An analysis of various wound washing methods and their efficacy in treating chronic wounds: A comprehensive review of existing literature
DOI:
https://doi.org/10.70196/jwrt.v1i1.2Keywords:
wound cleansing, wound care, wound chronicAbstract
Background: Methods for treating wounds continue to evolve in response to the increasing number of wounds seen each year. Whether patients have chronic or acute wounds, proper wound care can improve their quality of life. One of the most effective ways to speed up the wound healing process is to wash it. As excessive or inappropriate washing procedures can cause trauma to the wound bed, it is important to tailor the washing method to the specific wound condition.
Aims: Comparing the efficacy of different wound cleansing techniques for chronic wounds.
Design and Methods: A literature review. This research study is a literature review using PI(E)O (patient, intervention/exposure, and outcome) to determine the keywords used in the search in several databases. The databases used were PubMed, Wiley Online Library, Science Direct and ProQuest. The keywords used were (Wound Cleansing Method OR Wound Cleansing Technique) AND (Acute OR Chronic Wound).
Results: A total of 16,500 articles were identified, after screening for the last 5 years (2019-2024), in English, full text, duplication, and according to the title and abstract, 18 articles were obtained, and 9 articles were included in this study. The results of the literature search found nine articles describing the wound washing methods used by patients with acute and chronic wounds, including swabbing in 2 articles, and irrigation in 7 articles.
Conclusion: Irrigation is the most widely used method, due to the reduced number of bacteria, short healing time, minimal pain and high satisfaction rate. In addition, the irrigation method can be used in conjunction with other methods
References
Armstrong, D. G., Orgill, D. P., Galiano, R. D., Glat, P. M., Kaufman, J. P., Carter, M. J., DiDomenico, L. A., & Zelen, C. M. (2022). Use of a purified reconstituted bilayer matrix in the management of chronic diabetic foot ulcers improves patient outcomes vs standard of care: Results of a prospective randomised controlled MULTI‐CENTRE clinical trial. International Wound Journal, 19(5), 1197–1209. https://doi.org/10.1111/iwj.13715
Atiyeh, B. S., Dibo, S. A., & Hayek, S. N. (2009). Wound cleansing, topical antiseptics and wound healing. International Wound Journal, 6(6), 420–430. https://doi.org/10.1111/j.1742-481X.2009.00639.x
Bellingeri, A., Falciani, F., Traspedini, P., Moscatelli, A., Russo, A., Tino, G., Chiari, P., & Peghetti, A. (2016). Effect of a wound cleansing solution on wound bed preparation and inflammation in chronic wounds: A single-blind RCT. Journal of Wound Care, 25(3), 160–168. https://doi.org/10.12968/jowc.2016.25.3.160
Borges, E. L., Frison, S. S., Honorato-Sampaio, K., Guedes, A. C. M., Lima, V. L. D. A. N., Oliveira, O. M. M. D., Ferraz, A. F., & Tyrone, A. C. (2018). Effect of Polyhexamethylene Biguanide Solution on Bacterial Load and Biofilm in Venous Leg Ulcers: A Randomized Controlled Trial. Journal of Wound, Ostomy & Continence Nursing, 45(5), 425–431. https://doi.org/10.1097/WON.0000000000000455
Budirahmadina, N. A., Perdanakusuma, D. S., Ervianti, E., & Saputra, I. D. (2023). The Clinical Profile of Patients with Chronic Wounds at Dr. Soetomo General Hospital 2015-2020. Berkala Ilmu Kesehatan Kulit Dan Kelamin, 35(1), 57–66. https://doi.org/10.20473/bikk.V35.1.2023.57-66
Burhan, A., Ali Khusein, N. bin, & Sebayang, S. M. (2022). Effectiveness of negative pressure wound therapy on chronic wound healing: A systematic review and meta-analysis. Belitung Nursing Journal, 8(6), 470–480. https://doi.org/10.33546/bnj.2220
Burhan, A., & Arofiati, F. (2021). Effect of Compression Bandage on the Healing of Diabetic Foot Ulcers: A Scooping Review: 4th International Conference on Sustainable Innovation 2020–Health Science and Nursing (ICoSIHSN 2020), Yogyakarta, Indonesia. https://doi.org/10.2991/ahsr.k.210115.110
Burhan, A., Arofiati, F., Abreu Da Silva, V., & Mixrova Sebayang, S. (2023). Effect of ankle brachial index (abi) and compression therapy on diabetic foot ulcer healing. Current Diabetes Reviews, 19. https://doi.org/10.2174/1573399819666230331083420
