, 0.2 mm in width and 0.5 mm in depth was cut, 2-6 mm from the apex, to simulate uninstrumented canal extensions. On the wall of the other half, three standard saucer-shaped depressions of 0.3 mm in diameter and 0.5 mm in depth were cut at 2, 4 and 6 mm from the apex to simulate uninstrumented canal irregularities. Each groove and depression were filled with dentine debris mixed with 2% NaOCl to simulate a situation when dentine debris accumulates in uninstrumented canal extensions and irregularities during canal preparation. Each tooth was re-assembled by reconnecting the two halves, using wire and an impression putty material. Two per cent NaOCl was then delivered into each canal either using syringe irrigation (n = 8) or using ultrasonic irrigation (n = 8). Before and after irrigation, images of the two halves of the canal wall were taken, using a microscope and a digital camera, after which they were scanned into a PC as TIFF images. The amount of remaining dentine debris in the grooves and depressions was evaluated by using a scoring system between 0-3: the higher the score, the more the debris. The data were analysed by means of the Mann-Whitney U-test. RESULTS: Both forms of irrigation reduced the debris score significantly. The debris score was statistically significantly lower after ultrasonic irrigation than after syringe irrigation (P = 0.002 for grooves, P = 0.047 for depressions). CONCLUSION: Ultrasonic irrigation ex vivo is more effective than syringe irrigation in removing artificially created dentine debris placed in simulated uninstrumented extensions and irregularities in straight, wide root canals.

Cuspid↗
PubMed1996

Removal of surface bacteria by irrigation.

We examined the efficacy of various irrigation solutions delivered through a power irrigator to remove bacteria from three different surfaces. Titanium, stainless-steel, and cortical bone surfaces were coated with three different bacterial species: Staphylococcus aureus, Pseudomonas aeruginosa, and Staphylococcus epidermidis. They were then irrigated with 1 L of fluid delivered by jet lavage. The fluids tested were normal saline and solutions of bacitracin, neomycin, and soap. One set of specimens was not irrigated, as a control. After irrigation, the specimens were sonicated to remove residual bacteria, and the sonicate was quantitatively cultured to allow evaluation of the amount of residual bacteria on the surface. The results showed that removal of bacteria reflects an interaction between bacterial species, surface characteristics, and irrigation solution. Fewer bacteria were present in all the irrigation groups than in the control. Soap solution was as good as or better than any other solution at removing all three types of bacteria from all three surfaces, although not all of the pairwise comparisons were statistically significant. There was a significant advantage to soap solution over antibiotic irrigant or saline alone in removing Staphylococcus epidermidis from metallic surfaces. The use of soap solution for irrigation seems to improve the removal of some bacteria from some surfaces in this experimental model and may represent a better type of irrigation additive.

Anti-Bacterial Agents↗
PubMed1993

Irrigation does not dislodge or destroy tumor cells adherent to the tumor bed.

Local recurrences in the surgical bed after tumor resection may be due to residual tumor cells "dropping" into the wound. Irrigation with water is often used to remove these cells. We designed experiments to determine whether irrigation would prevent tumor recurrence. Surgical wounds of uniform size in C57BL/6 mice were seeded with 5 x 10(2), 5 x 10(3), 5 x 10(4), 5 x 10(5), or 5 x 10(6) viable syngeneic B16-F10 melanoma cells to test the hypothesis that irrigation with water would decrease local tumor recurrence. The tumor-contaminated wounds were irrigated with distilled water or with saline (0.9% NaCl) immediately or 5, 30, 60, 120, or 240 min after seeding. Control wounds were seeded but not irrigated. The technique of irrigation was altered in a second group of experiments such that the amount of time the tumor cells were exposed to the water or saline was 5, 10, or 15 min. To determine the rapidity and durability of tumor cell attachment to host tissue, 1 x 10(4) viable B16-F10 tumor cells were seeded in vitro onto freshly cut disks of syngeneic mouse dermis. The tissue was irrigated with saline or distilled water 0, 2, 5, 10, 15, 30, 60, 120, or 240 min later. Tumor growth was observed in all the mice and neither the mechanical action of irrigation nor the hypotonic effect of distilled water changed the rate of growth. Scanning electron microscopy (SEM) demonstrated stable and firm attachment to mouse tissue within seconds of seeding with no noticeable dislodgement or cytotoxicity by either saline or water irrigation. The data suggest that the commonly used technique of irrigating the bed of the resected tumor may not be of value in preventing local recurrences.

