Rationale and Comments

Whirlpools are a non-selective form of mechanical debridement. Utilizing whirlpools to treat wounds predisposes the patient to risks of bacterial cross-contamination, damage to fragile tissue from high turbine forces, and complications in extremity edema when arms and legs are treated in a dependent position in warm water. Other more selective forms of hydrotherapy should be utilized, such as directed wound irrigation or a pulsed lavage with suction.

Sponsoring Organizations

• American Physical Therapy Association

Sources

• Institute for Clinical Systems Improvement guideline

Disciplines

• Surgical

References

• Institute for Clinical Systems Improvement (ICSI). Pressure ulcer prevention and treatment protocol. Health care protocol. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2012 Jan. 88 p.
  
• Association for the Advancement of Wound Care (AAWC) venous ulcer guideline. Malvern (PA): Association for the Advancement of Wound Care (AAWC); 2010 Dec. 7 p.
  
• Water use in hydrotherapy tanks [Internet]. Atlanta (GA): Centers for Disease Control and Prevention. 2009 Aug 10 [cited 2014 Apr 23]. Available from: http://www.cdc.gov/healthywater/other/medical/hydrotherapy.html.
  
• Berrouane YF, McNutt LA, Buschelman BJ. Outbreak of severe pseudomonas aeruginosa infections caused by a contaminated drain in a whirlpool bathtub. Clin Infect Dis. 2000;31(6):1331–7.
  
• McCulloch J, Boyd VB. The effects of whirlpool and the dependent position on lower extremity volume. J Orthop Sports Phys Ther. 1992;16(4):169–73.