¿Agua del grifo para la limpieza de heridas?

Resum

Clinical practice question: For cleansing wounds, is water as effective as saline solution or other cleansing solutions? Summary of the research: Systematic review of randomized clinical trial (RCT) and quasi-experimental studies comparing water with saline or other solutions for cleansing wounds of any aetiology (except dental and burns). In sutured acute wounds, a RCT find less incidence of infections when the cleansing was made with water instead of saline solution (OR= 0,55, IC95%= 0,31 � 0,97). Another RCT don't find any difference between both products in non-sutured wounds (OR= 0,33, IC95%= 0,1 � 1,07), although there are some difference in cost, because water (1,16 $) is cheaper than saline (1,43 $). There is no difference comparing various kind of waters. Critical comment: The review presents a language bias, because only English databases are considered, what can affect something to its validity. The aim of the review was to compare water with saline and other solutions for wounds cleansing, assessing the healing and the infection rates, so in acute as in chronic wounds. However, all the selected papers make reference to acute lesions, for what we don't have solid elements to be able to extrapolate the data to chronic wounds. The use of water, distilled water, boiled water or saline solution has a favourable effects of wounds, because reduces the bacterial burden, removes debris and foreign bodies, contributing to healing process. When comparing the different types of solutions, there are not significant differences between cleansing products. Therefore the RCT are not conclusive for establish which is the most effective product, water or saline solution. Not even the use of antiseptics seems to be more effective than water cleansing, in some wounds, as episiotomy. So we can conclude that there is suitable evidence (Level A) to recommend the cleansing of acute wounds with water, distilled water, boiled water or saline solution. There are no data to consider that any cleansing product is more effective than others, except for economic criteria.