Pin-Ru Shih, Yi-Ting Huang, Ka-Wai Tam, Yun-Yun Chou, Ming-Chi Hu
{"title":"明智的选择:自来水与生理盐水在伤口清洗中的有效性和安全性的证据支持。","authors":"Pin-Ru Shih, Yi-Ting Huang, Ka-Wai Tam, Yun-Yun Chou, Ming-Chi Hu","doi":"10.1002/wjs.70079","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although normal saline is widely applied in wound irrigation, evidence suggests that tap water irrigation does not increase the risk of wound infection. In this study, the gap between current evidence and clinicians' awareness regarding wound care practice was examined.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted of trials published before July 2025 in the PubMed, Embase, and Cochrane Library databases. Individual effect sizes were standardized, and a meta-analysis was performed to estimate the pooled effect size through random-effects models. The primary and secondary outcomes were wound infection and healing, respectively. On the basis of the meta-analysis findings, a survey was conducted to assess the gap between current evidence and clinical practice among health care providers.</p><p><strong>Results: </strong>This study reviewed 12 trials involving 3330 patients with 3352 wounds. The risk of wound infection did not differ significantly between the tap water and normal saline groups (risk ratio, 0.78; 95% confidence interval, 0.59-1.03). In the trial sequential analysis for wound infection, the Z curve remained within the O'Brien-Fleming boundaries, even after the 11th interim significance test. A subsequent survey indicated that many clinicians exposed to these findings remained unwilling to practice tap water irrigation.</p><p><strong>Conclusions: </strong>Tap water irrigation does not increase the risk of wound infection. Despite widely available evidence, many clinicians remained reluctant to practice tap water irrigation. To facilitate broader acceptance of this irrigation approach, institutional guidelines, endorsement from key opinion leaders, and social media promotion are recommended.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2742-2751"},"PeriodicalIF":2.5000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Choosing Wisely: Evidence-Based Support for the Efficacy and Safety of Tap Water Versus Normal Saline for Wound Cleansing.\",\"authors\":\"Pin-Ru Shih, Yi-Ting Huang, Ka-Wai Tam, Yun-Yun Chou, Ming-Chi Hu\",\"doi\":\"10.1002/wjs.70079\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Although normal saline is widely applied in wound irrigation, evidence suggests that tap water irrigation does not increase the risk of wound infection. In this study, the gap between current evidence and clinicians' awareness regarding wound care practice was examined.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted of trials published before July 2025 in the PubMed, Embase, and Cochrane Library databases. Individual effect sizes were standardized, and a meta-analysis was performed to estimate the pooled effect size through random-effects models. The primary and secondary outcomes were wound infection and healing, respectively. On the basis of the meta-analysis findings, a survey was conducted to assess the gap between current evidence and clinical practice among health care providers.</p><p><strong>Results: </strong>This study reviewed 12 trials involving 3330 patients with 3352 wounds. The risk of wound infection did not differ significantly between the tap water and normal saline groups (risk ratio, 0.78; 95% confidence interval, 0.59-1.03). In the trial sequential analysis for wound infection, the Z curve remained within the O'Brien-Fleming boundaries, even after the 11th interim significance test. A subsequent survey indicated that many clinicians exposed to these findings remained unwilling to practice tap water irrigation.</p><p><strong>Conclusions: </strong>Tap water irrigation does not increase the risk of wound infection. Despite widely available evidence, many clinicians remained reluctant to practice tap water irrigation. To facilitate broader acceptance of this irrigation approach, institutional guidelines, endorsement from key opinion leaders, and social media promotion are recommended.</p>\",\"PeriodicalId\":23926,\"journal\":{\"name\":\"World Journal of Surgery\",\"volume\":\" \",\"pages\":\"2742-2751\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/wjs.70079\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/9/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/wjs.70079","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/1 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Choosing Wisely: Evidence-Based Support for the Efficacy and Safety of Tap Water Versus Normal Saline for Wound Cleansing.
Background: Although normal saline is widely applied in wound irrigation, evidence suggests that tap water irrigation does not increase the risk of wound infection. In this study, the gap between current evidence and clinicians' awareness regarding wound care practice was examined.
Methods: A comprehensive literature search was conducted of trials published before July 2025 in the PubMed, Embase, and Cochrane Library databases. Individual effect sizes were standardized, and a meta-analysis was performed to estimate the pooled effect size through random-effects models. The primary and secondary outcomes were wound infection and healing, respectively. On the basis of the meta-analysis findings, a survey was conducted to assess the gap between current evidence and clinical practice among health care providers.
Results: This study reviewed 12 trials involving 3330 patients with 3352 wounds. The risk of wound infection did not differ significantly between the tap water and normal saline groups (risk ratio, 0.78; 95% confidence interval, 0.59-1.03). In the trial sequential analysis for wound infection, the Z curve remained within the O'Brien-Fleming boundaries, even after the 11th interim significance test. A subsequent survey indicated that many clinicians exposed to these findings remained unwilling to practice tap water irrigation.
Conclusions: Tap water irrigation does not increase the risk of wound infection. Despite widely available evidence, many clinicians remained reluctant to practice tap water irrigation. To facilitate broader acceptance of this irrigation approach, institutional guidelines, endorsement from key opinion leaders, and social media promotion are recommended.
期刊介绍:
World Journal of Surgery is the official publication of the International Society of Surgery/Societe Internationale de Chirurgie (iss-sic.com). Under the editorship of Dr. Julie Ann Sosa, World Journal of Surgery provides an in-depth, international forum for the most authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. Contributions are reviewed and selected by a group of distinguished surgeons from across the world who make up the Editorial Board.