2.50
Hdl Handle:
http://hdl.handle.net/10755/163847
Category:
Abstract
Type:
Article
Level of Evidence:
Systematic Review
Research Approach:
Translational Research/Evidence-based Practice
Title:
Effectiveness of solutions, techniques and pressure in wound cleansing
Author(s):
Fernandez, Ritin; Grifiths, Rhonda D.; Ussia, Cheryl
Author Details:
Ritin Fernandez, RN, MN(CritCare), New South Wales Centre for Evidence-Based Health Care, Liverpool Health Service, Liverpool, NSW, Australia, email: ritin.fernandez@swsahs.nsw.gov.au; Rhonda Grifiths, RN, CM Bed(Nurs), MSc(Hons), DrPH; Cheryl Ussia, RN, CertWoundMan
Abstract:
Background: This systematic review updates a previous review published in 2001. Cleansing is a vital component of wound management; however; little attention has been give to the solutions and techniques used for cleansing purposes. The objective of this review was to assess the effectiveness of different solutions, pressures and techniques used for wound cleansing to prevent infection and promote wound healing. Search strategy: Randomised and clinical controlled trials were identified using the Cochrane Central Register of Controlled Trials (CENTRAL). Additional searches of other databases and hand searches of journals and bibliographies was undertaken to identify further trials. Selection criteria: All randomised and clinical controlled trials involving adults and/or children whose wounds were cleaned with commercial cleansers, normal saline, water, chlorhexidine, hydrogen peroxide or povidone-iodine were eligible for inclusion. Studies that utilised solutions for preoperative skin cleansing, compared solutions for burns or dental procedures, and those that compared dressings for patients with ulcers were excluded from this review. Outcomes included rate of healing, incidence of infections or levels of bacterial count. Selection of potential articles, assessment of methodological quality and data abstraction was conducted independently by two reviewers. Trials with similar patients, comparisons, and outcomes were pooled. The data were analysed using Cochrane Review Manager 4.2. Where pooling was inappropriate, trials are discussed in a narrative review. Results: Fourteen randomised controlled trials were included that compared various solutions for wound cleansing. The evidence indicates that there is no difference in the infection and healing rates in acute and chronic wounds cleansed with either tap water or normal saline. An irrigation pressure of 13 psi is effective for cleansing wounds and reducing infection without causing tissue trauma There were no studies comparing common techniques for wound cleansing such as swabbing or scrubbing. Showering postoperative wounds did not demonstrate any difference in infection rates; however, it increased the morale of the patient. Whirlpool therapy was effective in reducing inflammation and pain in surgical wounds. Conclusions: These conclusions are based on the best available clinical evidence. However, there is an urgent need to support these findings with rigorous research as some of the conclusions are based on single studies with limited sample sizes. Solutions for wound cleansing: 1) The evidence supports the use of potable tap water for cleansing lacerations in both adults and children and postoperative wounds in adults only. 2) Potable tap water as well as boiled and cooled water is also an effective wound cleansing solution. This finding, however, is based on a trial that had a small sample size. 3) The evidence to support the use of potable tap water is limited (only one study with low power); therefore, further studies are required to confirm that assumption. 4) Povidone-iodine is an effective cleansing solution for contaminated wounds.
Pressure for wound cleansing: A pressure of 13 psi is effective in reducing infection and inflammation in both adults and children with lacerations and traumatic wounds. Techniques for wound cleansing: 1) Evidence to support or refute swabbing and scrubbing to cleanse wounds is lacking.
2) The review demonstrated no evidence of a difference in the wound infection and healing rates between wounds that were showered and those that were not. 3) The evidence for showering ulcers and other chronic wounds is lacking; therefore, this technique of wound cleansing should be undertaken with caution. 4) Whirlpool therapy is effective to reduce pain and inflammation in surgical wounds and improve the healing rate in pressure ulcers. 5) The evidence to support the use of Sitz bath for patients following episiotomy is limited.
Keywords:
Wound care; Solutions, Therapeutic Use
Repository Posting Date:
27-Oct-2011
Date of Publication:
2004
Citation:
Fernandez, R., Griffiths, R., & Ussia, C. (2004). Effectiveness of solutions, techniques and pressure in wound cleansing.�JBI Reports,�2(7), 231-270.