Animals↗
PubMed1994

Haemodynamic consequences of warm cardiac irrigation during cardiac surgery.

Following cardiopulmonary bypass (CPB) and prior to closing the chest, some surgeons irrigate the heart and pericardium with warm saline. This prospective study, using each patient as his own control, evaluated the haemodynamic effects of warm (44 +/- 5 degrees C) irrigation on the heart and pericardium following CPB. Following discontinuation of CPB, a Mon-a-therm model 6500 thermocouple monitor measured the myocardial septum and the irrigating fluid temperatures. Immediately before, during and two minutes after irrigation of the heart and pericardium, we measured heart rate (HR), systemic blood pressure (BP), pulmonary artery pressure (PAP), central venous pressure (CVP), thermodilution cardiac output, and calculated systemic vascular resistance (SVR). During warm irrigation, HR increased from 93 +/- 15 to 101 +/- 13 min-1 and systolic BP increased from 111 +/- 17 to 131 +/- 27 mmHg. After irrigation, HR decreased to 96 +/- 12 min-1 with no change in systolic BP. The calculated SVR after irrigation increased to 1117 +/- 413 dynes.sec.cm-5 from the pre-irrigation value of 821 +/- 243 dynes.sec.cm-5, while cardiac index decreased to 2.4 L.min-1.m-2 from its pre-irrigation value of 2.99 L.min-1.m-2. Warm irrigation of the pericardial pouch causes tachycardic and hypertensive responses in patients undergoing cardiac surgery.

Adult↗
PubMed2004

Is there a role for small-diameter ureteral access sheaths? Impact on irrigant flow and intrapelvic pressures.

OBJECTIVES: To evaluate irrigant flows and intrapelvic pressures with small-diameter access sheaths. Ureteral access sheaths improve irrigant flow and decrease intrarenal pelvic pressures during flexible ureteroscopy. However, no comparisons of individual sheaths have been conducted. Previous studies have demonstrated more favorable results with the 12F sheath than with the 10F sheath. METHODS: Ureteral access sheaths were tested ex vivo in porcine kidneys. An 18F angiocatheter was placed in the renal pelvis and connected to a Hewlett Packard Gauss Pressure transducer. Irrigant was maintained at 100 mm Hg pressure. Irrigant flow and intrapelvic pressures were measured with three flexible ureteroscopes at baseline and using each of four 10F sheaths, with the sheaths positioned in the middle ureter and the ureteroscopes positioned in the renal pelvis. The pressure at which irrigant efflux through the sheath occurred and the rate of irrigant efflux through the access sheath were measured. RESULTS: Intrapelvic pressures measured greater than 40 mm Hg, and irrigant flows remained at less than 15 mL/min when the Olympus URF-P3 and Storz 11274AAU flexible ureteroscopes were tested with all four sheaths. The intrapelvic pressures, irrigant inflow, and irrigant efflux with the Wolf 7325.172 (7.5F) flexible ureteroscope were optimized in combination with the Cook Peelaway 10F and Applied Access 10F sheaths. CONCLUSIONS: Small ureteral access sheaths should be used only with the Wolf 7325.172 flexible ureteroscope. The Cook Peelaway (10F) and Applied Access (10F) sheaths offered the greatest increase in irrigant flow and decrease in intrapelvic pressures.

Animals↗
PubMed2002

Thyroid hormone metabolism in pediatric cardiac patients treated by continuous povidone-iodine irrigation for deep sternal wound infection.

