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FLOW: A Trial of Wound Irrigation in the Initial Management of Open Fracture Wounds

  Faculty of Health Sciences - Department of Health Research Methods; Evidence & Impact,

  Mohit Bhandari (bhandam@mcmaster.ca), Brad Petrisor (petrisor@mcmaster.ca), PJ Devereaux (philipj@mcmaster.ca), Stephen Walter (walter@mcmaster.ca), Bill Ristevski (ristevski@HHSC.CA), Kris Rajaratnam (krishan.rajaratnam@gmail.com), Dale Williams (drdwilliams@gmail.com), Matthew Denkers (pottruffk@hhsc.ca), Drew Bednar (drdrewbednar@cogeco.net), Brian Drew (drewb@hhsc.ca), Paula McKay (mckayp@mcmaster.ca), Kim Madden (maddenk@mcmaster.ca)

  Status
Complete
  Start Date
January, 2012
  Countries
Australia, Canada, India, Norway, United States of America

The results of this trial were unveiled at the 2015 Orthopaedic Trauma Association Annual Meeting and published in the New England Journal of Medicine (NEJM). The FLOW trial is the largest randomized trial conducted to date in the field of orthopaedic trauma, and represents a major international effort to identify a simple, effective and easily applicable strategy for the management of open fracture wounds.The FLOW trial included 27 international sites from the United States, Australia, Norway, and India, and collaborators from Australia and India participated on FLOW committees

Impact

Our study has implications for patients with open fractures worldwide. Our findings are particularly relevant for low-income and middle income countries, in which 90% of the road traffic fatalities globally, and probably a similar percentage of open fractures, occur. In such contexts, the knowledge that there is no benefit to the use of irrigation-pressure devices can guide allocation of limited resources - a result that is very important for combat settings.

Student Experience

A Health Research Methodology graduate student was the project manager for FLOW. Through this experience she was able to learn to coordinate multinational large-scale trials, develop her international network, and contribute to several publications in high-impact journals, including a first-author paper in the top orthopaedic journal

Countries
Australia, Canada, India, Norway, United States of America
Impact
Research
Institutional Partner(s)
Canadian Institutes of Health Research, Greenville Hospital System
Community Partner(s)
Industry Partner(s)
Key Outcomes
Publications
Sponsorship
Federal
Foreign
Sponsorship Details
Supported by research grants from the Canadian Institutes of Health Research, the U.S. Army Institute of Surgical Research Orthopedic Trauma Research Program, U.S. Army Institute of Surgical Research Peer Reviewed Orthopedic Research Program, and Association Internationale pour l’Ostéosynthèse Dynamique.
MOU
Yes

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