RE: Tap Water for Wound Irrigation --> RE: wound irrigation

January 15, 2008

I would recommend getting your tap water tested, it would really

depend on the water. But really, if it’s good enough to drink, bathe in,

flush eyes, brush teeth, etc., it should be good enough to clean a dirty

wound. Many of the surgeons by me recommend cleaning wounds in the shower with

Dawn dish detergent.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Locke's in

Colorado

Sent: Tuesday, January 15, 2008 12:10 AM

To:

Subject: Tap Water for Wound Irrigation --> RE:

wound irrigation

Hmmmm...that was a

new one.

I know there were

articles about not needing sterile gloves to do lacerations -- the non-sterile

(but clean) latex gloves work fine.

Tap water was a

new one for irrigation of wounds.

See below.

I suppose the IMP

clinic of the future will irrigate the wound with tap water, use non-sterile

latex gloves, and so it up with fishing line.

:-)

East Afr Med J. 2004 Jul ;81 (7):348-52 15490706 Atraumatic

intracutaneous skin closure with self-made fishing line suture compared to

commercial thread. [My paper] S Freudenberg , C Mkony , T Wilhelm , T Nyawawa , C Kuhn , R Grobholz , S Post OBJECTIVE: The aim

of this study was to prove, whether the intracutaneous skin closure with self

made fishing line suture is equivalent to commercial sutures. DESIGN: It was a

randomised blinded animal study. SETTING: The study was performed in December

2002 at the Muhimbili University College of Health Sciences in Dar-es-salaam.

SUBJECTS: Both German surgeons from Mannheim, and Tanzanian surgeons from Dar

es salaam operated on nine one year old Tanzanian domestic sheep.

INTERVENTIONS: 108 standardised cutaneous wounds on the backs of the animals

were closed by intracutaneous sutures either with self produced fishing line

suture or a commercial nylon suture (Ethilon). MAIN OUTCOME MEASURES: The

clinical and histological outcomes, as well as the costs of this self-made

fishing line suture, with a commercial nylon thread were evaluated and

compared. RESULTS: There are no significant differences between the two sutures

in histological or clinical findings, or in the reported ease of use by the

surgeons. The cost of a self-produced atraumatic thread is US$ 0.12, less than

one-twentieth of the cost of the commercial thread. CONCLUSION: Self-made

fishing nylon suture has characteristics and properties in sheep skin wounds

comparable to commercial nylon suture. The advantage of the commercial thread

is the guaranteed quality assurance. It is discussed whether this quality

assurance justifies the large price difference, and whether the self-produced

thread should be recommended to surgeons in countries where the costs of

surgical material often remains an obstacle for life saving operations. Mesh-terms:

Animals; Comparative Study; Nylons, economics; Random Allocation; Research Support, Non-U.S. Gov't; Sheep, Domestic; Skin, injuries; Skin, surgery; Sutures, economics; Wound Healing; Wounds, Penetrating, surgery;

Locke, MD

====================================

Items 1 - 20 of 31

[ ]1:

Edmonds

M.

Irrigation of simple lacerations with tap water or sterile

saline in the emergency department did not differ for wound infections.

Evid Based Med. 2007 Dec;12(6):181. No abstract available.

PMID: 18063741 [PubMed]

[ ]2:

Cooke

M.

Irrigation of simple lacerations with tap water or sterile

saline in the emergency department did not differ for wound infections.

Evid Based Nurs. 2007 Oct;10(4):113. No abstract available.

PMID: 17905765 [PubMed]

[ ]3:

Moscati

RM, Mayrose J, Reardon RF, Janicke DM, Jehle DV.

A multicenter comparison of tap water versus sterile saline

for wound irrigation.

Acad Emerg Med. 2007 May;14(5):404-9.

PMID: 17456554 [PubMed - indexed for MEDLINE]

[ ]4:

Hall

S.

A review of the effect of tap water versus normal saline on

infection rates in acute traumatic wounds.

J Wound Care. 2007 Jan;16(1):38-41. Review.

PMID: 17334147 [PubMed - indexed for MEDLINE]

[ ]5:

Ikeda

N, Hayasaka S, Hayasaka Y, Watanabe K.

Alkali burns of the eye: effect of immediate copious

irrigation with tap water on their severity.

Ophthalmologica. 2006;220(4):225-8.

PMID: 16785752 [PubMed - indexed for MEDLINE]

[ ]6:

Kompa

S, Redbrake C, Hilgers C, Wüstemeyer H, Schrage N, Remky A.

Effect of different irrigating solutions on aqueous humour

pH changes, intraocular pressure and histological findings after induced alkali

burns.

Acta Ophthalmol Scand. 2005 Aug;83(4):467-70.

PMID: 16029272 [PubMed - indexed for MEDLINE]

[ ]7:

Whaley

S.

