Wound irrigation in children: saline solution or tap water?

[Guest guest]

what are you guys thoughts on this? NS or water for irrigation in am EMS

situation?

Wound irrigation in children: saline solution or tap water?

Valente JH, Forti RJ, Freundlich LF, Zandieh SO, Crain EF.

Department of Pediatrics, Division of Emergency Medicine, i Medical

Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.

STUDY OBJECTIVE: Irrigation, a critical component of wound management, is

commonly performed with sterile normal saline solution. The purpose of this

study was to compare the infection rates of wounds irrigated with normal

saline solution versus those of wounds irrigated with running tap water.

METHODS: A prospective trial was conducted in an urban pediatric emergency

department. Tap water pressure and flow rates were measured, and cultures

were obtained before the study and at 5 months after study initiation.

Patients 1 to 17 years of age presenting to the pediatric ED with a simple

laceration were eligible. Exclusion criteria included immunocompromise,

complicated lacerations, or current use of or need for antibiotics. Patients

were allocated to the running tap water group or the standard normal saline

solution irrigation group. Wounds were closed in standard fashion. Patients

returned to the pediatric ED in 48 to 72 hours for evaluation. RESULTS: Two

hundred seventy-one patients were enrolled in the normal saline solution

group and 259 in the tap water group. Tap water and normal saline solution

pressures and flow rates differed. The groups did not differ in terms of

patient demographic characteristics or wound characteristics. However, more

wounds were located on the hand in the tap water group (21.3%; 95%

confidence interval [CI] 16.3% to 27.1%) compared with those in the normal

saline solution group (9.2%; 95% CI 5.9% to 13.4%). The wound infection

rates were similar in the 2 groups (normal saline solution group: 2.8% [95%

CI 1.1% to 5.7%] versus running tap water group: 2.9% [95% CI 1.2% to

5.9%]). CONCLUSION: There were no clinically important differences in

infection rates between wounds irrigated with tap water or normal saline

solution. Tap water might be an effective alternative to normal saline

solution for wound irrigation in children.

I got this from

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=12712026 & dopt=Abstract & itool=iconabstr