OBJECTIVE: The purpose of this study was to assess the influence of povidone-iodine mediastinal irrigation used for the treatment of deep sternal wound infection (DSWI) on thyroid function. METHODS: Thyroid function was studied in 18 pediatric cardiac patients treated with continuous povidone-iodine irrigation for DSWI. The median age of patients was 8 months (18 days-5.3 years). Serum concentrations of total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), reverse triiodothyronine (rT3) and thyroxine-binding globulin (TBG) were measured at three time points: (a) prior to mediastinal reexploration (before povidone-iodine exposure); (b) immediately after discontinuation of povidone-iodine irrigation; (c) 2 weeks after discontinuation of mediastinal irrigation. Urinary iodine excretion was examined on the last day of povidone-iodine exposure. RESULTS: Prior to the mediastinal reexploration, the median TT3 and TT4 levels were below the normal range, then increased significantly to concentrations within the normal range. The median serum FT3 levels were within the normal range throughout the observation period, though a significant increase of FT3 levels was observed after discontinuation of irrigation. The median serum FT4 concentrations were within the normal range prior to irrigation and did not change significantly. The median rT3 levels were within the normal range, close to upper normal limit. The median TBG levels were within the normal range throughout the observation period, though a significant increase of TBG levels was observed during the period of mediastinal irrigation. The median TSH level was within the normal range prior to mediastinal irrigation and did not change significantly. Urinary iodine concentrations in infants with povidone-iodine irrigation were significantly higher 6700 microg/l (range, 1600-15000 microg/l) than in the group of 53 healthy infants 200 microg/l (range, 20-780 microg/l, P<0,001). CONCLUSIONS: Our data showed that the use of povidone-iodine irrigation in the patients with DSWI has not lead to any significant alteration in thyroid function within the study period.

Anti-Infective Agents, Local↗
PubMed2001

Monitoring of irrigation fluid absorption during percutaneous nephrolithotripsy: the use of 1% ethanol as a marker.

This study was performed in 32 ASA I patients undergoing percutaneous nephrolithotripsy under general anaesthesia, using absorption of 1% ethanol as a marker to monitor irrigation fluid absorption. Various parameters of fluid absorption were studied and compared, including irrigation fluid volume, irrigation time, total volume of irrigation fluid absorbed and the rate of irrigation. The amount of irrigant used vs. the volume absorbed and the volume absorbed vs. total irrigation time were observed. Fluid absorption occurred in 78% of patients, and 28% absorbed volumes in excess of 1 l. The mean volume of fluid absorbed was 696.7 ml. The maximum fluid absorption was observed when the irrigation fluid volume, total irrigation time and irrigation rate exceeded 10 l, 30 min and 200 ml.min(-1), respectively. In conclusion, this study has shown 1% ethanol to be a safe, simple and cost-effective marker of fluid absorption during percutaneous nephrolithotripsy associated with minimal adverse effects.

Adult↗
PubMed1999

Effectiveness of neomycin/polymyxin bladder irrigation to treat resistant urinary pathogens in those with spinal cord injury.

Individuals with spinal cord injury (SCI) will sometimes develop bacterial organisms in the bladder that are resistant to oral antibiotics. This study evaluated the effectiveness of a 5-day course of intermittent neomycin/polymyxin bladder irrigation at eradicating or changing the bacterial sensitivity from parenteral to oral antibiotics. A chart review of individuals with SCI who were treated with neomycin/polymyxin bladder irrigations was performed. Inclusion criteria included the use of an indwelling catheter and the presence of asymptomatic bacteria resistant to oral antibiotics. The most common reason for treatment was eradication of resistant organisms prior to urologic testing. Bladder irrigation consisted of 3 rinses with 30 ml 3 times a day for 5 days. Pre- and post-urine samples were compared for white blood cells (WBCs), colony count and culture, and sensitivity. Chi-square tests were used to determine whether the proportion of changes in resistance or sensitivities was different from zero. The Wilcoxon Signed Rank Test was used to determine differences in bacteria, colony counts, and WBCs. Ten individuals were identified. A total of 12 neomycin/polymyxin irrigation treatments were evaluated because 2 individuals had a second series of irrigations at least 6 months apart. Nine of the 12 (75%) were considered to have successful irrigations because there was a change in culture sensitivity so that oral antibiotics would be effective post irrigation. This was statistically significant. There were no significant changes in colony counts or the number of WBCs. The authors concluded that while neomycin/polymyxin bladder irrigation did not change the type of organism, it was effective in changing resistance of most organisms. Individuals could then be treated with oral rather than intravenous or intramuscular antibiotics. Further work is needed to determine whether other variables, such as increased length of time of irrigation or increased frequency of irrigations, may actually eradicate the organisms.

