A multicenter comparison of tap water versus sterile saline for wound irrigation.
OBJECTIVE
To compare wound infection rates for irrigation with tap water versus sterile saline before closure of wounds in the emergency department.


METHODS
The study was a multicenter, prospective, randomized trial conducted at two Level 1 urban hospitals and a suburban community hospital. Subjects were a convenience sample of adults presenting with acute simple lacerations requiring sutures or staples. Subjects were randomized to irrigation in a sink with tap water or with normal saline using a sterile syringe. Wounds were closed in the standard fashion. Subjects were asked to return to the emergency department for suture removal. Those who did not return were contacted by telephone. Wounds were considered infected if there was early removal of sutures or staples, if there was irrigation and drainage of the wound, or if the subject needed to be placed on antibiotics. Equivalence of the groups was met if there was less than a doubling of the infection rate.


RESULTS
A total of 715 subjects were enrolled in the study. Follow-up data were obtained on 634 (88%) of enrolled subjects. Twelve (4%) of the 300 subjects in the tap water group had wound infections, compared with 11 (3.3%) of the 334 subjects in the saline group. The relative risk was 1.21 (95% confidence interval = 0.5 to 2.7).


CONCLUSIONS
Equivalent rates of wound infection were found using either irrigant. The results of this multicenter trial evaluating tap water as an irrigant agree with those from previous single institution trials.
Moscati
Ronald M
RM
Department of Emergency Medicine, State University of New York at Buffalo, USA. moscati@buffalo.edu
Mayrose
James
J
Reardon
Robert F
RF
Janicke
David M
DM
Jehle
Dietrich V
DV
D000328:Adult; D004636:Emergency Service, Hospital; D005260:Female; D005618:Fresh Water; D006801:Humans; D022125:Lacerations / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D012965:Sodium Chloride; D007507:Therapeutic Irrigation / Q000379:methods*; D014946:Wound Infection / Q000517:prevention & control
D012965:Sodium Chloride