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Is Pulse Lavage Still Relevant in Wound Care?

Jennifer A Gardner, PT, DPT, MHA, CWS

January 16, 2013

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Question

Is pulse lavage still being used? In what way?

Answer

Yes, pulse lavage is still being used regularly. It combines the mechanical debridement factor with negative pressure. I did use pulse lavage frequently in my first job. Harriet Loehne is one of the premier users of pulse lavage. She is down in Georgia, I believe, and she still uses pulse lavage a great deal for abdominal wounds, say after a morbidly obese person has a panniculectomy. If the patient is left with a very large abdominal wound, she may use pulse lavage for treatment. It gives a very effective cleaning of the wound, and then the negative pressure of the suction of the pulse lavage helps promote wound healing. It is good for undermined or tunneled areas.  There is an attachment that you can use that is like a really flexible straw.  You can put the straw into the undermining and the sinus tracking and get good cleaning of an area that you might not otherwise be able to reach.  

The problem with pulse lavage is that it can aerosolize the bacteria in the wound. Following pulse lavage, they have found that cultures of both the therapist and the patient’s noses were positive for the presence of the same bacteria as was in the patient's wound. This is because the therapist and the patient were both inhaling the bacteria that was aerosolized with the pulse lavage.  Instead of taking this valuable product off the market, the Centers for Disease Control came up with very specific guidelines for using pulse lavage.  It has to be a single patient room, and all horizontal surfaces either have to be covered or wiped down after the treatment.  Anyone in the room must wear full protective personal equipment.   Heads must be covered.  Feet must be covered.  Faces must be covered.  You have to wear a mask because of the bacteria. 

Pulse lavage kind of fell off the radar because of the time intensiveness of the treatment; it has to be a single patient room, and you have clean up well afterwards.  That is one reason why it is not used as regularly, but it is still out there.  If you want more information on it, you can Google “pulse lavage” and / or Google “Harriet Loehne."


jennifer a gardner

Jennifer A Gardner, PT, DPT, MHA, CWS

Dr. Gardner has been a physical therapist for 15 years with the last 10 concentrated solely on wound care. She became a Certified Wound Specialist in 2001 and recently successfully passed her re-certification in October 2011. Currently, Dr. Gardner is employed at Underwood-Memorial Hospital as the Manager of Wound Care Services, supervising both inpatient wound care and the outpatient wound center. In addition, she has been adjunct professor at College of St. Scholastica in Duluth, MN for the last 7 years, teaching Integumentary to doctoral physical therapy students.  Dr. Gardner has presented both nationally and internationally on various wound care topics and continues to participate in research studies on new concepts in wound healing.


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