Open fractures: wound irrigation: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Open fractures: wound irrigation

Sample item

During debridement of an open tibial fracture, which type of irrigation is preferred?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Copious low-pressure irrigation with normal saline

Large volumes of low-pressure saline wash out contamination without driving bacteria and debris into the tissues. High-pressure lavage can damage bone and spread contamination deeper. Antiseptic additives are not shown to be better and can damage cells.

Option by option

  • A. Copious low-pressure irrigation with normal saline (correct)

    Correct. Low-pressure saline in large volume is the preferred method.

  • B. Povidone iodine soaks without saline

    Antiseptic soaking is not a substitute for saline irrigation.

  • C. High-pressure pulsatile lavage with antibiotic solution

    High pressure risks driving contamination into the tissue and harming bone.

  • D. Irrigation with hydrogen peroxide only

    Hydrogen peroxide alone is not adequate and is toxic to tissues.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Copious low-pressure irrigation with normal saline. Large volumes of low-pressure saline wash out contamination without driving bacteria and debris into the tissues.

Why is "Povidone iodine soaks without saline" not the answer?

Antiseptic soaking is not a substitute for saline irrigation.

Why is "High-pressure pulsatile lavage with antibiotic solution" not the answer?

High pressure risks driving contamination into the tissue and harming bone.

Why is "Irrigation with hydrogen peroxide only" not the answer?

Hydrogen peroxide alone is not adequate and is toxic to tissues.

What concept does this question test?

It tests Open fractures: wound irrigation in Orthopaedics. High-pressure lavage can damage bone and spread contamination deeper. Antiseptic additives are not shown to be better and can damage cells.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Open fractures: wound irrigation?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.