|
|
Post by dannusmaximus on Dec 17, 2015 15:42:35 GMT
Link to the article:
www.upi.com/Health_News/2015/12/17/Study-Saline-better-than-soap-and-water-to-clean-wounds/7011450356518/
. The study involved open limb fractures and compared using soap and water or saline at different pressures to 'debride' (fancy speak for 'rinse out') wound sites. The takeaway? Low pressure saline solution was the best way to clean injuries prior to a surgical fix of these injuries.
So, for the average joe this likely means that instead of scrubbing your poor kids skinned up knees or sundry other injuries with soap and water, you will probably do just fine pouring a couple of bottles of pre-made saline solution over it to get the debris out and wash out the dead/loose skin. This stuff is cheap and available damn near anywhere first aid supplies are sold. Link to one example of the product:
www.walmart.com/ip/BAXTER-BSCI050123-Saline-Solution-500-mL/40892592
You can buy a large volume syringe (it's going to look like a turkey baster with volume markings on it) to use with the saline to give yourself the ability to apply a little pressure to make sure you're getting all the nasties out. I would obviously not recommend self-debriding a major wound, and you can always use basically any source of clean water to wash an injury in a pinch. The important thing is to make sure there isn't a bunch of crud left in the injury before you bandage it up.
All in all, a few bottles of normal saline, 500 or 1000 mL, are not a bad thing to have in your home first aid supplies. |
|
|
|
Post by Browning35 on Dec 17, 2015 16:07:24 GMT
Hmm, interesting.
On the ambulance that was kind of a no-brainer (simply cause we didn't have soap and water and we had a bunch of saline), my poor son though.
Just wondering, on scrapped knees and hands where dirt is in the wound I'm curious if soap and water with a light scrubbing action would still be best to get the gunk out or if saline and a light scrubbing action would accomplish the same thing.
|
|
|
|
Post by LowKey on Dec 17, 2015 17:40:48 GMT
Hmm, interesting. On the ambulance that was kind of a no-brainer (simply cause we didn't have soap and water and we had a bunch of saline), my poor son though. Just wondering, on scrapped knees and hands where dirt is in the wound I'm curious if soap and water with a light scrubbing action would still be best to get the gunk out or if saline and a light scrubbing action would accomplish the same thing. Particularly if there is tar or asphalt residue in the wound. I can recall a few times s a kid coming home with scrapes that were black from contact with fresh asphalt. |
|
|
|
Post by scbrian on Dec 17, 2015 18:59:44 GMT
I have a few scars where cuts closed over gravel, etc where it wasn't cleaned out well enough.
This takes into account a surgical or "professional" visit afterwards. Any studies for home care of wounds where a DR isnt available? Also 3% isn't a very significant difference.
"
The study showed very low water pressure using saline, rather than soap, better cleaned wounds -- 14.8 percent of patients cleaned with soap needed a second operation, compared to 11.6 percent of the group cleaned with saline."
This does tickle the back of my mind though, I remember reading a few years ago a study on hand washing, that stated using regular soap only assisted in lubrication of the hands, the actual cleaning was from the hands rubbing against each other in water...
|
|
|
|
Post by Browning35 on Dec 17, 2015 22:45:16 GMT
I have a few scars where cuts closed over gravel, etc where it wasn't cleaned out well enough. This takes into account a surgical or "professional" visit afterwards. Any studies for home care of wounds where a DR isnt available? Also 3% isn't a very significant difference. Well...definitely not a huge difference, but every little bit helps. Also, saline might not sting as much as soap. Yeah, I remember seeing that. It was an article along the same lines as this one. Soap: How Much Cleaner Does It Actually Make Your Hands? (*Click*)Particularly if there is tar or asphalt residue in the wound. I can recall a few times s a kid coming home with scrapes that were black from contact with fresh asphalt. Read my mind, those were exactly the ones that I was thinking of. |
|
|
|
Post by dannusmaximus on Dec 18, 2015 1:20:16 GMT
I would personally use soap and water and as much scrubbing as I could stand if I had really grungy scrapes, but there is something to be said for tolerating the procedure. If you can't hold your kid still more than 2 seconds because the soap and water sting too bad, but they will tolerate a copious wash with saline, that can only be a good thing.
Also, maybe the saline has some residual bacteriostatic action as opposed to plain soap and water?
ALSO, vigorous scrubbing or use of harsh cleaners can actually delay healing, at least from what I've learned from some friends in wound care. Something about the chemicals (like hydrogen peroxide) and mechanical action interfering with wound granulation. This is more and issue for long term wound issues, like diabetic ulcers or pressure sores, but it's evidently a thing.