Administration, Intravesical↗
PubMed2002

The biomechanical effect of high-pressure irrigation on diaphyseal fracture healing in vivo.

OBJECTIVES: To evaluate the effect of both high-pressure pulsatile lavage and bulb syringe irrigation on the biomechanical parameters of fracture healing using an in vivo open noncontaminated diaphyseal femoral fracture model in rats. BACKGROUND: The utility of high-pressure pulsatile lavage irrigation on soft tissue debridement has been extrapolated to a similar perceived benefit in the debridement of bone. However, there have been several reports of a possible deleterious effect that high-pressure pulsatile lavage may have on bone architecture, intramedullary bacterial and contaminant seeding, and fracture healing. Although a previous in vivo histologic study suggests damage to bone architecture and impairment of early bone formation, it remains unclear whether these microscopic findings translate to a detectable decline in the biomechanical strength of the healing fracture. To our knowledge, there have been no reports of the in vivo effects high-pressure pulsatile lavage on fracture healing in open diaphyseal fractures. MATERIALS AND METHODS: Using sterile technique, standard open transverse mid-shaft femur fractures were created in thirty-six rats randomized into three groups: a control group underwent retrograde intramedullary pinning only; a bulb syringe irrigation group and a high-pressure pulsatile lavage group underwent identical procedures as the control group, except that the osteotomy site was irrigated with bulb syringe irrigation and high-pressure pulsatile lavage, respectively, before insertion of the intramedullary pin. Six rats from each group were killed at three weeks and six weeks, and the femora was mechanically tested in bending. RESULTS: Mechanical testing of the thirty-six femora revealed that the peak bending force (17.7 +/- 10.2 N) and stiffness (21.2 +/- 5.1 N/mm) of the healing fracture in the high-pressure irrigation group were significantly lower at three weeks when compared with the control (peak force, 28.1 +/- 5.9 N; stiffness, 31.4 +/- 5.8 N/mm) and the bulb syringe (peak force, 27.7 +/- 3.3 N; stiffness, 23.6 +/- 4.5 N/mm) irrigation groups (p < 0.05). The 37 percent lower peak bending force and 32 percent lower stiffness in the high-pressure pulsatile lavage group after three weeks of fracture healing were not present in the femora tested at six weeks. The high-pressure pulsatile lavage group did reveal a trend toward a lower peak bending force and stiffness after six weeks of fracture healing when compared with the control and bulb syringe irrigation groups, but the differences were not statistically significant at the 95 percent level. CONCLUSIONS: The use of high-pressure pulsatile lavage in open noncontaminated diaphyseal femur fractures in rats has a significant negative impact on the mechanical strength of the fracture callous during the early phases (three weeks) of fracture healing. However, it appears that the early deleterious effect of high-pressure pulsatile irrigation is not apparent in the late phases (six weeks) of fracture healing. Further study is required to evaluate the effect of high-pressure pulsatile lavage on fracture healing in the presence of wound contamination, fracture comminution, and soft tissue damage. CLINICAL SIGNIFICANCE: The findings of this study suggest that selective use of high-pressure irrigation in the management of open fractures appears warranted. In situations in which high-pressure lavage may be deleterious to bone healing, alternative strategies that optimize bacterial removal from soft tissues while preserving bone architecture will need to be investigated.

Animals↗
PubMed2006

Traumatic wound debridement: a comparison of irrigation methods.