Burhan, A., & Sebayang, S. M. (2022). The Combination of Polyhexamethylene Biguanide and Cadexomer Iodine in Healing Chronic Venous Leg Ulcers: A Case Report. Viva Medika: Jurnal Kesehatan, Kebidanan Dan Keperawatan, 16(1), 12–21. https://doi.org/10.35960/vm.v16i1.832
Cochrane. (2020). Welcome to RevMan 5.4. Cochrane Review. https://training.cochrane.org/system/files/uploads/protected_file/RevMan5.4_user_guide.pdf
Davis, K. E., La Fontaine, J., Farrar, D., Oz, O. K., Crisologo, P. A., Berriman, S., & Lavery, L. A. (2020). Randomized clinical study to compare negative pressure wound therapy with simultaneous saline irrigation and traditional negative pressure wound therapy for complex foot infections. Wound Repair and Regeneration, 28(1), 97–104. https://doi.org/10.1111/wrr.12741
De Francesco, F., Riccio, M., & Jimi, S. (2022). Contribution of Topical Agents such as Hyaluronic Acid and Silver Sulfadiazine to Wound Healing and Management of Bacterial Biofilm. Medicina, 58(6), 835. https://doi.org/10.3390/medicina58060835
Frescos, N. (2018). Assessment of pain in chronic wounds: A survey of Australian health care practitioners. International Wound Journal, 15(6), 943–949. https://doi.org/10.1111/iwj.12951
Gardezi, M., Roque, D., Barber, D., Spake, C. S. L., Glasser, J., Berns, E., Antoci, V., Born, C., & Garcia, D. R. (2021). Wound Irrigation in Orthopedic Open Fractures: A Review. Surgical Infections, 22(3), 245–252. https://doi.org/10.1089/sur.2020.075
Gould, L., Abadir, P., Brem, H., Carter, M., Conner-Kerr, T., Davidson, J., DiPietro, L., Falanga, V., Fife, C., Gardner, S., Grice, E., Harmon, J., Hazzard, W. R., High, K. P., Houghton, P., Jacobson, N., Kirsner, R. S., Kovacs, E. J., Margolis, D., … Schmader, K. (2015). Chronic Wound Repair and Healing in Older Adults: Current Status and Future Research. Journal of the American Geriatrics Society, 63(3), 427–438. https://doi.org/10.1111/jgs.13332
Haddaway, N. R., Page, M., Pritchard, C. C., & McGuinness, L., A. (2020). PRISMA2020: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis Campbell Systematic Reviews. https://doi.org/10.1002/cl2.1230
Ikuta, K. S., Swetschinski, L. R., Robles Aguilar, G., Sharara, F., Mestrovic, T., Gray, A. P., Davis Weaver, N., Wool, E. E., Han, C., Gershberg Hayoon, A., Aali, A., Abate, S. M., Abbasi-Kangevari, M., Abbasi-Kangevari, Z., Abd-Elsalam, S., Abebe, G., Abedi, A., Abhari, A. P., Abidi, H., … Naghavi, M. (2022). Global mortality associated with 33 bacterial pathogens in 2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 400(10369), 2221–2248. https://doi.org/10.1016/S0140-6736(22)02185-7
Iqbal, A., Jan, A., Wajid, M., & Tariq, S. (2017). Management of Chronic Non-healing Wounds by Hirudotherapy.
Izadi, M., Bozorgi, M., Hosseine, M. S., Khalili, N., & Jonaidi-Jafari, N. (2018). Health-related quality of life in patients with chronic wounds before and after treatment with medical ozone. Medicine, 97(48), e12505. https://doi.org/10.1097/MD.0000000000012505
Jeo, W., Pratama, D., Training Program in Surgery, Department of Surgery, Faculty of Medicine Universitas Indonesia, dr. Cipto Mangunkusumo General Hospital, Jakarta., Vanto, Y., Training Program in Surgery, Department of Surgery, Faculty of Medicine Universitas Indonesia, dr. Cipto Mangunkusumo General Hospital, Jakarta., Kekalih, A., Department of Community Medicine, Faculty of Medicine Universitas Indonesia, Moenadjat, Y., & Department of Surgery, Faculty of Medicine Universitas Indonesia, dr. Cipto Mangunkusumo General Hospital, Jakarta. (2020). Postoperative Wound Irrigation Using Distilled Water in Preventing Surgical Site Infection in a Tertiary Hospital: A Retrospective Cohort and Cost-effective Study. The New Ropanasuri : Journal of Surgery, 5(1), 5–8. https://doi.org/10.7454/nrjs.v5i1.1074
Kolimi, P., Narala, S., Nyavanandi, D., Youssef, A. A. A., & Dudhipala, N. (2022). Innovative Treatment Strategies to Accelerate Wound Healing: Trajectory and Recent Advancements. Cells, 11(15), 2439. https://doi.org/10.3390/cells11152439
Lavery, L. A., Davis, K. E., La Fontaine, J., Farrar, J. D., Bhavan, K., Oz, O. K., & Crisologo, P. A. (2020). Does negative pressure wound therapy with irrigation improve clinical outcomes? A randomized clinical trial in patients with diabetic foot infections. The American Journal of Surgery, 220(4), 1076–1082. https://doi.org/10.1016/j.amjsurg.2020.02.044
