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A multicenter comparison of tap water versus sterile saline for wound irrigation.
作者： Moscati RM；Mayrose J；Reardon RF；Janicke DM；Jehle DV ；
出处： Acad Emerg Med.2007V14N5 :404-9
Keywords:wound irrigation;tap water;saline;infections
ObjectivesTo compare wound infection rates for irrigation with tap water versus sterile saline before closure of wounds in the emergency department.
MethodsThe study was a multicenter, prospective, randomized trial conducted at two Level 1 urban hospitals and a suburban community hospital. Subjects were a convenience sample of adults presenting with acute simple lacerations requiring sutures or staples. Subjects were randomized to irrigation in a sink with tap water or with normal saline using a sterile syringe. Wounds were closed in the standard fashion. Subjects were asked to return to the emergency department for suture removal. Those who did not return were contacted by telephone. Wounds were considered infected if there was early removal of sutures or staples, if there was irrigation and drainage of the wound, or if the subject needed to be placed on antibiotics. Equivalence of the groups was met if there was less than a doubling of the infection rate.
ResultsA total of 715 subjects were enrolled in the study. Follow-up data were obtained on 634 (88%) of enrolled subjects. Twelve (4%) of the 300 subjects in the tap water group had wound infections, compared with 11 (3.3%) of the 334 subjects in the saline group. The relative risk was 1.21 (95% confidence interval = 0.5 to 2.7).
ConclusionsEquivalent rates of wound infection were found using either irrigant. The results of this multicenter trial evaluating tap water as an irrigant agree with those from previous single institution trials.
一项分别在都市1级医院和城郊社区医院急诊科同时开展的多中心、前瞻性、随机试验，比较了用水龙头水与无菌生理盐水冲洗伤口的感染率。需要缝合伤口的单纯撕裂伤成年人被随机分配到用洗涤槽水龙头冲洗组或无菌注射用生理盐水冲洗组，伤口按标准操作关闭。受试者被要求回到急诊科拆线。如果提早拆线、或伤口需要再冲洗和引流、或需要用抗菌互则被视为有感染。组间感染率小于一倍则视为等效。结果显示：直接用水龙头冲洗组伤口感染率为4%，用无菌生理盐水冲洗组为3.3%，相对危险比（RR）1.21，可信区间（CI）0.5-2.7。
研究结论：急诊科伤口冲洗，无论是直接用水龙头水冲洗还是无菌盐水冲洗，在伤口闭合后的感染率无显著统计学差异。 |
发表于 2013-5-10 10:15
发表于 2013-6-25 17:22
，同时也无比地钦佩您的批判性思维和扩展思维。硬着头皮用谷歌快速看了下原文。