OBJECTIVES: To test wound debridement efficacy and soft tissue damage produced by high-pressure pulsatile lavage (HPPL), suction irrigation, and bulb syringe irrigation. DESIGN: Randomized trial in an in vitro model. SETTING: Medical school orthopaedic department. PATIENTS/PARTICIPANTS: No patients were used in this study. INTERVENTION: Beef flank steaks (100-g +/- 10-g) were divided into 8 test groups and incised uniformly. Four test groups were contaminated with 2 g of rock dust and 4 were not. The specimens were then treated as follows: nothing (control), bulb irrigation, suction irrigation, or HPPL. MAIN OUTCOME MEASUREMENTS: Runoff from the irrigation was collected, filtered, lyophilized, and ashed to allow for quantitative determination of organic and inorganic material removed from the wound by each irrigation method. Digital photographs of the tissue samples were subjected to blinded grading on a scale of 1 to 5 to assess macroscopic soft tissue damage. RESULTS: Qualitatively, tissue samples treated with HPPL consistently received worse grades for tissue damage than samples in any other experimental group. Quantitative soft tissue damage analysis revealed that significantly more organic material was removed from samples treated with HPPL (141.3 +/- 58.9 mg) than those treated with bulb syringe (50.7 +/- 28.6 mg) or suction irrigation (108.7 +/- 174.5 mg). Surprisingly, significantly less inorganic contaminant was removed from tissue samples treated with HPPL (1549.6 +/- 77.3 mg) than those treated with bulb syringe (1834.9 +/- 39.1 mg) or suction irrigation (1827 +/- 39.4 mg). CONCLUSIONS: There has been some concern regarding damage produced by HPPL. According to our quantitative soft tissue damage data, tissue treated by HPPL was damaged significantly more than tissue treated with bulb syringe or suction irrigation. Our qualitative tissue damage grade data showed that HPPL treated test groups appeared more damaged than other irrigation groups. Surprisingly, HPPL removed significantly less inorganic contaminant than other debridement methods, and it is proposed that HPPL may drive some contaminants deeper into the tissue rather than removing them. This study seems to support the concept that suction and sharp debridement, as practiced by most surgeons, may remove foreign bodies well without the use of HPPL.

Animals↗
PubMed1998

The tolerability of lactated Ringer's solution and BSS plus for ocular irrigation with and without the Morgan therapeutic lens.

OBJECTIVE: To evaluate two solutions, lactated Ringer's (LR) and a balanced salt solution (BSS Plus, Alcon Laboratories, Ft. Worth, TX), compared with normal saline solution (NSS), for ocular irrigation in healthy adult volunteers with and without the Morgan therapeutic lens (MTL). METHODS: This was a prospective, double-blind, randomized study of healthy volunteers who were at least 18 years of age. Exclusion criteria included the use of analgesics within four hours of the study. A complete ophthalmologic examination was performed at baseline and at the completion of the study. Following randomization and prior to any intervention, baseline discomfort scores were obtained by means of a verbally administered, horizontal, 100-mm, unnumbered analog discomfort scale. Both eyes of each volunteer were irrigated simultaneously for 15 minutes, with additional discomfort scores being recorded every 5 minutes using the same 100-mm, unnumbered analog discomfort scale. A global evaluation to assess the method of irrigation and the solutions used for irrigation was completed by both the physician blinded to the treatment groups and the volunteers. The volunteers were continuously monitored for any adverse effects resulting from the irrigation solutions or MTL. RESULTS: Sixty-three volunteers were recruited into the study, with 61 entered in the final analysis. Age and gender were balanced within each group. There was no significant difference in discomfort scores between the two groups; however, all discomfort scores decreased over time (p = 0.008). A lens-solution interaction was identified, with LR being the most tolerated when administered with the MTL. A statistically higher ocular pH difference was seen between the pre- and postirrigation readings for the control eye in volunteers irrigated with MTL (p = 0.046). Analysis of the global evaluations for each group revealed no difference in the distributions of physician and volunteer scores. No adverse event was reported in either group. CONCLUSION: There does not appear to be any difference in discomfort scores between the ocular irrigation fluids when used without the MTL. Overall, the use of the MTL appears well tolerated by healthy, adult volunteers. However, there does appear to be a significant lens-solution effect on volunteers' discomfort scores, with LR having significantly lower discomfort scores when used for ocular irrigation with the MTL. The authors conclude that the use of the MTL for ocular irrigation is well tolerated and recommend using LR as the irrigation solution for maximal patient comfort.

