PICO Research Paper Tap water vs. Saline

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Introduction

Proper cleansing is perhaps the key component for acute and chronic wound management. Cleansing methods differ among health care providers and institutions, and many times is based on an individual’s experience and preference. Many cleansing solutions exist today. In this research, the author focused on the use of tap water versus sterile cleansing solutions such as Normal Saline and sterile water. Many cleansing solutions are safe and have been proven to provide effective results, whereas others may damage the tissue, destroy cells, increase infection rates and delay the healing process.
Normal saline is regarded as the most appropriate and preferred cleansing solution by health care providers because it is nontoxic, isotonic solution that does not damage healing tissue. However, tap water is most commonly used among people, especially those that are discharged home and ordered to continue wound care at home. Tap water is cost effective and easily available, therefore of interest as a cleaning solution. Tap water showed to be as effective as any sterile solution in acute and chronic wound care.

As an emergency and trauma nurse, I am often involved in the care of acute traumatic wounds and chronic wounds as well. Many practitioners prefer the use of a sterile isotonic solution, such as Normal saline while irrigating and cleansing wounds. After many years working with traumatic and chronic wounds, I have wonder if there is significant evidence to argue the following PICO question: When caring for patients in need of wound care, does sterile isotonic saline reduce infection rate and shorten healing time when compared to tap water?
The following research will give us a better understanding on the use of sterile water versus tap water in the treatment of acute and chronic wounds from the emergency room perspective.
P- Patients with acute or chronic wounds that present to the ER for wound care. I- Using tap water for wound



References: Fernandez, R, Griffiths, R, Ussia, C. (2008). Water for wound cleansing. Cochrane Database of Systematic Reviews. Issue 1. Art. No:CD003861. DOI: 10.1002/14651858.CD003861.pub2. Weiss, E. (2012). Water is a safe and effective alternative to sterile normal saline for wound irrigation prior to suturing: a prospective, double-blind, randomized, and controlled clinical trial. British Medical Journal. http://bmjopen.bmj.com/content/3/1/e001504.full DOI: 10.1136/bmjopen-2012-001504. Ljubič, A. (2013). Cleansing chronic wounds with tap water or saline: a review. Journal Of Community Nursing. 27(1), 19-21. Bansal BC, Wiebe RA, Perkins SD. (2002). Tap water for irrigation of laceration. AM J Emerg Med.

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