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.