There is some debate in clinical circles about the potential advantages and disadvantages of cleansing solutions in wounds.
To identify and synthesize the best available evidence on the effectiveness of cleansing solutions for wound treatment in clinical practice.
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.
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).
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.
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.
International Journal of Evidence-Based Healthcare © 2014 The Joanna Briggs Institute