Hashim, Anas Amri
(2015)
A pilot study of sterile saline versus reverse osmosis water in traumatic laceration wound cleansing in Emergency Department in Hospital Universiti Sains Malaysia, Kelantan and Hospital Tengku Ampuan Afzan, Pahang.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction: Traumatic laceration wound is a common reason for people seeking treatment
in emergency care setting. As for current practice, sterile saline is still the most common
agent used in cleansing or irrigating the wound in the emergency department. In overseas,
there have been studies on alternative cleansing agent particularly tap water, which have
showed equal or better outcomes in term of wound infection. There is no previous study been
conducted on wound cleansing using Reverse Osmosis water.
Objectives: To compare the rate of wound infection between sterile saline and reverse
osmosis water cleansing for traumatic laceration wound.
Method: This study was a multicenter, prospective, randomised controlled trial conducted at
two tertiary hospitals. Subjects were a convenience sample of adults presenting with acute
simple traumatic laceration requiring wound cleansing. They were randomized using block
randomization method to irrigation with ‘sterile saline’ or ‘reverse osmosis’ water. Wounds
were closed in the standard fashion. Follow-ups were done on day 5 and 14 after the
intervention to assess for outcome or wound infection
Results: A total of 48 patients (n=48) were selected and randomised into RO water group
(n=24) and Saline group (n=20) (4 patients withdrew). The infection rate for sterile saline
cleansing was 5% (95% CI -4.55%, 14.55%) compared to RO cleansing which was 4.17%
(95% CI -3.83%, 12.17%). Relative risk for RO water group was 0.834 (95%CI 0.056,
12.494) compare to saline group. Fisher’s Exact test showed no significant effect on type of
cleansing agent on wound infection.
Conclusion: There was no significant difference between reverse osmosis and saline on
wound infection. Reverse osmosis water can be considered as alternative cleansing agent to
sterile saline in acute uncomplicated traumatic laceration wounds.
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