比較自來水與生理食鹽水對傷口的清潔:利用AMSTAR綜觀系統性文獻回顧

Translated title of the contribution: A Comparison Between Tap Water and Saline for Wound Cleansing: An Overview of Systematic Reviews Using AMSTAR

石馥綺, 吳承樺, 林芸如, 張瑞珊, 潘柔雯, 賴慧娟, 黃采薇

Research output: Contribution to journalArticle

Abstract

Background: Numerous solutions such as tap water and sterile saline are available for wound cleansing, yet the evidence of these interventions is complex across the literature. Purpose: We aimed to compare the difference between tap water and saline for wound cleansing through an overview of systematic reviews. Methods: MEDLINE, EMBASE, CINAHL and the Cochrane Database of Systematic Reviews were searched on Oct. 2016. Systematic reviews that examined adults receiving care for their wound cleansing were included. Two reviewers independently screened the literature, abstracted data, and assessed study quality using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. Results: Seven systematic reviews were included after screening and 4 were systematic reviews without a meta-analysis. Overall, 42.86% of included reviews were rated as being of high quality (AMSTAR score ≥8). For the pressure ulcers, two studies reported no statistically significant change in healing was seen when wounds were cleaned with water was compared with saline. For the chronic wounds, two studies showed there was no increase in infection or in wound healing rates between patients whose wounds were cleaned with tap water or sterile saline. Finally, 4 of studies presented that the use of tap water to cleanse acute wounds in adults and children was not associated with a statistically significant difference in infection rate when compared to saline. Conclusion / Implications for Practice: The high quality evidence indicates that using tap water to cleanse acute, chronic or pressure wounds are no significant difference increases or reduces infection when compared to saline. The AMSTAR scale can useful to evaluate the quality of systematic reviews. However, most studies were consistently across all outcomes throughout the literature. Clinicians and nurses rarely use the results to wound cleansing. The gap between what we know and what we do remains a challenge for the discipline and the professions. Evidence-based medicine has emphasized the fact that often decisions are value and partiality sensitive. To do the best for the individual patient, clinicians need to evaluate patients' values and preferences, especially of shared decision-making.
Original languageTraditional Chinese
Pages (from-to)91-101
Number of pages11
Journal弘光學報
Issue number79
DOIs
Publication statusPublished - 2017

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Wounds and Injuries
Water
Infection
Nurse Clinicians
Saline Waters
Patient Preference
Pressure Ulcer
Evidence-Based Medicine
MEDLINE
Wound Healing
Meta-Analysis
Decision Making
Databases
Pressure

Cite this

比較自來水與生理食鹽水對傷口的清潔:利用AMSTAR綜觀系統性文獻回顧. / 石馥綺; 吳承樺; 林芸如; 張瑞珊; 潘柔雯; 賴慧娟; 黃采薇.

In: 弘光學報, No. 79, 2017, p. 91-101.

