Monday, November 7, 2022

Laceración Irrigation

First10 EM - By Justin Morgenstern - November 07, 2022
In part 2 of the laceration evidence series, we are going to tackle all of the evidence around wound irrigation and cleansing. The value of irrigation seems pretty obvious. Traumatic wounds are contaminated, and we should do our best to clean them. “The solution to pollution is dilution.” Therefore most of the (relatively limited) evidence focuses on exactly how we should irrigate. That being said, we should always question our assumptions, so in addition to questions about how we should be irrigating, we will also consider the very basic question of whether irrigation helps at all. 
Bottom line: Tap water is definitely no worse than saline, and may in fact be better. When you consider the costs and environmental impacts of sterile saline, tap water is almost certainly better. The most interesting part of this data is that, based on the limited data we have, tap water irrigation is also no different than no irrigation at all, which really does raise questions of the value of irrigation in general.