Acetates↗
PubMed1990

Clinical and microbiological effects of subgingival and gingival marginal irrigation with chlorhexidine gluconate.

Recent interest in the local delivery of antimicrobial and anti-inflammatory agents has stimulated interest in the efficacy of various treatment regimens. Chlorhexidine gluconate (CHX) delivered daily by home-applied marginal irrigation as a 0.04% solution in combination with a single professional irrigation of 0.12% CHX was tested over a 3-month period. Sixty periodontal maintenance patients each having at least 2 pockets greater than or equal to 4 mm probing depth, and bleeding on probing were assigned to either Group 1: one professional subgingival 0.12% CHX (Peridex) irrigation (Perio Pik) followed by adjunctive daily home marginal 0.04% CHX irrigation (Pik Pocket); Group 2: one professional subgingival 0.12% CHX irrigation followed by adjunctive daily home marginal water irrigation; Group 3: one professional subgingival water irrigation followed by adjunctive daily home marginal water irrigation; or Group 4: control. At baseline and 3 month visits, subgingival plaque samples were taken from 2 sites per patient. Cultural microbiological analysis was performed using non-selective and selective media. Plaque Index, Gingival Index, pocket probing depths, and gingival recession were assessed. Scaling and root planing (supportive periodontal treatment) was provided for each patient followed by subgingival irrigation as outlined above. At 3 months the Gingival Index and pocket probing depths were both significantly reduced (P less than .05) in all irrigation groups compared to baseline. There were no significant changes in clinical parameters in the control group from baseline to 3 months. In Group 1 the GI was significantly reduced (P less than .05) compared to Group 4 at 3 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Bacteremia following subgingival irrigation and scaling and root planing.

The purpose of this study was to determine the incidence of bacteremia after a single professional subgingival irrigation with a 0.12% chlorhexidine gluconate mouthrinse (CHX) as well as after a subsequent scaling and root planing (S/RP) during the same visit. Thirty subjects each with at least 1 site that probed 4 mm or more and bled on probing were randomly assigned to the following groups: 1) irrigation with 0.12% CHX; 2) irrigation with sterile water; and 3) non-irrigated controls. To begin the study blood was drawn just before and 2 minutes after irrigation. Thirty minutes later, blood was drawn again just before and 2 minutes after S/RP at the same site. Specimens were cultured for anaerobic and aerobic microorganisms using standard cultural techniques. Eighteen blood cultures from 15 subjects yielded positive cultures resulting in 23 isolates. Gram-positive rods comprised 34.8% of the total isolates; Gram-positive cocci 34.8%, Gram-negative rods 21.7%, and Gram-negative cocci 8.7%. In the CHX group, bacteremia was detected in 5 subjects after irrigation and in 2 other subjects after S/RP. In the water group, bacteremia was detected in one subject after irrigation and in 4 subjects after S/RP. The control group had 3 bacteremias after S/RP. There was no significant difference between the incidence of bacteremia associated with irrigation by CHX or sterile water (P = 0.141). There was also no significant difference in the incidence of bacteremia after S/RP between the CHX and sterile water irrigation groups and in patients who did not receive irrigation (control group) (P = 0.88).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

The role of subgingival irrigations in the treatment of periodontitis.

