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“Normal isotonic (same concentration as blood or body fluids) saline (salt water) is generally favored to cleanse wounds. Two investigators from Australia studied the Cochrane Controlled Trials Register and four other major databases to report in 2008 on 11 randomized and quasi-randomized controlled trials that compared rates of infection and healing with water and saline, as well as no cleansing. Tap water was statistically more effective than saline at reducing infection rates in adults with acute (new) wounds and no different than saline in children. No statistical differences in infection rates were seen when wounds were cleansed with tap water or not cleansed at all. So you have lots of choices when confronted with an acute wound.” Wow!
This arouses a host of diverse, even impassioned thoughts. Were the wounds the same severity, depth, size or location? How were they cleansed? With a rag, under running water or by scrubbing? If you are a nurse, how can this sanctified surgical saline be no better than, even not as good as tap water? How much cheaper is tap water than a bottled product sold by a company, medical or otherwise? What about making your home saline with table salt?
No matter what discussion derives, it may be sort of pouring salt into the wound unnecessarily. The part about no cleansing being as good as tap water even flies into the face of maternal (Doctor Mom) intuition!
What could be more interesting and confusing are the 57 comments about this report that were posted on the Web site by doctors from around the world. Their responses were wider in opinion than I could imagine or list here. They ranged from “it changed my mind,” to disbelief, to questioning how the study of studies was done, to questioning appropriately all the nitpicking variables possible in any such attempt. A good point kept ringing through about the quality of water used, especially from countries where the only available water is routinely contaminated with human and/or animal waste products but still used for all purposes.
A lot of readers will, of course, snort and say balderdash. (I heard you. Don’t deny it.) The point that may be valid without much problem is that saline, sterile or not, just may not be necessary, as has been believed and taught. One doctor from a poor country commented how expensive bottled saline was compared to tap water, very meaningful in a country with scarce resources.
There was a subtle implication that all water used was from treated sources, like we so fortunately have in the U.S., Australia, New Zealand, etc. A majority of the world’s people do not have potable/drinkable water running freely from faucets. We are so blessed to have this resource. If it’s good enough to drink, it should be good enough to cleanse a kid’s boo-boo with it. We can’t be careless about infections, hand washing and the like, but we can be a bit practical and add a pinch of perspective instead of salt to this picture.
