Intervention Review

Water for wound cleansing

  1. Ritin Fernandez1,2,*,
  2. Rhonda Griffiths3

Editorial Group: Cochrane Wounds Group

Published Online: 15 FEB 2012

Assessed as up-to-date: 14 DEC 2011

DOI: 10.1002/14651858.CD003861.pub3


How to Cite

Fernandez R, Griffiths R. Water for wound cleansing. Cochrane Database of Systematic Reviews 2012, Issue 2. Art. No.: CD003861. DOI: 10.1002/14651858.CD003861.pub3.

Author Information

  1. 1

    University of Wollongong, School of Nursing, Midwifery and Indigenous Health, Kogarah, New South Wales, Australia

  2. 2

    St George/Sutherland Hospitals and Health Services, Kogarah, Australia

  3. 3

    University of Western Sydney, School of Nursing and Midwifery, Penrith South DC, NSW, Australia

*Ritin Fernandez, ritin.fernandez@sesiahs.health.nsw.gov.au. ritin@uow.edu.au.

Publication History

  1. Publication Status: Edited (no change to conclusions), comment added to review
  2. Published Online: 15 FEB 2012

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 一般語言總結
  6. Plain language summary

Background

Although various solutions have been recommended for cleansing wounds, normal saline is favoured as it is an isotonic solution and does not interfere with the normal healing process. Tap water is commonly used in the community for cleansing wounds because it is easily accessible, efficient and cost effective; however, there is an unresolved debate about its use.

Objectives

The objective of this review was to assess the effects of water compared with other solutions for wound cleansing.

Search methods

For this fourth update we searched the Cochrane Wounds Group Specialised Register (searched 9 November 2011); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 4); Ovid MEDLINE (2010 to October Week 4 2011); Ovid MEDLINE (In-Process & Other Non-Indexed Citations, November 8, 2011); Ovid EMBASE (2010 to 2011 Week 44); and EBSCO CINAHL (2010 to 4 November 2011).

Selection criteria

Randomised and quasi randomised controlled trials that compared the use of water with other solutions for wound cleansing were eligible for inclusion. Additional criteria were outcomes that included objective or subjective measures of wound infection or healing.

Data collection and analysis

Two review authors independently carried out trial selection, data extraction and quality assessment. We settled differences in opinion by discussion. We pooled some data using a random-effects model.

Main results

We included 11 trials in this review. We identified seven trials that compared rates of infection and healing in wounds cleansed with water and normal saline; three trials compared cleansing with no cleansing and one trial compared procaine spirit with water. There were no standard criteria for assessing wound infection across the trials, which limited the ability to pool the data. The major comparisons were water with normal saline, and tap water with no cleansing. For chronic wounds, the risk of developing an infection when cleansed with tap water compared with normal saline was 0.16, (95% CI 0.01 to 2.96) demonstrating no difference between the two groups. The use of tap water to cleanse acute wounds in adults and children was not associated with a statistically significant difference in infection when compared to saline (adults: RR 0.66, 95% CI 0.42 to 1.04; children: RR 1.07, 95% CI 0.43 to 2.64). We identified no statistically significant differences in infection rates when wounds were cleansed with tap water or not cleansed at all (RR 1.06, 95% CI 0.07 to 16.50). Likewise, there was no difference in the infection rate in episiotomy wounds cleansed with water or procaine spirit. The use of isotonic saline, distilled water and boiled water for cleansing open fractures also did not demonstrate a statistically significant difference in the number of fractures that were infected.

Authors' conclusions

There is no evidence that using tap water to cleanse acute wounds in adults or children increases or reduces infection. There is not strong evidence that cleansing wounds per se increases healing or reduces infection. In the absence of potable tap water, boiled and cooled water as well as distilled water can be used as wound cleansing agents.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 一般語言總結
  6. Plain language summary

The effects of water compared with other solutions for wound cleansing

Water is frequently used for cleaning wounds to prevent infection. This can be tap water, distilled water, cooled boiled water or saline (salty water). Using tap water to cleanse acute wounds in adults does not increase the infection rate; however, there is no strong evidence that cleansing per se is better than not cleansing. The reviewers concluded that where tap water is high quality (drinkable), it may be as good as other methods such as sterile water or saline (salty) water (and more cost-effective), but more research is needed.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 一般語言總結
  6. Plain language summary

