Comparison of the irrigation of open fractures of the lower limbs with normal saline versus tap water in patients presenting to accident and emergency of Jos University Teaching Hospital (Juth), Jos, Nigeria

Abstract

Infection is a major contributing factor to the morbidity and mortality associated with traumatic wounds. Tap water has been used for centuries as wound cleanser while normal saline is regarded as the most appropriate and preferred cleansing solution. The objective of the study was to determine the outcome of irrigation of open fractures of the lower limbs with normal saline versus tap water in  patients with open fractures. A randomized prospective study was done to compare the infection rate and bacteriology of open fractures of the lower limbs when irrigated with normal saline versus tap water amongst 107 patients in normal saline group and 102 patients in the tap water group was carried out in Department of Orthopedics and Trauma, Jos University Teaching Hospital, Jos using simple random sample method. The mean age for normal saline group was 37.2±1.4 years and 39.4±1.4 years for the tap water group. The male to female ratio was 3.1:1 in the normal saline group and 3.5:1 in tap water group. Ninety-five (45.5%) of the 209 patients had  their wounds infected, 50 (46.7%) from normal saline group and 45 (44.1%) from tap water group. No statistically significant difference in infection rate in the two groups (P=0.705). No statistically significant difference in distribution of bacterial isolates from the wounds of both groups (P=0.886). It can be deduced that tap water is an effective alternative to normal saline for irrigation of open fractures.