The effectiveness of cleansing solutions for wound treatment

Abstract

Background: 

There is some debate in clinical circles about the potential advantages and disadvantages of cleansing solutions in wounds.

Objective: 

To identify and synthesize the best available evidence on the effectiveness of cleansing solutions for wound treatment in clinical practice.

Methods: 

Inclusion criteria “Participants”: patients aged 18 years or more in any setting, excluding malnourished patients and with chronic and acute wounds, excluding obstetric wounds. Intervention: any cleansing or antiseptic solution or chemicals. Outcome: infection and healing rate.

Results: 

Three original articles were included and the interventions were: Tap water versus Sterile saline and Povidone-iodine-soaked gauze versus Saline-soaked gauze. A positive effect in the prevention of infection rates was observed in the tap water group (OR = 0.79; 95% Cl: 0.36, 1.72). For acute wounds, the odds ratio of developing an infection when cleansing with tap water compared with saline was 0.98 (95% CI: 0.43, 2.25).

Discussion: 

There were no statistically significant differences between the healing and infection rates in the wounds cleansed with tap water or normal saline. Therefore, tap water can be considered a safe and cost-effective alternative. There may be a trend towards a lower wound infection rate when povidone-iodine is used in surgical wounds, but this is not significant for varicose vein surgery.

Conclusion: 

There is some evidence that tap water reduces infection when compared to saline. There may be a trend towards a lower wound infection rate when povidone-iodine is used in surgical wounds. This review included few cleansing solutions, thus the evidence is not strong enough to produce a best practice. However, these findings have extreme relevance for clinical practice, and they should be put into practice and considered by health professionals.