Medical wound irrigation systems are described that may be used in environments such as hospitals and first aid stations, and for military applications, e.g., for medics and along transport routes for the wounded. The irrigation systems can provide continuous variable pressure for irrigating a wound. For example, in some embodiments, a medical irrigation system can be used to provide a steady pressure level while irrigating about one liter of solution in less than about one minute, e.g., to assist during wound irrigation and debridement. The medical irrigation system may include an air-powered irrigation device, which pressurizes an irrigation solution, such as a cleansing fluid, to create an ejection force. In some embodiments, the medical irrigation system can include a replaceable bottle cap with an inlet for connecting to a source of pressurized fluid (e.g., pressurized gas, such as pressurized air) and an outlet for the irrigation solution/cleansing fluid.