Can tap water be used to irrigate wounds in A&E?
After critiquing the seven selected articles, it seems likely that tap water can be used as an irrigant and cleansing agent for soft-tissue wounds. However, the current research on tap water has involved human and rat wound studies and tap water culture studies (Dire, 1990; Riyat and Quinton, 1997; Moscati, 1998). The research is strong, but limitations in current research remain an issue for practice (Towler, 2000). The use of tap water is a cost and practicality issue, and changing current practice is always difficult, as it would seem that the use normal saline is more of a ritualistic process rather than one based on hard evidence (Glover, 1999). Two key conclusions could be drawn from the available research: The tap water tested was generally agreed to be safe from harmful bacteria and had no contaminating bacteria; Human and rat models showed a clear benefit in using tap water to cleanse soft tissue wounds, thus concluding tap water is safe for use on wounds (Towler, 2000). The financial benefits were also stated in the studies; tap water can have huge cost-saving potential for A&E departments. In an increasingly cost-conscious NHS this could be a major driving factor for changing practice. However, there were limitations in the methodologies of the selected articles in this critique. Most of the studies measured wound infection rates, but the various researchers did not take into account other factors affecting the likelihood of infection rates and wound progress which would ultimately affect wound infection rates by killing any bacteria in vivo.
O'Neill
Daniel
D
A&E Department, Frimley Park Hospital, Camberley, Surrey.
D016529:Emergency Nursing / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D015403:Nursing Evaluation Research; D012965:Sodium Chloride / Q000627:therapeutic use; D007507:Therapeutic Irrigation / Q000379:methods* / Q000451:nursing* / Q000592:standards; D016896:Treatment Outcome; D014867:Water; D014871:Water Microbiology; D014947:Wounds and Injuries / Q000451:nursing*
D014867:Water; D012965:Sodium Chloride