Comparison Between Sterile Saline and Tap Water for the Cleaning of Acute Traumatic Soft Tissue Wounds.

OBJECTIVE:To find out if there were any differences in infection rates if acute traumatic soft tissue wounds were cleaned with tap water instead of sterile saline.DESIGN:Randomised study.SETTING:Emergency department at one city hospital.SUBJECTS:705 consecutive patient with soft tissue wounds less than six hours old that did not penetrate a viscus, cavity, or joint and could be treated by primary suture.INTERVENTIONS:Randomly allocated to have the wound cleaned with either sterile saline or tap water in addition to debridement.MAIN OUTCOME MEASURE:Rate of wound infection, the presence of which was indicated by pus in the wound and prolonged healing.RESULTS:The infection rate in wounds cleaned with sterile saline was 10.3% compared with 5.4% in wounds cleaned with tap water (p less than 0.05). Infected wounds were significantly larger than uninfected ones (p less than 0.05) and more likely to be located on a lower extremity (p less than 0.05). There were no microbiological differences between the two groups, and no bacterial species grown from tap water was subsequently grown from an infected wound.CONCLUSION:Sterile saline should be replaced by tap water for the cleaning of acute traumatic superficial soft tissue wounds.