Luck, J. B., Campagne, D., Falcón Banchs, R., Montoya, J., & Spano, S. J. (2016). Pressures of Wilderness Improvised Wound Irrigation Techniques: How Do They Compare? Wilderness & Environmental Medicine, 27(4), 476–481. https://doi.org/10.1016/j.wem.2016.09.002
Ludolph, I., Fried, F. W., Kneppe, K., Arkudas, A., Schmitz, M., & Horch, R. E. (2018). Negative pressure wound treatment with computer‐controlled irrigation/instillation decreases bacterial load in contaminated wounds and facilitates wound closure. International Wound Journal, 15(6), 978–984. https://doi.org/10.1111/iwj.12958
Mak, S. S.-S., Lee, M.-Y., Cheung, J. S.-S., Choi, K.-C., Chung, T.-K., Wong, T.-W., Lam, K.-Y., & Lee, D. T. (2015). Pressurised irrigation versus swabbing method in cleansing wounds healed by secondary intention: A randomised controlled trial with cost-effectiveness analysis. International Journal of Nursing Studies, 52(1), 88–101. https://doi.org/10.1016/j.ijnurstu.2014.08.005
Malviya, V., Goyal, S., Bansal, V., & Jaiswal, K. (2022). Clinical uses of NPWT with irrigation of normal saline in diabetic foot ulcer: Outcome assessed by DEPA score. Journal of Cutaneous and Aesthetic Surgery, 15(1), 58. https://doi.org/10.4103/JCAS.JCAS_227_20
Ministry of Heallth RI. (2018). Hasil Utama Riskesdas 2018. Kementrian Kesehatan RI. https://kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Hasil-riskesdas-2018_1274.pdf
Monika, P., Chandraprabha, M. N., Rangarajan, A., Waiker, P. V., & Chidambara Murthy, K. N. (2022). Challenges in Healing Wound: Role of Complementary and Alternative Medicine. Frontiers in Nutrition, 8, 791899. https://doi.org/10.3389/fnut.2021.791899
Norman, G., Shi, C., Goh, E. L., Murphy, E. M., Reid, A., Chiverton, L., Stankiewicz, M., & Dumville, J. C. (2022). Negative pressure wound therapy for surgical wounds healing by primary closure. Cochrane Database of Systematic Reviews, 2022(4). https://doi.org/10.1002/14651858.CD009261.pub7
Papadakis, M. (2021). Wound irrigation for preventing surgical site infections. World Journal of Methodology, 11(4), 222–227. https://doi.org/10.5662/wjm.v11.i4.222
Qin, C.-H., Zhang, H.-A., Chee, Y.-H., Pitarini, A., & Adem Ali, A. (2019). Comparison of the use of antibiotic-loaded calcium sulphate and wound irrigation-suction in the treatment of lower limb chronic osteomyelitis. Injury, 50(2), 508–514. https://doi.org/10.1016/j.injury.2018.10.036
Sapra, A., & Bhandari, P. (2023). Diabetes. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551501/
Sen, C. K. (2021). Human Wound and Its Burden: Updated 2020 Compendium of Estimates. Advances in Wound Care, 10(5), 281–292. https://doi.org/10.1089/wound.2021.0026
Suyanto, S., & Amal, A. I. (2017). MODERN WOUND IRRIGATION DEVICE (MWID) REDUCE THE NUMBER OF BACTERIA IN DIABETIC ULCER PATIENTS. INDONESIAN NURSING JOURNAL OF EDUCATION AND CLINIC (INJEC), 2(1), 105. https://doi.org/10.24990/injec.v2i1.125
Tottoli, E. M., Dorati, R., Genta, I., Chiesa, E., Pisani, S., & Conti, B. (2020). Skin Wound Healing Process and New Emerging Technologies for Skin Wound Care and Regeneration. Pharmaceutics, 12(8), 735. https://doi.org/10.3390/pharmaceutics12080735
Vogt, T. N., Koller, F. J., Dias Santos, P. N., Lenhani, B. E., Guimarães, P. R. B., & Kalinke, L. P. (2020). Quality of life assessment in chronic wound patients using the Wound-QoL and FLQA-Wk instruments. Investigación y Educación En Enfermería, 38(3). https://doi.org/10.17533/udea.iee.v38n3e11
Weiss, E. A., Oldham, G., Lin, M., Foster, T., & Quinn, J. V. (2013). Water is a safe and effective alternative to sterile normal saline for wound irrigation prior to suturing: A prospective, double-blind, randomised, controlled clinical trial. BMJ Open, 3(1), e001504. https://doi.org/10.1136/bmjopen-2012-001504
Yang, C., Yang, C., Chen, Y., Liu, J., Liu, Z., & Chen, H.-J. (2023). The trends in wound management: Sensing, therapeutic treatment, and “theranostics.” Journal of Science: Advanced Materials and Devices, 8(4), 100619. https://doi.org/10.1016/j.jsamd.2023.100619
Yu, R., Zhang, H., & Guo, B. (2022). Conductive Biomaterials as Bioactive Wound Dressing for Wound Healing and Skin Tissue Engineering. Nano-Micro Letters, 14(1), 1. https://doi.org/10.1007/s40820-021-00751-y
Zhao, R., Liang, H., Clarke, E., Jackson, C., & Xue, M. (2016). Inflammation in Chronic Wounds. International Journal of Molecular Sciences, 17(12), 2085. https://doi.org/10.3390/ijms17122085
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