Open Fracture? Saline Trumps Soap and Water

A team of researchers—led by the McGill University Health Centre, Montreal, Canada—has found that the standard practice of preoperative wound cleaning using soap and water needs to be challenged. The researchers, who worked in collaboration with the Research Institute of the McGill University Health Centre, found that soap and water is less effective than using saline water alone. Mohit Bhandari, M.D., M.Sc., Ph.D., was the principal investigator for the study. Dr. Bhandari is a professor of surgery for the Michael G. DeGroote School of Medicine at McMaster.

The study included 2, 400 people at 41 sites across the Canada, the U.S., Australia, Norway and India. All participants had suffered an open arm or leg fracture, and had their wounds cleaned with either soap and water, or a saline water solution, and one of three different levels of water pressure.

As indicated in the December 15, 2015 news release, “The researchers found that very low water pressure was an acceptable, low-cost alternative for washing out open fractures, and that the reoperation rate was higher in the group that used soap.”

“The findings, which were published in the New England Journal of Medicine, could lead to significant cost savings, particularly in developing countries where open fractures are particularly common.”

“The researchers added that their findings may be particularly relevant for low and middle income countries where 90% of road traffic fatalities, and probably a similar proportion of open fractures, occur, according to the World Health Organization.”