Non-Chilled Saline Irrigation Does Not Affect Postoperative Complication Rate in Percutaneous Foot and Ankle Surgery When Compared to Chilled Saline Irrigation

Category: Other; Midfoot/Forefoot Introduction/Purpose: The advent of minimally invasive percutaneous foot and ankle surgery techniques has helped lower certain complication rates, including wound infection and nonunion. The percutaneous burr is the working horse to perform these procedures. One concern with using the burr is that heat generated from prolonged use may induce bone thermal necrosis, affecting healing and outcomes. It is in contention whether further chilling the irrigation fluid may affect postoperative complication rates. Thus, the objective of this study is to assess the impact of chilled vs non-chilled saline during burr use on percutaneous foot surgery. Methods: Data was prospectively collected for 384 consecutive patients undergoing percutaneous foot and ankle surgeries at two separate facilities, treated with either non-chilled saline or chilled saline. Age, sex, complication rates, union rates and time to union data were collected. Categorical and numerical statistical analysis was performed. Results: 384 patients (chilled = 191, non-chilled = 193) were included. The mean age (SD) for all patients was 50.82 (14.28). Time to union took an average (SD) of 9.87 (3.59) weeks for the chilled saline group and 9.27 (2.91) weeks for the non-chilled saline group (P = .07). Union rates were 100% in the chilled saline group and 99.5% in the non-chilled saline group (P = .50). Complication rates were 1.6% in both the chilled and non-chilled saline groups (P = .65). The complications seen in the chilled saline group included one superficial wound dehiscence, and two delayed unions. The non-chilled saline group saw one non-union, one case of sural neuritis and one case of painful hardware removal. Conclusion: Based on the available data, no significant difference could be detected between chilled saline and non-chilled saline groups during burr use for percutaneous foot surgery when comparing union times, union rates and complication rates.