Water for wound cleansing.

Area of Science:

• Wound care and management
• Infection control
• Evidence-based medicine

Background:

• Normal saline is a preferred wound cleansing solution due to its isotonic properties.
• Tap water is widely used in community settings for wound cleansing due to accessibility and cost-effectiveness.
• The efficacy and safety of tap water for wound cleansing remain subjects of debate.

Purpose of the Study:

• To assess the effects of different types of water for wound cleansing.
• To compare water-based cleansing with no cleansing or other solutions like normal saline.

Main Methods:

• Conducted a systematic review of randomized controlled trials (RCTs).
• Searched multiple databases including Cochrane Wounds, CENTRAL, MEDLINE, Embase, and CINAHL Plus up to May 2021.
• Included 13 RCTs involving 2504 participants with various wound types.

Main Results:

• Cleansing with tap water showed little or no difference in wound healing compared to no cleansing (low-certainty evidence).
• The effects of tap water, distilled water, or cooled boiled water compared to normal saline on wound infection and healing were uncertain (very low-certainty evidence).
• Limited data were available for other outcomes such as wound size reduction, pain, and patient satisfaction.

Conclusions:

• The current evidence, all of low or very low certainty, suggests tap water may not significantly impact wound healing compared to no cleansing.
• There is insufficient evidence to determine the effects of tap water, distilled water, or cooled boiled water compared to saline for wound cleansing.
• Further high-quality research is needed to clarify the role of different water types in wound care.