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Wound irrigation versus swabbing technique for cleansing noninfected chronic wounds: A systematic review of differences in bleeding, pain, infection, exudate, and necrotic tissue
Örebro University, School of Health Sciences. Swedish Centre for Skin and Wound Research (SCENTR), School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Department of Health, Government of Nunavut, Box 1000, Station 1000, Iqaluit, Nunavut, X0A 0H0, Canada.
Health Disciplines Practice and Education, Unity Health Toronto, Toronto, Ontario, Canada.
Home and Community Care Support Services South East, 1471 John Counter Blvd, Kingston, Ontario, K7M 8S8, Canada.
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2023 (English)In: Journal of tissue viability, ISSN 0965-206X, Vol. 32, no 1, p. 136-143Article, review/survey (Refereed) Published
Abstract [en]

PURPOSE: To systematically summarize and review the existing literature to determine the difference between wound cleansing techniques, irrigation and swabbing, in relation to bleeding, pain, infection, necrotic tissue and exudate in non-infected chronic wounds including pressure injuries, venous and arterial leg ulcers and diabetic foot ulcers.

METHODS: A systematic search of the electronic databases Ovid Medline, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and EMBASE was performed to identify all relevant literature in English. The search also included systematic reviews as a method to obtain additional potential citations by manually searching the reference lists. Included studies were assessed for methodological quality using the Cochrane Risk of Bias Tool.

RESULTS: One study met eligibility criteria. Two hundred fifty six patients with wounds healing via secondary intention (n = 256) were included. Wound cleansing via swabbing technique was associated with increased perception of pain and increased rates of infection when compared to the irrigation group (93.4% versus 84.2% p = 0.02 and 5.2% versus 3.3% p = 0.44, respectively). Only a small proportion of this sample met the inclusion criteria, so the results are not considered externally valid.

CONCLUSION: Wound cleansing remains a controversial topic. Despite calls for further research, there continues to remain a large gap in evidence to guide practice. Irrigation continues to replace swabbing in the management of chronic wounds, although evidence of improved outcomes is virtually nonexistent. Although the one study identified was of sound methodological quality, chronic wounds accounted for only a small percentage of the sample. Therefore, results are not generalizable to those with chronic wounds. Further research is needed to determine the effectiveness of basic wound cleansing techniques before considering more costly products.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 32, no 1, p. 136-143
Keywords [en]
Bleeding, Chronic wound, Cleansing, Exudate, Infection, Necrotic tissue, Pain
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-102532DOI: 10.1016/j.jtv.2022.11.002ISI: 000950431000001PubMedID: 36462962Scopus ID: 2-s2.0-85143122489OAI: oai:DiVA.org:oru-102532DiVA, id: diva2:1716289
Available from: 2022-12-05 Created: 2022-12-05 Last updated: 2024-04-08Bibliographically approved

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Rajhathy, ErinBeeckman, DimitriFalk-Brynhildsen, Karin

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