Publisher:
Joanna Briggs Institute
Conference Date:
2006
Conference Name:
Joanna Briggs Institute 2006 International Convention
Conference Host:
Joanna Briggs Institute
Conference Location:
Hilton Adelaide, South Australia
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typeArticleen_GB
dc.evidence.levelSystematic Reviewen_US
dc.research.approachTranslational Research/Evidence-based Practiceen_US
dc.titleEffectiveness of solutions, techniques and pressure in wound cleansingen_GB
dc.contributor.authorFernandez, Ritinen_US
dc.contributor.authorGrifiths, Rhonda D.en_US
dc.contributor.authorUssia, Cherylen_US
dc.author.detailsRitin Fernandez, RN, MN(CritCare), New South Wales Centre for Evidence-Based Health Care, Liverpool Health Service, Liverpool, NSW, Australia, email: ritin.fernandez@swsahs.nsw.gov.au; Rhonda Grifiths, RN, CM Bed(Nurs), MSc(Hons), DrPH; Cheryl Ussia, RN, CertWoundManen_US
dc.identifier.urihttp://hdl.handle.net/10755/163847-
dc.description.abstractBackground: This systematic review updates a previous review published in 2001. Cleansing is a vital component of wound management; however; little attention has been give to the solutions and techniques used for cleansing purposes. The objective of this review was to assess the effectiveness of different solutions, pressures and techniques used for wound cleansing to prevent infection and promote wound healing. Search strategy: Randomised and clinical controlled trials were identified using the Cochrane Central Register of Controlled Trials (CENTRAL). Additional searches of other databases and hand searches of journals and bibliographies was undertaken to identify further trials. Selection criteria: All randomised and clinical controlled trials involving adults and/or children whose wounds were cleaned with commercial cleansers, normal saline, water, chlorhexidine, hydrogen peroxide or povidone-iodine were eligible for inclusion. Studies that utilised solutions for preoperative skin cleansing, compared solutions for burns or dental procedures, and those that compared dressings for patients with ulcers were excluded from this review. Outcomes included rate of healing, incidence of infections or levels of bacterial count. Selection of potential articles, assessment of methodological quality and data abstraction was conducted independently by two reviewers. Trials with similar patients, comparisons, and outcomes were pooled. The data were analysed using Cochrane Review Manager 4.2. Where pooling was inappropriate, trials are discussed in a narrative review. Results: Fourteen randomised controlled trials were included that compared various solutions for wound cleansing. The evidence indicates that there is no difference in the infection and healing rates in acute and chronic wounds cleansed with either tap water or normal saline. An irrigation pressure of 13 psi is effective for cleansing wounds and reducing infection without causing tissue trauma There were no studies comparing common techniques for wound cleansing such as swabbing or scrubbing. Showering postoperative wounds did not demonstrate any difference in infection rates; however, it increased the morale of the patient. Whirlpool therapy was effective in reducing inflammation and pain in surgical wounds. Conclusions: These conclusions are based on the best available clinical evidence. However, there is an urgent need to support these findings with rigorous research as some of the conclusions are based on single studies with limited sample sizes. Solutions for wound cleansing: 1) The evidence supports the use of potable tap water for cleansing lacerations in both adults and children and postoperative wounds in adults only. 2) Potable tap water as well as boiled and cooled water is also an effective wound cleansing solution. This finding, however, is based on a trial that had a small sample size. 3) The evidence to support the use of potable tap water is limited (only one study with low power); therefore, further studies are required to confirm that assumption. 4) Povidone-iodine is an effective cleansing solution for contaminated wounds.<br/>Pressure for wound cleansing: A pressure of 13 psi is effective in reducing infection and inflammation in both adults and children with lacerations and traumatic wounds. Techniques for wound cleansing: 1) Evidence to support or refute swabbing and scrubbing to cleanse wounds is lacking.<br/>2) The review demonstrated no evidence of a difference in the wound infection and healing rates between wounds that were showered and those that were not. 3) The evidence for showering ulcers and other chronic wounds is lacking; therefore, this technique of wound cleansing should be undertaken with caution. 4) Whirlpool therapy is effective to reduce pain and inflammation in surgical wounds and improve the healing rate in pressure ulcers. 5) The evidence to support the use of Sitz bath for patients following episiotomy is limited.en_GB
dc.subjectWound careen_US
dc.subjectSolutions, Therapeutic Useen_US
dc.date.available2011-10-27T11:30:39Z-
dc.date.issued2004en_GB
dc.date.accessioned2011-10-27T11:30:39Z-
dc.identifier.citationFernandez, R., Griffiths, R., & Ussia, C. (2004). Effectiveness of solutions, techniques and pressure in wound cleansing.�JBI Reports,�2(7), 231-270.en_US
dc.publisherJoanna Briggs Instituteen_US
dc.identifier.issn1479-697X-
dc.conference.date2006-
dc.conference.nameJoanna Briggs Institute 2006 International Convention-
dc.conference.hostJoanna Briggs Institute-
dc.conference.locationHilton Adelaide, South Australia-
dc.identifier.citationFernandez, R., Griffiths, R., & Ussia, C. (2004). Effectiveness of solutions, techniques and pressure in wound cleansing.�JBI Reports,�2(7), 231-270.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.-
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