Saline water better than soap and water for cleaning wounds- Study

Patients were monitored to see who would need to have an additional operation within 12 months because of infection or problems with wound healing. The researchers found that very low water pressure was an acceptable, low-cost alternative for washing out open fractures, and that the reoperation rate was higher in the group that used soap.

“There has been a lot of controversy about the best way to clean the dirt and debris from serious wounds with bone breaks,” said Mohit Bhandari, principal investigator and a professor of surgery at McMaster University.

“All wounds need to be cleaned out — a process known as debridement — but evidence shows that cleaning wounds with soap was not better than just water, which was unexpected,” Bhandari said.

“These findings may have important implications for the care of patients with open fractures worldwide since developing countries deal with a disproportionate number of cases,” said Edward Harvey from McMaster University.

“Most of the time we were using soap and water with a high pressure delivery system to clean the wound, but now we don’t, and that makes the best practice much cheaper,” he said.

The study involved patients across 41 sites in the US, Canada, Australia, Norway and India. The majority of patients were men in their 40s with a lower extremity fracture, and the most common reason for the injury was a motor vehicle accident. The researchers said that their findings may be particularly relevant for low and middle income countries where 90 per cent of road traffic fatalities, and probably a similar proportion of open fractures occur.