Should Acute Wounds Be Cleaned With Tap Water?

Researchers of The Cochrane Collaboration (Oxford, United Kingdom) considered data from eleven trials that compared rates of infection and healing in wounds when treated with various cleansing regimes. Seven trials were identified that compared rates of infection and healing in wounds cleansed with water and normal saline, three trials compared cleansing with no cleansing, and one trial compared procaine spirit with water. There were no standard criteria for assessing wound infection across the trials, which limited the ability to pool the data. The major comparisons were water with normal saline, and tap water with no cleansing. For chronic wounds, the relative risk of developing an infection when cleansed with tap water compared with normal saline was 0.16. Tap water was more effective than saline in reducing the infection rate in adults with acute wounds. The use of tap water to cleanse acute wounds in children was not associated with a statistically significant difference in infection when compared to saline. No statistically significant differences in infection rates were seen when wounds were cleansed with tap water or not cleansed at all. Likewise, there was no difference in the infection rate in episiotomy wounds cleansed with water or procaine spirit. The use of isotonic saline, distilled water, and boiled water for cleansing open fractures also did not demonstrate a statistically significant difference in the number of fractures that were infected. The study was published in the January 2008 issue of The Cochrane Library.

"The decision to use tap water to cleanse wounds should take into account the quality of water, nature of wounds, and the patient's general condition,” said lead author Ritin Fernandez, RN, MN, of the Australian Center for Applied Nursing Research (Liverpool NSW, Australia).

Cleaning wounds caused by injuries is part of standard medical care, but there is a debate on the matter, as research has shown that using a chemical-containing antiseptic may slow wound healing. Many people recommend saline (salt solution) instead, but others worry that this will wash away growth promoters and infection-fighting white blood cells. However, sterile saline is also not always available, and as an alternative, some suggest using drinkable tap water, or clean water that has been boiled.

The Cochrane Library is a collection of databases that contain independent evidence to inform healthcare decision-making. In addition to Cochrane reviews, The Cochrane Library provides other sources of reliable information, from other systematic review abstracts, technology assessments, economic evaluations and individual clinical trials.


Related Links:
The Cochrane Collaboration
Centre for Applied Nursing Research
The Cochrane Library