اثر شستشوی با محلول های مختلف بر میزان بروز عفونت زخم

Introduction: Management of acute and chronic wounds has significantly altered in the last decade but little attention has been paid to the solution used for cleansing the wounds. Therefore, the present study aimed to compare the effects of tap water, distilled water, and normal saline for wound cleansing in emergency department. Methods: This is a double-blind randomized clinical trial with a 10-day follow up. Patients who had superficial wounds were randomly divided into 3 treatment groups: normal saline, distilled water, and tap water. The wounds were cleansed using a 20 - 60 milliliter syringe with an 18 gauge needle. All the patients were discharged with the same antibiotic and were followed 48 hours and 10-day to determine the presence or absence of infection symptoms. The evaluated outcomes were infection incidence in the first 48 hours and 10 days after being discharged. Results: 1200 patients were included in the present study (57% male, average age 25.5 ± 11.0 years). 43 (3.5%) patients showed infection symptoms in the first 48 hours. Ten (2.5%) patients were in normal saline treated group, 15 (3.7%) patients were in distilled water group, and 18 (4.4%) patients were in tap water treated group (p=0.32). 13 (3.2%) patients in normal saline group, 20 (4.9%) patients in distilled water group and 23 (5.6%) in the tap water group did not take their antibiotics. Prevalence of infection were higher in patients who did not take antibiotics (p < 0.001). The 10-day follow-up revealed that all the patients were recovered and showed no infection symptoms. Conclusion: The results of the present study showed that the prevalence of infection in using the 3 agents (normal saline, distilled water and tap water) for cleansing wounds was similar. Therefore, drinking water could be considered as an alternative for cleansing wounds.مقدمه: مدیریت زخم های حاد و مزمن در دهه اخیر تغییرات زیادی داشته اما توجه بسیار کمی بر نوع محلول مورد استفاده در شستشوی زخم شده است. بر این اساس مطالعه حاضر با هدف مقایسه بروز عفونت زخم در سه روش شستشوی زخم با نرمال سالین، آب مقطر و آب معمولی در مراجعین به اورژانس طراحی شد. روش کار: مطالعه حاضر یک کارآزمایی بالینی تصادفی شده دوسویه کور با پیگیری 10 روزه می باشد. در پژوهش حاضر موارد زخم های سطحی مراجعه کننده به اورژانس، به طور تصادفی توسط یکی از محلول های نرمال سالین، آب مقطر و آب معمولی شستشو داده شدند. تمامی بیماران با آنتی بیوتیک مشابه ای مرخص شدند و پس از 48 ساعت و 10 روز بیماران از نظر بروز احتمالی علایم پیگیری شدند. پیامدهای مورد ارزیابی شامل بروز عفونت و بهبودی طی 48 ساعت ابتدایی و 10 روز پس از ترخیص در نظر گرفته شد. يافته ها: در مطالعه حاضر 1200 بیمار وارد شدند (57/0 درصد مرد، میانگین سنی 11/0±25/5 سال). 43 (3/5 درصد) بیمار در پیگیری 48 ساعته علائم عفونت را نشان دادند. از این بین 10 (2/5 درصد) بیمار در گروه تحت درمان با نرمال سالین، 15 (3/7 درصد) بیمار در گروه آب مقطر و 18 (4/4 درصد) بیمار در گروه شستشو با آب معمولی بودند (0/32=p). سیزده (3/2 درصد) بیمار در گروه نرمال سالین، 20 (4/9 درصد) فرد در گروه آب مقطر و 23 (5/6 درصد) بیمار در گروه تحت درمان با آب معمولی از مصرف آنتی بیوتیک ممانعت کرده بودند (0/24=p). شیوع عفونت در بیمارانی بیشتر بود که از مصرف آنتی بیوتیک ممانعت کرده بودند (0/001>p). در نهایت نیز پیگیری 10 روزه نشان داد تمامی بیماران بهبودی یافته و هیچ علامتی از بروز عفونت در آنها مشاهده نشد. نتيجه گيری: یافته های مطالعه حاضر نشان داد شیوع عفونت در سه روش شستشوی زخم با نرمال سالین، آب مقطر و آب معمولی مشابه هم می باشد. بنابراین استفاده از آب آشامیدنی ممکن است به عنوان یک روش جایگزین در شستشوی زخم در نظر گرفته شود

Effects of irrigation with different solution on Incidence of Wound Infection

Introduction: Management of acute and chronic wounds has significantly altered in the last decade but little attention has been paid to the solution used for cleansing the wounds. Therefore, the present study aimed to compare the effects of tap water, distilled water, and normal saline for wound cleansing in emergency department. Methods: This is a double-blind randomized clinical trial with a 10-day follow up. Patients who had superficial wounds were randomly divided into 3 treatment groups: normal saline, distilled water, and tap water. The wounds were cleansed using a 20 - 60 milliliter syringe with an 18 gauge needle. All the patients were discharged with the same antibiotic and were followed 48 hours and 10-day to determine the presence or absence of infection symptoms. The evaluated outcomes were infection incidence in the first 48 hours and 10 days after being discharged. Results: 1200 patients were included in the present study (57% male, average age 25.5 ± 11.0 years). 43 (3.5%) patients showed infection symptoms in the first 48 hours. Ten (2.5%) patients were in normal saline treated group, 15 (3.7%) patients were in distilled water group, and 18 (4.4%) patients were in tap water treated group (p=0.32). 13 (3.2%) patients in normal saline group, 20 (4.9%) patients in distilled water group and 23 (5.6%) in the tap water group did not take their antibiotics. Prevalence of infection were higher in patients who did not take antibiotics (p < 0.001). The 10-day follow-up revealed that all the patients were recovered and showed no infection symptoms. Conclusion: The results of the present study showed that the prevalence of infection in using the 3 agents (normal saline, distilled water and tap water) for cleansing wounds was similar. Therefore, drinking water could be considered as an alternative for cleansing wounds