Saline Water Better Than Soap and Water for Presurgical Wound Cleaning

Although it is standard practice to clean open fractures with soap and water prior to surgery, the results of a recent study suggest it may be more effective to use saline water instead. For the study, published in the New England Journal of Medicine, 2400 patients with open arm or leg fractures had their wounds cleaned with either a saline water solution or soap and water, with the water pressure set to 1 of 3 different levels.

After monitoring the patients over a 12-month period, the research team found that those in the soap and water group were more likely to require an additional operation than those in the saline water group. The researchers also deemed very low water pressure to be an acceptable, low-cost alternative for washing out open 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 researcher Mohit Bhandari, MD, in a press release. “All wounds need to be cleaned out … but evidence shows that cleaning wounds with soap was not better than just water, which was unexpected.”

“Most of the time, we were using soap and water with a high-pressure delivery system to clean the wound, but now we don’t, and that makes the best practice much cheaper,” added study author Edward Harvey, MD.

The study authors expressed hope that their findings could lead to significant cost savings in developing nations, where open fractures are more likely to occur.