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running head: can water be used?

Can Water be used for Wound Healing?
Mary S. Skrypiec
Ferris State University
Normal saline is an isotonic solution that is used in health care facilities to clean
wounds because it does not interfere with the healing process (Fernandez, 2012) !t has
been a topic of discussion that water could ha"e the same benefits as normal saline for
wound healing #he s$stemic re"iew Water for Wound Cleansing, conducted b$
Fernandez and %riffith& pro"es that water pre"ents infections 'ust as much as normal
saline and is more cost effecti"e
( wound is classified as an in'ur$ to the s)in which then brea)s the membrane
lea"ing an open sore ( wound can result from traumatic in'uries or surgical procedures
(n acute wound should heal on its own within a short period of time from when it
occurred (*ound care,201+) !f that wound does not heal within the e,pected time
frame, the wound is then considered chronic (201+) #his means that there is not
enough blood, o,$gen or nutrients helping the wound heal (201+) #o treat wounds,
health care facilities use a normal saline flush Normal saline is used because it
remo"es bacteria or debris from the wound without damaging health$ tissue
(Fernandez, 2012) #he stud$ Water for Wound Cleansing was conducted b$ -itin
Fernandez and -honda %riffiths that concludes tap water can ha"e the same results in
pre"enting infections as normal saline and is more cost effecti"e (2012)
The Study
#he stud$ conducted was a s$stematic re"iew using random controlled trials
(-.#s) (Fernandez, 2012) #he stud$ had 11 -.#s where the participants were humans
of all genders, ages, and races (2012) #he ages of the participants ranged from two to
/0 (2012) #wo out of the 11 trials were ta)en using children (2012) #en of the 11 trials
e"aluated the participants in different emergenc$ rooms, and the other trial was in a
communit$ setting (2012) #he participants all had wounds that were either acute or
chronic (2012) #here were fi"e trials that in"ol"ed people with lacerations (2012) #he
researchers, Fernandez and %riffith conducted their assessments on their trial patients
themsel"es using sub'ecti"e and ob'ecti"e data outcomes (2012) #he sub'ecti"e traits
were pus, discoloration or redness& the ob'ecti"e traits were bacterial counts, wound
counts and wound biops$ reports (2012) #he researchers would contact the
participants for up to si, wee)s and documented the results of healing (2012)
The Outcomes
#here were si, trials that compared cleaning acute and chronic wounds with tap
water "ersus normal saline (Fernandez, 2012) #hese si, trials included 1,+11 adults
and 0+0 children (2012) #he acute wounds trials showed that there was no increase or
reduction in infections when cleaning with tap water (2012) #here was also no dela$ed
healing process when using tap water instead of normal saline (2012) #he results
between children and adult were the same (2012) !n chronic wounds, 2%riffith reported
no statisticall$ significant difference in infection rates in non3sutured chronic wounds
that were cleansed with either tap water or normal saline4 (2012) 5nce tap water
pro"ed to be 'ust as effecti"e as normal saline, the researchers estimated how much
health care facilities could sa"e b$ using tap water to irrigate wounds #he$ found that
when using normal saline for wounds it costs 61+0& when using tap water for wounds it
cost 611/ (2012) (fter these calculations were made, the$ used the .7. to find that
eight million lacerations occur $earl$ in the 8nited 9tates and conducted that there
could be a sa"ing of 6:0,:00,00 if health care facilities switched to tap water irrigation
(2012) #herefore, using tap water instead of normal saline will not increase the ris) of
infection, will not dela$ healing time, and will cheaper for the health care facilities and
The Limitations
#he limitations to this stud$ are that the researchers onl$ did follow ups to the
participants for si, wee)s 9ince the stud$ was done on acute and chronic wounds the
si, wee) time frame might not of been long enough to ma)e sure all the wounds ha"e
healed completel$ #he$ also did not follow them long enough to see if the$ had an$
complications after the wound healed with scarring
Nursing Diagnosis
1 (t ris) for impaired tissue in tissue integrit$ r;t wound incision:
a !nter"ention: <ducation on proper cleaning techni=ues with water
b !nter"ention: <ducation on proper nutrition to promote healing
c !nter"ention: <ducation on correct dressing changes
2(t ris) for infection r;t poor wound cleansing
a !nter"ention: <ducation on how man$ times to rinse with water
b !nter"ention: <ducation on s;s of infections
c !nter"ention: <ducation on correct dressing changes
+ -eadiness for enhance self3health management r;t wound incision:
a !nter"ention: <ducation on proper nutrition and e,ercise
b !nter"ention: <ducation on wound care techni=ues with water and s;s of
c !nter"ention: <ducation on how to ta)e care of infected wound with water
Outcome Criteria
#here should be no signs or s$mptoms of infection #herefore, the wound should
not ha"e an$ redness, swelling, warmth feeling, tenderness or ha"e an$ pus (ll the
bacterial counts, wound counts and wound biops$ reports should come from the lab
clear #he patient should be able to state how often to clean the wound #he$ should
also be able to state how often to perform dressing changes !n si, wee)s the patient
should ha"e a completel$ healed wound and pac) to normal dail$ acti"it$
Wound Care Centers. (2013, January 1). Acute Wounds. Retrieved June 29, 2014, from http://
Fernandez, R., & Griffiths, R. (2012, February 15). Water for wound cleansing. . Retrieved June
28, 2014, from