Infections in a wound can delay the healing process and in some cases lead to serious medical complications. Cleaning the wound with water is a normal process to decrease infection in both new and chronic wounds. The current process uses sterile saline water or water passed through a special sterilization system. The sterile water costs extra money or requires specialized equipment. In situations outside of a medical setting, sterile water is not always available.
A review of 11 wound-cleansing studies was published in the Cochrane Library. The review suggests that when it comes to wound cleansing, drinkable tap water may be a better solution. Water defined as drinkable tap water meets standards set by the Environmental Protection Agency (EPA) and is considered free from harmful bacteria and waste.
Researchers conducted a systematic review, a study that combines information from other studies to make one conclusion. This systematic review included 11 trials that assessed the infection rate of wounds after cleaning with tap water compared to sterile saline (salt) water in healthcare settings. The studies included adults and children with acute (recent) wounds, and patients with chronic wounds. There was another recent study, published in the Academy of Emergency Medicine , which was not included in this review. This study reviewed 715 adults who went to emergency rooms with simple lacerations. Patients were treated with wound irrigation (washing) with tap water or normal saline (salt) water.
Overall there was no increase in infection rate in patients who had wounds cleaned with tap water. In three trials with 1,338 adult patients, the infection rate was reduced with tap water. In two studies with 535 children, there was no difference in infection rate. In one study of patients with chronic wounds there was also no difference in infection rates.
In the separate study of 715 patients in the emergency room the infection rates were almost the same. The tap water group had a rate of 4% and the saline group had a rate of 3.3%.
This study suggests that drinkable tap water is at least as effective as saline water, in one case even better. In some situations, tap water is the only option, and this review suggests it is safe. The use of tap water can decrease medical care costs and the need for specialized equipment.
It is important to properly care for a wound to prevent infections. If you suspect a wound has become infected see your physician.
RESOURCES:
American Academy of Family Physicians
http://familydoctor.org
US Environmental Protection Agency
http://www.epa.gov/safewater
References:
Fernandez R. Griffiths R. Water for wound cleansing. Cochrane Database Syst Rev . 2008[1]:CD003861. Available at: http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003861/frame.html. . Accessed April 1, 2008.
Moscati RM, Mayrose J, Reardon RF, et al. A multicenter comparison of tap water versus sterile saline for wound irrigation. Acad Emerg Med . 2007;14:404-409.
Last reviewed May 2008 by Larissa J. Lucas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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