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The Bitt-er Truth: A Comparative Review of Efficacy, Safety, and the Real Cost of Bite Wound Irrigation
Poster
Talk Description

Institution: Nepean Hospital - NSW , Australia

Background: Clinical practice for bite wound irrigation remains highly heterogeneous, often driven by institutional tradition or surgeon preference rather than standardized evidence. Given the high risk of polymicrobial infection from dog, cat, and human bites, selecting an optimal irrigant is critical for both clinical outcomes and resource stewardship. Objectives: To evaluate the comparative efficacy, safety profiles, and cost-effectiveness of Povidone-iodine (PI) 10%, Chlorhexidine 0.015% with Cetrimide 0.15% solution, Hydrogen Peroxide (H2O2) 3%, and Sodium Chloride (NS) 0.9%. Methods: A narrative review was conducted to synthesize current data on infection rates and antimicrobial activity. The review specifically examines the challenges posed by distinct bite organisms Results: Each irrigant presents a unique profile of benefits and risks. Povidone-iodine offers rapid, broad-spectrum activity but faces concerns regarding fibroblast toxicity at high concentrations. Chlorhexidine/Cetrimide provides persistent antimicrobial action but carries risks of ototoxicity and ocular irritation. Hydrogen Peroxide is assessed for its mechanical debridement via effervescence against its potential for tissue damage and air embolism. Finally, Sodium Chloride serves as the benchmark for safety and volume-based mechanical clearance, though it lacks intrinsic bactericidal properties. Significant cost variations were noted, with specialized antiseptics costing substantially more per unit volume than standard saline. Conclusion: Choosing the correct irrigant requires balancing the specific microbiology of the bite against the chemical risks of the agent. By centralizing this data into a quick-reference summary, this poster provides a pragmatic tool to move beyond "surgeon preference" and toward a standardized, evidence-based approach to wound washout.
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Dr Kaveenesh Robert - , Dr Jake Hindmarch - , Dr Odette Snazelle - , Dr Sina Sobhanmanesh -

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