Cleaning wounds with salt water works better than soap and water

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 Surgery nurse
A surgery nurse washes her hands before starting procedures to clean the wound of an amputee patient with MRSA (Methicillin resistant Staphylococcus Aureus) in the prep-room next to the operating theatre at the Unfallkrankenhaus Berlin (UKB) hospital in Berlin February 29, 2008. MRSA is an antibiotic resistant so-called 'super-bug', which can cause deadly infections. Reuters/Fabrizio Bensch

Using saline water has been found to be more effective in cleaning wounds than soap and water. A new study suggests that the use of salt water solution might significantly help patients with open fractures, leading to significant cost savings especially in developing countries.

Researchers from McMaster University and Research Institute of the McGill University Health Centre observed patients for 12 months to see who would require an additional operation due to infection or problems with wound healing after using either saline water or soap and water. Results show that use of soap and water to clean open wounds promoted higher rate of additional operation compared with saline water.

The study, published in the New England Journal of Medicine, involved patients from the US, Canada, Australia, Norway and India. The findings come from the analysis of the effects of saline water solution and the combination of soap and water on 2,400 people with open arm or leg fractures.

"There has been a lot of controversy about the best way to clean the dirt and debris from serious wounds with bone breaks," said Dr Mohit Bhandari, lead researcher and a professor of surgery at McMaster. "All wounds need to be cleaned out -- a process known as debridement -- but evidence shows that cleaning wounds with soap was not better than just water, which was unexpected."

The researchers believe that low and middle income countries would significantly benefit from the findings as they cover 90 percent of road traffic fatalities.

"These findings may have important implications for the care of patients with open fractures worldwide since developing countries deal with a disproportionate number of cases," said Dr Edward Harvey, chief of Orthopaedic Trauma at the McGill University Health Centre and a professor of surgery at McGill University.

Moreover, wounds are commonly cleaned with soap and water with a high pressure delivery system. However, the researchers also found that very low water pressure could be an acceptable, cheaper alternative to clean open fractures.

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