Tap water or normal saline for cleansing traumatic wounds?

Br J Community Nurs. 2004 Nov;9(11):471-8. Review.

PMID: 15580097 [PubMed - indexed for MEDLINE]

[ ]8:

Jito

J, Nakasu Y, Nakasu S, Hatsuda N, Matsuda M.

Tissue plasminogen activator levels after single

intracisternal injection in patients with subarachnoid hemorrhage.

Neurol Med Chir (Tokyo). 2004 Feb;44(2):55-60; discussion 60.

PMID: 15018324 [PubMed - indexed for MEDLINE]

[ ]9:

Patel

S, Beldon P.

Examining the literature on using tap water in wound

cleansing.

Nurs Times. 2003 Oct 28-Nov 3;99(43):22-4. Review.

PMID: 14626040 [PubMed - indexed for MEDLINE]

[ ]10:

Griffiths

RD, Fernandez RS, Ussia CA.

Is tap water a safe alternative to normal saline for wound

irrigation in the community setting?

J Wound Care. 2001 Nov;10(10):407-11.

PMID: 12964289 [PubMed - indexed for MEDLINE]

[ ]11:

Quintero-Betancourt

W, Gennaccaro AL, TM, Rose JB.

Assessment of methods for detection of infectious

Cryptosporidium oocysts and Giardia cysts in reclaimed effluents.

Appl Environ Microbiol. 2003 Sep;69(9):5380-8.

PMID: 12957926 [PubMed - indexed for MEDLINE]

[ ]12:

[No

authors listed]

Flushing wounds in children--is tap water OK?

Child Health Alert. 2003 Jun;21:4. No abstract available.

PMID: 12814092 [PubMed - indexed for MEDLINE]

[ ]13:

Valente

JH, Forti RJ, Freundlich LF, Zandieh SO, Crain EF.

Wound irrigation in children: saline solution or tap water?

Ann Emerg Med. 2003 May;41(5):609-16.

PMID: 12712026 [PubMed - indexed for MEDLINE]

[ ]14:

Fernandez

R, Griffiths R, Ussia C.

Water for wound cleansing.

Cochrane Database Syst Rev. 2002;(4):CD003861. Review.

PMID: 12519612 [PubMed - indexed for MEDLINE]

[ ]15:

Bansal

BC, Wiebe RA, Perkins SD, Abramo TJ.

Tap water for irrigation of lacerations.

Am J Emerg Med. 2002 Sep;20(5):469-72.

PMID: 12216046 [PubMed - indexed for MEDLINE]

[ ]16:

Kompa

S, Schareck B, Tympner J, Wüstemeyer H, Schrage NF.

Comparison of emergency eye-wash products in burned porcine

eyes.

Graefes Arch Clin Exp Ophthalmol. 2002 Apr;240(4):308-13.

Epub 2002 Mar 7.

PMID: 11981646 [PubMed - indexed for MEDLINE]

[ ]17:

O'Neill

D.

Can tap water be used to irrigate wounds in A & E?

Nurs Times. 2002 Apr 2-8;98(14):56-9. Review.

PMID: 11974735 [PubMed - indexed for MEDLINE]

[ ]18:

Chou

TD, Lee TW, Chen SL, Tung YM, Dai NT, Chen SG, Lee CH, Chen TM, Wang HJ.

The management of white phosphorus burns.

Burns. 2001 Aug;27(5):492-7.

PMID: 11451604 [PubMed - indexed for MEDLINE]

[ ]19:

C.

The use of Askina saline in the wound cleansing process.

Br J Nurs. 2000 Jan 27-Feb 9;9(2):115-6. Review.

PMID: 11022436 [PubMed - indexed for MEDLINE]

[ ]20:

Pieper

B, Templin TN, Dobal M, Jacox A.

Wound prevalence, types, and treatments in home care.

Adv Wound Care. 1999 Apr;12(3):117-26.

PMID: 10655791 [PubMed - indexed for MEDLINE]

From:

[mailto: ] On Behalf Of Lonna Larsh

Sent: Monday, January 14, 2008 2:25 PM

To:

Subject: Re: wound irrigation

As usual, beautiful Joanne. Elegant and inexpensive.

Lonna

joanne holland wrote:

Sterile irrigation:

I have a plug in pot that I use for

making tea: takes about a minute to boil the water to use for

irrigation. Why buy it? No one ever said it had to be distilled,

just clean. Just like in the old movies: " boil some

water, Nurse. " Oh, that would be me.

