Research Paper on Tap Water vs. Normal Saline for Wound Healing in Adults

Different solutions like normal saline and tap water help wound healing; however, proof of these interventions remains intricate across various studies (Chan et al., 2016). This paper intended to compare the treatment of wounds using ordinary tap water to using normal saline, and intervention that can lead to better and faster wound healing. The PICOT question, therefore, involves: in adult patients with open wounds, does the treatment using ordinary tap water compared to normal saline to lead to better and faster wound healing?

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Search Terms

Healing, open wounds, tap water, normal saline solution, cleansing, and adult patients.

Methodology

This paper employed logical assessments using databases explored in 2016 by MEDLINE, CINAHL, EMBASE, Nursing Collection, Cochrane Controlled Trials Register, Health STAR, and Cochrane Wounds Group Specialized Register. Extra reviews got conducted through reference lists of incorporated publications. Communication with researchers, organization agents, and content specialists got instigated to ascertain further eligible researches (Chan et al., 2016). Studies in various languages got included as long as they got quasi-randomized or randomized controlled tests of human subjects that equated the utilization of ordinary tap water with normal saline for wound treatment of adult patients with open wounds in any environment (Chan et al., 2016). Wound treatment refers to implementing fluids to eliminate loosely attached fragments and necrotic matter from the open wound surface.

The interventions, features of the subjects, follow-up, results, and conclusions were evaluated and verified from the various reviews. The main results quantity involved subjective and objective open wound infection. Secondary measures entailed fraction of healed open wounds in adult patients, healing rate, and patient and employee contentment (Santos et al., 2016). The approach involved methodical studies that evaluated adults under healthcare for their open injuries. Two analyses self-sufficiently vetted the abstracted information, literature, and examined research reliability through the AMSTAR (Assessment of Multiple Systematic Reviews) instruments.

Main Results

Specific appraisal criteria classified 11 reviews for the research, of which seven orderly appraisals got incorporated after selection while four entailed analytical studies devoid of a meta-analysis (Santos et al., 2016). The model sizes oscillated between 45 and 840 adult patients aged above 35 years (Santos et al., 2016). Primary and secondary results variables got identified and documented between weeks one and six after injury (Frees, 2018). Wound contamination was measured subjectively, such as purulent discharge, redness, smell, or pain in all seven research pieces, and one investigation employed blinded result evaluation (treatment solution deployed remained unknown to evaluators). The results indicated that 42.86 of incorporated assessments had a high-quality rating (AMSTAR tally ≥ 8) (Frees, 2018).

Out of adult patients with open surgical wounds in three reviews, there existed no major healing rates between treatment with ordinary tap water and normal saline (Frees, 2018). In one study, regular tap water minimized the relative risk of healing by 0.45 compared to normal saline to treat acute soft skin wounds that got soaked (Frees, 2018). Two reviews indicated no statistically significant recovery for the pressure ulcer patients when open wounds were cleaned with normal saline compared with ordinary tap water. However, two assessments for adult patients suffering from chronic open wounds indicated no escalation in curative wound rates or in infection between adult patients whose open wounds got treated with ordinary tap water or normal saline.

Four of the research showed that treating acute open injuries using regular tap water had no link with a statistically substantial variation in infection when equated to normal saline (Resende et al., 2016). Adult patients with open wounds showed that they considered ordinary tap water as more economical than normal saline. Besides, adult patients felt satisfied using regular tap water to treat their injuries (Resende et al., 2016). Two teams stated that the quality of ordinary tap water met the state's national health standards in which the information got sampled and that bacteria amounts remained low.

Discussion

High-quality proof shows that using ordinary tap water to treat open wounds in adult patients had little variation in better and faster wound healing than normal saline (Resende et al., 2016). The AMSTAR tool helped in examining the quality of analytical studies. However, several pieces of research showed consistent results throughout the reviews. Healthcare providers hardly utilize the outcomes to open wound treatment. The difference between the information people hold and the actions they undertake continues to remain a challenge for the healthcare sector and personnel (Huang & Choong, 2019). Evidence-based medicine stresses the idea that decisions remain partial and value-sensitive. Medical personnel must assess patients' preferences and values, particularly regarding joint decision-making.

Appropriate wound treatment settings can lead to better and faster wound healing. Cleansing approaches always vary among clinicians and hospitals. Different treatment solutions exist, and their choices should entail treatment success and the absence of cytotoxicity. Most washing solutions have proved effective and safe outcomes, while others may destroy and damage cells vital to the healing process (Huang & Choong, 2019). The normal saline cleansing solution remains the most preferred and suitable treatment solution because it remains an isotonic and nontoxic cleansing agent that does not destroy nor damage curative flesh.

Ordinary tap water gets generally utilized hence remain a remarkable cleansing agent. However, studies on regular tap water and normal saline solutions to treat open wounds in adult patients require more research. Some research indicates that ordinary tap water remains a commonly used cleansing agent for open wounds (Huang & Choong, 2019). However, there exists a high risk of harmful effects by using regular tap water. People across the globe have, for centuries, used ordinary tap water for cleaning open wounds without proof of severing effects or related infection risk. Such a history can prove that standard tap water seems a safety wound cleanser.

Conclusion

Different wound cleansing solutions exist across the world. However, there exist arguments that normal saline solutions have more preference due to its sterility and isotonicity. Most studies indicate a non-important difference in using ordinary tap water and normal saline to treat wounds in adult patients. Therefore, whether a patient uses regular tap water or normal saline, the outcome has no significant variation in the betterment or faster wound healing.

References

Chan, M. C., Cheung, K., & Leung, P. (2016). Tap water versus sterile normal saline in wound swabbing. Journal of Wound, Ostomy and Continence Nursing, 43(2), 140-147. www.ingentaconnect.com/content/wk/won/2016/00000043/00000002/art00007

Frees, K. E. (2018). Equine practice on wound management: Wound cleansing and hygiene. Veterinary Clinics: Equine Practice, 34(3), 473-484. www.vetequine.theclinics.com/article/S0749-0739(18)30045-2/abstract

Huang, C. Y., & Choong, M. Y. (2019). Comparison of wounds’ infection rate between tap water and normal saline cleansing: A metaanalysis of randomized control trials. International Wound Journal, 16(1), 300-301. www.onlinelibrary.wiley.com/doi/abs/10.1111/iwj.12980

Resende, M. M., Rocha, C. A., Corrêa, N. F., Veiga, R. R., Passos, S. J., Novo, N. F., ... & Damasceno, C. A. (2016). Tap water versus sterile saline solution in the colonization of skin wounds. International Wound Journal, 13(4), 526-530. www.onlinelibrary.wiley.com/doi/abs/10.1111/iwj.12470

Santos, E., Queirós, P., Cardoso, D., Cunha, M., & Apóstolo, J. (2016). The effectiveness of cleansing solutions for wound treatment: a systematic review. Revista de Enfermagem Referência, 4(9). www.researchgate.net/profile/Paulo_Queiros2/publication/303688352_

Appendix

Chan, M. C., Cheung, K., & Leung, P. (2016). Tap water versus sterile normal saline in wound swabbing. Journal of Wound, Ostomy and Continence Nursing, 43(2), 140-147. The authors provide an in-depth analysis of whether there are variations in wound contagion and healing proportions when open wounds are treated with ordinary tap water or normal saline.

Frees, K. E. (2018). Equine practice on wound management: Wound cleansing and hygiene. Veterinary Clinics: Equine Practice, 34(3), 473-484. The author confirms that ordinary tap water used to treat open wounds does not increase the risk of infection or delay healing.

Huang, C. Y., & Choong, M. Y. (2019). Comparison of wounds’ infection rate between tap water and normal saline cleansing: A metaanalysis of randomized control trials. International Wound Journal, 16(1), 300-301. The authors examine the cleansing of wounds using ordinary tap water to utilize normal saline through a meta-analysis of randomized control trials.

Resende, M. M., Rocha, C. A., Corrêa, N. F., Veiga, R. R., Passos, S. J., Novo, N. F., ... & Damasceno, C. A. (2016). Tap water versus sterile saline solution in the colonization of skin wounds. International Wound Journal, 13(4), 526-530. The authors of the article assess the irrigation of wounds using tap water and the impact on skin wounds colonization.

Santos, E., Queirós, P., Cardoso, D., Cunha, M., & Apóstolo, J. (2016). The effectiveness of cleaning solutions for wound treatment: a systematic review. Revista de Enfermagem Referência, 4(9). The authors followed a systematic review to identify and produce the best available suggestion on the usefulness of cleansing solutions for wound management.