Tap Water vs. Sterile Saline for Wound Irrigation.

Narrative: Various solutions are available for use in wound irrigation. It has been suggested that normal saline may be preferable because of its isotonicity and sterility. This review examines tap water as an alternative to normal saline for wound cleansing and prevention of subsequent infection. A Cochrane review, including three studies of adults and two studies of children, compared the rates of acute infection from the use of these two solutions for acute wound cleansing.1 In adults (1,328 participants), there was a nonsignificant decrease in wound infection in the tap water group (relative risk = 0.66; 95% confidence interval [CI], 0.42 to 1.04). In children (535 participants), there was a nonsignificant increase in wound infections in the tap water group (relative risk = 1.07; 95% CI, 0.43 to 2.64). A double-blind randomized controlled trial published since this Cochrane review found similar results. In the 663 participants studied, there was no difference between those irrigated with tap water vs. normal saline, with a trend toward decreased infections in the tap water group.2 Given the lack of adverse events and the affordability of tap water, tap water should be considered as preferable to normal saline for cleansing of acute wounds.