Irrigating with a syringe is

useful, but I often point it back into the sterile plastic casing backwards,

so the big open end of the case is down, and I can spray the water into a

directed site without having to be too close because a very narrow

stream makes it hurt the patient more. Also, it keeps the water stream

from splashing purulence upon your clothes by accident. They sell little

wide ended nozzels attachments which do this, but the syringe casing

works very well: I have to cut or burn a little hole in the end to hold

the plastic needle end of the syringe. Usually do this while waiting for

the water to boil.

Joanne Holland DVM/MD the Old MD in Drain, Oregon

Ben Brewer wrote:

Simple wounds can be irrigated with tap water

with the same outcome.

Ben Brewer MD

wound irrigation

We're one week into our new

micropractice in Rhode Island. Two of us

(moms with young kids) are essentially job-sharing, rotating mornings

and afternoons, sharing 1,000 sq feet that we bought together. No

staff. Lots of computers. Six patients on the panel so far, 994 to go.

What are people using for a wound irrigation set-up? Just sterile

water, syringe, and basin? Any less-expensive way to do it?

Thanks,

Denny

Barrington Family Medicine

(401)246-1300

Looking for last minute shopping deals? Find

them fast with Yahoo! Search.

Looking for last minute shopping deals? Find

them fast with Yahoo! Search.

Be a better friend, newshound, and know-it-all with Yahoo!

Mobile. Try

it now.

January 15, 2008

There are mechanical tap water filters at your local Lowe's/Home Depot that can give you added security. I suspect installing one of these filters will be less expensive than formally testing the tap water in any office. I would be skeptical of water authority reports on their product.

-- Pedro Ballester, M.D.Warren, OH

January 15, 2008

I thought it was JOY detergent( really . it was supposed to sting less)

ALso there was a surgeon who years ago wrote up that for minor swabbing of

blood he would take the first tissue in the box sticking up intot he air

and toss it then use tissues not more expensive gauze and had never had an

infection

add tissues kelly to the water nonsterile gloves fishing line.

Re: wound irrigation

As usual, beautiful Joanne. Elegant and inexpensive.

Lonna

joanne holland wrote:

Sterile irrigation:

I have a plug in pot that I use for making tea: takes about a

minute to boil the water to use for irrigation. Why buy it? No one

ever said it had to be distilled, just clean. Just like in the old

movies: " boil some water, Nurse. " Oh, that would be me.

Irrigating with a syringe is useful, but I often point it back

into the sterile plastic casing backwards, so the big open end of the

case is down, and I can spray the water into a directed site without

having to be too close because a very narrow stream makes it hurt the

patient more. Also, it keeps the water stream from splashing purulence

upon your clothes by accident. They sell little wide ended nozzels

attachments which do this, but the syringe casing works very well: I

have to cut or burn a little hole in the end to hold the plastic needle

end of the syringe. Usually do this while waiting for the water to boil.

Joanne Holland DVM/MD the Old MD in Drain, Oregon

Ben Brewer wrote:

Simple wounds can be irrigated with tap water with the same outcome.

Ben Brewer MD

wound irrigation

We're one week into our new micropractice in Rhode Island. Two of us

(moms with young kids) are essentially job-sharing, rotating mornings

and afternoons, sharing 1,000 sq feet that we bought together. No

staff. Lots of computers. Six patients on the panel so far, 994 to go.

What are people using for a wound irrigation set-up? Just sterile

water, syringe, and basin? Any less-expensive way to do it?

Thanks,

Denny

Barrington Family Medicine

(401)246-1300

_____

Looking for last minute shopping deals? Find

<http://us.rd.yahoo.com/evt=51734/*http:/tools.search.yahoo.com/newsearc

h/category.php?category=shopping> them fast with Yahoo! Search.

_____

Looking for last minute shopping deals? Find

<http://us.rd.yahoo.com/evt=51734/*http:/tools.search.yahoo.com/newsearc

h/category.php?category=shopping> them fast with Yahoo! Search.

_____

Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try

<http://us.rd.yahoo.com/evt=51733/*http:/mobile.yahoo.com/;_ylt=Ahu06i62

sR8HDtDypao8Wcj9tAcJ%20> it now.

January 15, 2008

Tap water is now standard in most ED's. Volume is the critical thing.

________________________________

From: on behalf of

Sent: Tue 1/15/2008 6:14 AM

To: 'Kathy Saradarian '; ' '

Subject: RE: Tap Water for Wound Irrigation --> RE: wound

irrigation

I thought it was JOY detergent( really . it was supposed to sting less)

ALso there was a surgeon who years ago wrote up that for minor swabbing of

blood he would take the first tissue in the box sticking up intot he air

and toss it then use tissues not more expensive gauze and had never had an

infection

add tissues kelly to the water nonsterile gloves fishing line.

Re: wound irrigation

As usual, beautiful Joanne. Elegant and inexpensive.

Lonna

joanne holland <joandvmmd@... <mailto:joandvmmd%40yahoo.com> > wrote: