Dear Editors,
Many clinical doctors tried to use tap water for wound cleansing in different groups, such as adult, children, acute stage, chronic stage, lacerations and incisions, etc., in the past decades,1 but there is no evidence‐based analysis about the safety of tap water therapy. We want to demonstrate the infection rates after wound cleansing using tap water through this systematic review and meta‐analysis.
The Cochrane Library, PubMed, EMBASE, and Clinical Trials.gov databases have been searched through June 2018 for published studies with the following inclusion criteria: (1) randomised control trials (RCTs); (2) wound cleansing in experience groups with tap water and observation groups with normal saline; (3) no other intervention (dressing, medical solution) to the wounds; (4) infection rates had been documented; and (5) full English articles available. Exclusion criteria were: (1) animal or laboratory models; (2) duplicate databases; (3) study design was not available; and (4) wounds infected before intervention. The first author selected eligible studies according to our inclusion and exclusion criteria. The second author collected studies data and rechecked any available studies from reference lists. Pooled odds ratios (ORs) with confidence intervals (CIs) were obtained through meta‐analysis by assessment of wound infection rates.
Figure 1 shows the process of study selection. Nine RCTs were selected from initial screening, which included 426 trials.2, 3, 4, 5, 6, 7, 8, 9, 10 All the studies were published in the English language. A total of 1546 patients who had accepted tap water therapy for wound cleansing were included in this analysis. The infection rate did not significantly change after tap water therapy (OR = 0.75; 95% CI, 0.53–1.07, P = 0.11; Figure 2).
Figure 1.
Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement of search results
Figure 2.
Comparison of tap water and normal saline. Outcome: infection rate (R) [Colour figure can be viewed at wileyonlinelibrary.com]
The safety of wound cleansing with tap water has been established because there was no difference in the infection rate between the tap water and normal saline groups.
CONFLICT OF INTEREST
All the authors do not have any conflict of interest.
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