WOUND CARE

Tap Water Versus Sterlised Water In Wound Care

Table Of Contents

Table Of Contents2

Introduction3

Background3

Methods8

Discussion8

Solutions, Techniques and Pressure for Wound Cleansing8

Critique12

Is tap water a safe alternative to normal saline for wound cleansing (4)?18

Sample Criteria21

Independent Variable21

Dependent Variables21

Critique25

Water for wound cleansing26

Critique28

Wound Cleansing: Water or Saline28

Critique30

Conclusion31

Tap Water Versus Sterlised Water In Wound Care

Introduction

There are several advantages of tap water that contribute to its success as an irrigant. Among these benefits are the much larger volume of fluid used from a faucet; the constant high-pressure flow supplied by most city water supplies; the cheap, plentiful supply of tap water; and the elimination of the need for extra supplies such as syringes, splashguards, and basins. The water supplies of most areas in the United States are chlorinated and monitored closely for pathogenic bacteria, so there is little reason to expect that the use of tap water would contribute to wound infection rates. Certainly, many minor wounds are irrigated with tap water daily in homes throughout the country without any adverse effects.

Most wounds can simply be placed under a faucet and irrigated for about 30 seconds. Warm or lukewarm water should be used for patient comfort. For wounds located on body parts that are awkward to place in a sink, a length of tubing can be attached to the faucet and used to reach the patient's laceration, or the more traditional water or saline in a basin may be employed.

Background

One observational study 16 questions the need for any irrigation of clean wounds on the face and scalp. These highly-vascularized areas generally have low rates of infection. Excluding high-risk patients (those with kidney disease, diabetes, immunocompromised state) and high-risk wounds (those with fascia or muscle involvement, overlying vital structures, open fractures, involvement of the intraoral mucosa, visible contamination, with foreign bodies present, with delayed presentation), the authors found no difference in the rate of infection between those repaired with and without irrigation. Also, wounds that were irrigated displayed a nonsignificant reduced likelihood of optimal cosmetic appearance at the time of suture removal. Local trauma from the process of irrigation may, in fact, contribute to scarring. This study certainly raises an important question about the need for vigorous irrigation of clean lacerations in areas not prone to infection. (Pettry, 2006 358).

Microbial factors that influence the establishment of a wound infection are the amount of bacterial pathogen, virulence, and inoculation site. When these factors are favorable to the pathogen, impaired host defenses set the stage for enacting the chain of events that produce wound infection (Pettry, 2006 364).

Most wounds are contaminated by the patient's own endogenous flora, which are present on the skin, mucous membranes, or hollow viscera (Pettry, 2006 362). The traditional microbial concentration associated with infection is a count higher than 10,000 organisms per cm2 of tissue. The most common pathogens on skin and mucosal surfaces are gram-positive cocci (notably staphylococci); however, gram-negative aerobes and anaerobic bacteria contaminate skin in the groin/perineal areas.( Singhal,2006)

The most common group of bacteria responsible for wound infections is Staphylococcus ...