ALSO, ALSO, our hospital now recommends alcohol foam as primary hand cleaning methodology, preferred even to soap and water - - unless your hands are literally dripping with blood and other nasties, in which case you do a through soap and water wash to gross decon and then follow up with the foam.
|
|
|
|
Post by omegaman on Dec 18, 2015 5:25:20 GMT
Cool study, but scbrian points out an interesting observation; which, after giving a quick glance at the journal article, I think it is odd that they determined an approximate difference of 3%ish to be "significant". It is possible (and common) to use cherry-picked statistical models to show what you want. I admit to not being familiar with the stats used in the study, but looking at the sample size and relative balance among treatments, 3%ish is stretching what I would consider "significant". From what I gather from the study--no difference between soap or saline or psi.
Maybe I missed this, but was there categories or an index of the severity or cause of fractures? I.e., were all treated wounds equal in "severity" (intensity). If not, that could easily account for any variance amongst treatments.
Not discounting the study, just pointing out different ways to possibly interpret data and advocating to all my homies and peeps that skepticism is a virtue and a clever statistician can translate data multiple ways.
|
|
|
|
Post by dannusmaximus on Dec 18, 2015 12:08:29 GMT
Cool study, but scbrian points out an interesting observation; which, after giving a quick glance at the journal article, I think it is odd that they determined an approximate difference of 3%ish to be "significant". It is possible (and common) to use cherry-picked statistical models to show what you want. I admit to not being familiar with the stats used in the study, but looking at the sample size and relative balance among treatments, 3%ish is stretching what I would consider "significant". From what I gather from the study--no difference between soap or saline or psi. Maybe I missed this, but was there categories or an index of the severity or cause of fractures? I.e., were all treated wounds equal in "severity" (intensity). If not, that could easily account for any variance amongst treatments. Not discounting the study, just pointing out different ways to possibly interpret data and advocating to all my homies and peeps that skepticism is a virtue and a clever statistician can translate data multiple ways. Good points. Here's the conclusion summary from the actual New England Journal of Medicine abstract:
"The rates of reoperation were similar regardless of irrigation pressure, a finding that indicates that very low pressure is an acceptable, low-cost alternative for the irrigation of open fractures. The reoperation rate was higher in the soap group than in the saline group. (Funded by the Canadian Institutes of Health Research and others; FLOW ClinicalTrials.gov number, NCT00788398.)"
Based on the wording in the article I linked (which in turn linked to the NEJM report), the trial size was around 2,500 patients, and it seemed focused on motor vehicle accident injuries, specifically in developing countries where surgical cleansers might be in short supply or prohibitively expensive. The study financiers included the U.S. DOD as well as the Canadian national institutes of health, which (at least probably) means it was a fairly non-biased study and there wasn't any overt reason for the funding agencies to have researchers massage the data (like if it was a study primarily financed by the Association to Sell Saline Solution or Citizens Against Surgical Soap...  )
Here's a link to the actual study:
www.nejm.org/doi/full/10.1056/NEJMoa1508502#t=articleBackground
It seems like the findings were not so much that 'saline is better than soap and water' like the original title of the article I linked stated (perhaps a good example of a bit of journalistic license to enhance interest in the article?), but that low pressure saline wash was a credible alternative to mechanical debridement with surgical cleansers. Still good scoop, especially when it comes to wound treatment in austere settings.
The linked NEJM article has some details about the actual statistical data and compilation methods for anybody interested, but WTF Omega?!?! I thought you were a PBR guzzling, battle-tested jarhead, not some wonky science geek who was interested in 'statistics' or 'data sets' or 'words'...
|
|
|
|
Post by omegaman on Dec 18, 2015 14:18:24 GMT
First thing I did was go directly to the journal article to read methodology, experimental design, sample size, and statistical analysis...'cuz I'm a PRB guzzling jarhead and wonky science geek 
I am a legit scientist, yo. Gotz and lab and microscopes and shit, fo reelz  |
|
|
|
Post by scbrian on Dec 18, 2015 15:33:48 GMT
First thing I did was go directly to the journal article to read methodology, experimental design, sample size, and statistical analysis...'cuz I'm a PRB guzzling jarhead and wonky science geek
I am a legit scientist, yo. Gotz and lab and microscopes and shit, fo reelz Yes, yes, I know we all think of OM as more of a Zach Galifianakis than a Neil deGrasse Tyson, but it's true. Even if I cant get him to admit that Crotalus horridus horridus and Crotalus horridus atricaudatus are two different species  |
|
|
|
Post by NamelessStain on Dec 21, 2015 12:33:57 GMT
Wait? I thought all the SC members were uneducated rednecks?! Oh wait, that's how they think of us on the other forum.
SCIENCE, BISHES!!
Note: Still trying to get OM off the PBR. /dangles cases of Yuengling
|
|
|
|
Post by NamelessStain on Dec 24, 2015 13:16:19 GMT
|
|
)