以水清洗傷口

背景

清水被頻繁的使用在清潔傷口以避免感染。這可以是自來水、蒸餾水、放涼的滾水或鹽水。成人身上使用自來水清潔急性傷口不會增加感染率;然而,沒有有力證據顯示清潔本身較不清潔好。審閱者結論是在自來水品質高(可飲用)之處,水之使用可能與其他方法一樣好,像是無菌水或鹽(鹹)水(且較具成本效益),但仍需要更多研究。

目標

本審閱目標是評估清水與其他溶劑在傷口清潔上的效果。

搜尋策略

就此第4次更新我們搜尋了考科藍創傷群組專業註冊(搜尋至2011年11月9日);考科藍對照試驗註冊(CENTRAL) (考科藍圖書館2011年第4期);Ovid MEDLINE (2010年到2011年10月第4周);Ovid MEDLINE (In-Process & Other Non-Indexed Citations,2011年11月8日);Ovid EMBASE (2010年到2011年第44周);與EBSCO CINAHL (2010 年到2011年11月4日)。

選擇標準

隨機與準隨機對照試驗中,採用比較了水與其他溶劑在傷口清潔上的使用。額外準則為包含有客觀與主觀傷口感染或癒合測量的果。

資料收集與分析

兩位審閱作者獨立執行試驗選擇、數據摘錄與品質評估。我們討論意見以平息差異。我們採用隨機效果模型集合一些數據。

主要結論

此審閱中我們採用了11個試驗。我們找出7個試驗,比較清水與生理鹽水清洗傷口的感染與癒合率;3個試驗比較有洗清與無洗清,而一個試驗比較procaine spirit與清水。沒有標準準則可在所有試驗評估傷口感染,這限制了集合數據的能力。主要比較是水與生理鹽水,以及自來水與無清潔。就慢性傷口而言,發展出感染的風險在自來水清潔與生理鹽水相比時為0.16,(95% CI 0.01 to 2.96)顯示兩群組間無差異。成人與兒童身上使用自來水來洗清急性傷口與生理鹽水比較時,並無發生感染的統計上顯著差異(成人:RR 0.66, 95% CI 0.42 to 1.04;兒童:RR 1.07, 95% CI 0.43 to 2.64)。自來水洗清與完全無洗清相比時我們在感染率中找出統計上顯著差異, (RR 1.06, 95% CI 0.07 to 16.50)。 同樣的,在外陰切開術中以清水或procaine spirit清潔傷口的感染率上無差異。使用等滲壓鹽水、蒸餾水、滾水在清潔開放性骨折上,也沒有在受感染的骨折數中顯示出統計上的顯著差異。

作者結論

沒有證據顯示在成人或兒童身上使用自來水清理急性傷口會增加或減少感染。沒有有力的證據顯示清潔傷口是否增加癒合或是減少感染。沒有自來水的地方、滾水與冷水以及蒸餾水當做傷口清潔劑的使用。

 

一般語言總結

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 一般語言總結
  6. Plain language summary

以水清洗傷口

清水與其他溶液比較,在傷口清潔上的效果

人們經常用水清洗傷口以避免感染──其型態可以是自來水、蒸餾水、開水或食鹽水(鹽水)。以自來水清洗成年人急性傷口的做法,不會提高感染率;然而,並未存在強力證據顯示傷口清洗本身比不清洗來得好。本回顧做出下列結論:在自來水水質較高(可飲用)的環境下,其效果可能和其他方法(如無菌水或食鹽水〔鹽水〕)一樣好(且成本效益較高),但仍需要更多的研究。

譯註

East Asian Cochrane Alliance 14th December, 2011 翻譯
翻譯由 台灣衛生福利部/台北醫學大學實證醫學研究中心 資助

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 一般語言總結
  6. Plain language summary

voda za čišćenje rana

Učinci vode u usporedbi s drugim otopinama za čišćenje rana

Kako bi se spriječila infekcija, voda se često koristi za čišćenje rana. To može biti voda iz slavine, destilirana voda, ohlađena flaširana voda ili fiziološka otopina (slana voda). Korištenje vode iz slavine za čišćenje akutnih rana u odraslih osoba ne povećava učestalost infekcija, međutim nema čvrstih dokaza da je čišćenje rana samo po sebi bolje od nikakvog čišćenja. Autori Cochrane sustavnog pregleda, nakon analiziranja 11 kliničkih pokusa, zaključuju da pitka voda može biti jednako dobra kao i druge metode za čišćenje rana, kao što su sterilna voda i fiziološka otopina (a uz to je i jeftinija). Ako nije dostupna pitka voda iz slavine, za čišćenje rana može se koristiti kuhana i flaširana voda, kao i destilirana voda.

Translation notes

Translated by: Croatian Branch of the Italian Cochrane Centre