Skip the soap when removing dead tissue from open fracture

February 24, 2016

For more than a hundred years, surgeons have known that open fractures (in which the bone protrudes from the skin) heal better if dead and damaged tissue is removed. However, there has been intense debate about how best to do this.

Now, a large international clinical trial published in the New England Journal of Medicine has finally laid this debate to rest. The trial compared two different salt solutions commonly used to flush out the wounded area and three different flushing pressures. Results show that flushing pressure made no difference, but patients who received a salt solution with soap were 32 percent more likely to require another operation than patients who received a plain salt solution.

As indicated in the journal’s editorial, the trial is expected to change practice around the world, benefitting patients and reducing health care costs.

Dr. Steven Papp led the Ottawa site of the trial and co-authored the publication. Dr. Papp is an orthopedic surgeon at The Ottawa Hospital and assistant professor at the University of Ottawa.

Authors: FLOW Investigators, Bhandari M, Jeray KJ, Petrisor BA, Devereaux PJ, Heels-Ansdell D, Schemitsch EH, Anglen J, Della Rocca GJ, Jones C, Kreder H, Liew S, McKay P, Papp S, Sancheti P, Sprague S, Stone TB, Sun X, Tanner SL, Tornetta P 3rd, Tufescu T, Walter S, Guyatt GH.

Funders: Canadian Institutes of Health Research, U.S. Army, Association Internationale pour l’Ostéosynthèse Dynamique, The Ottawa Hospital Foundation.

About The Ottawa Hospital

The Ottawa Hospital is one of Canada’s largest learning and research hospitals with over 1,100 beds, approximately 12,000 staff and an annual budget of over $1.2 billion. Our focus on research and learning helps us develop new and innovative ways to treat patients and improve care. As a multi-campus hospital, affiliated with the University of Ottawa, we deliver specialized care to the Eastern Ontario region, but our techniques and research discoveries are adopted around the world. We engage the community at all levels to support our vision for better patient care.

For further information, please contact

Jennifer Ganton
Director, Communications and Public Relations
Ottawa Hospital Research Institute
Office: 613-798-5555 x 73325
Cell: 613-614-5253