Venous gas embolism following hydrogen peroxide irrigation during debridement of chronic osteomyelitis lesion

Shukrimi, A.; Aminudin, C.A.; Azril, M.A.; Hadi, M.R.A.

Medical Journal of Malaysia 61(Suppl A): 88-90

2006


ISSN/ISBN: 0300-5283
PMID: 17042238
Document Number: 10375
We report a case of a previously healthy 53-year-old man who developed an intrα-operative catastrophic event occurring in association with the use of hydrogen peroxide for wound irrigation following surgical debridement of a chronic osteomyelitis lesion of the humerus. It is our intention to highlight this potentially fatal consequence of hydrogen peroxide irrigation as part of bone debridement procedure. This case will serve as a reminder to orthopaedic surgeons who frequently use hydrogen peroxide in their surgical practice. Hydrogen peroxide is a potentially dangerous solution, particularly when it is used for irrigation of a semiclosed space such as medullary canal of the long bone. In such circumstance, hydrogen peroxide should not he used as a chemical adjunct to surgical debridement and/or securing hemostatsis because the evolved gas cannot be dissipated freely. Its clinical use should he restricted to a role as an adjunctive agent for wound encrusted with blood. Greater pre-emptive awareness among surgeons and anaesthetists for this potential iatrogenic consequence is important.

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Venous gas embolism following hydrogen peroxide irrigation during debridement of chronic osteomyelitis lesion