Expensive Sterile Saline, or Tapwater? It’s a Wash!

If you grew up in the rural South like Doc Gurley, your childhood memories include such everyday events as peeling all the epithelium off both knees and elbows, stubbing the entire top off both big toes, and then sliding into so much dirt with said injuries that the injured skin looked like a new, high-tech version of an organic compost-graft. So what did my Southern Mama do when faced with this disaster? She hauled the budding young Doc into thetub.jpg bathroom, cranked up the tub-faucet to deafening Niagara levels, and held my wet, wiggling injured bits under the pounding water. Everyone’s mother did that. My mother learned it from her mother, and she was a Grandma that could pinch-hit in the child-wrestling department, if necessary, decades after she started putting a little “blue rinse” in her grey hair. Before the age of five, there was enough ceiling blood spatters and screams echoing off tiled walls in my childhood to merit an Emmy for the category of Best Horror Melodrama, Grandmother Starring.

Did it hurt that badly to have my scrapes washed? Well, nah, but why pass up the chance for some trauma-drama? More importantly, now, from the armchair sidelines of adulthood–was the fire-hose of water the right thing to do, medically speaking? We have so many options these days. What should you do when a loved one comes home with a bad case of road rash? Push up your sleeves and don your WWF gold belt, or head to the drugstore for a plastic bottle of hermetically sealed (expiration date unexpired) sterile saline?

Here we have some great practical news (Doc Gurley’s favorite kind) from the world of science. The fabulous people at the Cochrane Review (who spend their lives pouring over tiny numbers while wearing bifocals–imagine watchmakers with a numbers fetish) have compiled, compared, and contrasted all the research on whether it is safe to use drinkable tapwater to clean wounds, compared to uber-expensive sterile saline. The answer is…ta-da! Tapwater may be better for cleaning acute wounds in adults, is equal to saline with kids, and may have an advantage when it comes to cleaning chronic wounds in adults. There are some caveats, however. This fabulous news is somewhat dimmed by the fact that cleaning, with anything, was not shown to dramatically reduce infection rates (or at all!). However, I’m pretty sure those researchers did not evaluate the effectiveness of washing for removing from human wounds embedded biscuit-like lumps of gravel, grass and Cheerios. Probably could have found an advantage to water then, that’s my bet. Give yo Mama a hug today in honor of the merits of good old tapwater!

P.S. Does no one stub toes anymore? My children have never even heard of such a thing, and recoil in horror at the thought (granted, it is, to use a clinical term, kinda icky-poo). If you’ve ever stubbed, share your comments below.

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