While the efficacy of oral irrigations with antimicrobial agents on the clinical and microbial parameters of gingivitis is well established, the study of the efficacy of intrapocket irrigants on periodontitis has yielded conflicting and inconclusive results regarding both clinical and microbiological parameters. The overall goal of this review paper is to summarize the available information on the efficacy of intrapocket irrigation in the treatment of patients with periodontitis. The following topics are addressed: 1) the penetrability of the irrigant; 2) pocket irrigation without scaling and root planing; 3) professional pocket irrigation following scaling and root planing; 4) irrigations between recalls; and 5) safety of intrapocket irrigation. Single irrigation of periodontal pockets for short periods of time before or after scaling and root planing has limited effects on periodontal healing. However, continuous irrigation of the periodontal lesion with agents such as povidone iodine during thorough scaling and root planing, such as that carried out under local anesthesia, has promise as an antimicrobial adjunct in periodontal therapy.

Anti-Infective Agents↗
PubMed1998

Heat generation during ultrasonic instrumentation of dentin as affected by different irrigation methods.

Heat is produced by magnetostrictive ultrasonic scalers which may cause injury to pulpal and periodontal tissues. Water coolant flows around the instrument stack and is directed at the instrument tip to reduce the generation of heat. Sound surgical practice requires the use of a sterile coolant for ultrasonic scaling during surgery. Intermittent bulb irrigation is one way to deliver sterile coolant when using ultrasonic scalers not equipped with a dedicated sterile water reservoir. The purpose of this study was to compare the temperature rise in dentin during ultrasonic scaling using either ultrasonic handpiece irrigation or intermittent bulb irrigation. Twenty dentin/cementum root slabs were prepared for each thickness of 0.5, 1.5, and 2.5 mm. A 3.0 mm x 1.5 mm field was outlined on each slab to indicate the area of intended instrumentation. Each slab was mounted such that a thermocouple placed in contact with dentin opposite the area of instrumentation was shielded from irrigation. Twenty samples of each thickness were ultrasonically scaled during which dentin temperature was recorded every 5 seconds over a 30-second period. All 60 slabs were first treated with dental unit ultrasonic handpiece water irrigation, followed by no irrigation, and finally by bulb irrigation with sterile saline. Repeated measures analysis of variance indicated that there were differences among the three treatment groups for temperature change over the course of the study (P < 0.001). Dentin temperature increased with both decreasing slab thickness and with increasing duration of instrumentation. However, only scaling without irrigation produced a rise in dentin temperature from baseline to a level reported as deleterious to pulpal and periodontal tissues. Bulb syringe irrigation delivered as a continuous drip and ultrasonic unit water spray minimized heat generation to physiologically tolerable levels. Intermittent bulb irrigation appears to be a satisfactory alternative to use of ultrasonic scaler water spray for cooling during ultrasonic scaling at surgery.

Analysis of Variance↗
PubMed1999

Contrast media radiography in patients with retrosternal irrigation drainage for severe sternal wound infection.

Severe wound infection after open-heart surgery is a potentially life-threatening complication, which is mostly treated by re-operation with debridement, and insertion of closed irrigation drainage. Until now there is no consensus about the appropriate duration of irrigation therapy. Since the retrosternal irrigation cavity is likely to become continually smaller as the infection heals, this study was intended to answer the question, as to whether this process can be made visible by the use of contrast media radiography, and whether this information could be used to determine when an irrigation therapy can safely be discontinued. In 1997, 34 patients suffered from sternal wound healing disturbances which required re-operation at our institution (incidence = 0.97%). During the re-operation, a closed retrosternal irrigation drainage was inserted. Of the 34 patients contrast media radiography examinations were carried out on the first, 4th and 12th postoperative day (POD), which consisted of an antero-posterior x-ray of the chest after contrast media injection through each inlet tube. At POD 4 and 12 in the majority of cases, the retrosternal irrigation cavity became smaller when compared with the previous x-ray examination. Only in three of the non-survivors there was a huge irrigation cavity visible at the 12th POD, which sometimes even included the pleural cavity. We conclude that in patients with mediastinitis treated by insertion of a closed irrigation drainage, the retrosternally irrigated cavity seems to become smaller over the therapeutic course of treatment. This process can be visualized by contrast media radiography. Results from this examination should be included in decision making about the best time for discontinuation of the irrigation therapy.

Anti-Infective Agents, Local↗