At our institution, the laparoscopic irrigator aspirator (LIA) is used as the primary means of irrigation in open fractures, as it allows for quicker and more efficient irrigation. The purpose of this technical trick is to evaluate the cost and time savings between gravity tubing, pulse lavage, and LIA methods.
Materials and Methods:
The 3 different methods of irrigation, gravity tubing, pulse lavage, and LIA, were set up, and the time to use one 3 L bag of normal saline was recorded for each. The list prices for each method of irrigation were obtained, and the time and cost saved per 3 L bag was multiplied by 3 for the total time and cost 9 L of irrigation.
The LIA was the most efficient irrigation method and saved 303 seconds over gravity and 534 seconds saved over pulse lavage over 9 L. For cost, the laparoscopic resulted in $156.15 saved over gravity and $332.80 saved over pulse lavage over 9 L when accounting for cost of operating room time and cost of implant. At our institution, 34 open tibia fractures were treated in 2019, which results in 2.86 hours and $5309.10 saved over gravity and 5.04 hours and $11,315.2 saved over pulse lavage by using the LIA.
Lap irrigation is a viable alternative to gravity tubing and pulse lavage for open fracture irrigation and results in both time and cost savings.