Research output: Contribution to journalArticle

石馥綺 ; 吳承樺 ; 林芸如 ; 張瑞珊 ; 潘柔雯 ; 賴慧娟 ; 黃采薇. / 比較自來水與生理食鹽水對傷口的清潔:利用AMSTAR綜觀系統性文獻回顧. In: 弘光學報. 2017 ; No. 79. pp. 91-101.
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title = "比較自來水與生理食鹽水對傷口的清潔:利用AMSTAR綜觀系統性文獻回顧",
abstract = "背景:許多溶液,如自來水或生理食鹽水經常被使用在傷口的清潔,但哪一種溶液對傷口清潔較好,卻仍無定論。目的:本研究目的是利用AMSTAR (Assessment of Multiple Systematic Reviews)比較兩種溶液在傷口清潔的系統性文獻回顧結果,並評價系統性文獻本身之品質。方法:本研究收集了系統性文獻回顧文章來了解自來水與生理食鹽水在傷口清潔上的差異。共搜尋PubMed, EMBASE, CINAHL及Cochrane Database of Systematic Reviews等資料庫,不限開始時間,收集至2016年10月,不限制語言,納入傷口清潔的系統性文獻回顧,由兩位作者分別檢視文獻、摘要,並利用AMSTAR評價研究品質。結果:共收集七篇系統性文獻回顧文章,其中有四篇未做統合分析,整體來說,所收錄的研究有3篇(42.86{\%})屬於高品質(AMSTAR ≥8分)。在所收錄之七篇系統性文獻中,針對壓傷傷口癒合情形部分,其中有兩篇研究比較自來水與生理食鹽水並無顯著差異;在慢性傷口部分,其中有兩篇研究指出感染情形並無增加且傷口癒合速度亦無差異。最後,其中有四篇研究提到使用自來水清潔急性傷口在感染率上跟生理食鹽水並無差異。結論與實務應用:本研究之高品質系統性文獻回顧的文章都指出使用自來水與生理食鹽水在急性、慢性及壓傷傷口感染及癒合情形兩者皆未有顯著影響。本研究使用AMSTAR來協助判斷系統性文獻文章之品質,然而,許多研究均一致表示自來水與生理食鹽水在傷口清潔上無顯著差異,但臨床上卻鮮少執行,所知和所做仍有挑戰,實證醫學在執行上需要評估病患需求與價值觀,並分享醫療決策。",
keywords = "傷口清潔, AMSTAR, 系統性文獻回顧, 自來水, Wound cleansing, Systematic review, tap water",
author = "石馥綺 and 吳承樺 and 林芸如 and 張瑞珊 and 潘柔雯 and 賴慧娟 and 黃采薇",
year = "2017",
doi = "10.6615/HAR.201703.79.08",
language = "繁體中文",
pages = "91--101",
journal = "弘光學報",
issn = "1025-0662",
publisher = "弘光科技大學",
number = "79",

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TY - JOUR

T1 - 比較自來水與生理食鹽水對傷口的清潔:利用AMSTAR綜觀系統性文獻回顧

AU - 石馥綺, null

AU - 吳承樺, null

AU - 林芸如, null

AU - 張瑞珊, null

AU - 潘柔雯, null

AU - 賴慧娟, null

AU - 黃采薇, null

PY - 2017

Y1 - 2017

N2 - 背景:許多溶液,如自來水或生理食鹽水經常被使用在傷口的清潔,但哪一種溶液對傷口清潔較好,卻仍無定論。目的:本研究目的是利用AMSTAR (Assessment of Multiple Systematic Reviews)比較兩種溶液在傷口清潔的系統性文獻回顧結果,並評價系統性文獻本身之品質。方法:本研究收集了系統性文獻回顧文章來了解自來水與生理食鹽水在傷口清潔上的差異。共搜尋PubMed, EMBASE, CINAHL及Cochrane Database of Systematic Reviews等資料庫,不限開始時間,收集至2016年10月,不限制語言,納入傷口清潔的系統性文獻回顧,由兩位作者分別檢視文獻、摘要,並利用AMSTAR評價研究品質。結果:共收集七篇系統性文獻回顧文章,其中有四篇未做統合分析,整體來說,所收錄的研究有3篇(42.86%)屬於高品質(AMSTAR ≥8分)。在所收錄之七篇系統性文獻中,針對壓傷傷口癒合情形部分,其中有兩篇研究比較自來水與生理食鹽水並無顯著差異;在慢性傷口部分,其中有兩篇研究指出感染情形並無增加且傷口癒合速度亦無差異。最後,其中有四篇研究提到使用自來水清潔急性傷口在感染率上跟生理食鹽水並無差異。結論與實務應用:本研究之高品質系統性文獻回顧的文章都指出使用自來水與生理食鹽水在急性、慢性及壓傷傷口感染及癒合情形兩者皆未有顯著影響。本研究使用AMSTAR來協助判斷系統性文獻文章之品質,然而,許多研究均一致表示自來水與生理食鹽水在傷口清潔上無顯著差異,但臨床上卻鮮少執行,所知和所做仍有挑戰,實證醫學在執行上需要評估病患需求與價值觀,並分享醫療決策。

AB - 背景:許多溶液,如自來水或生理食鹽水經常被使用在傷口的清潔,但哪一種溶液對傷口清潔較好,卻仍無定論。目的:本研究目的是利用AMSTAR (Assessment of Multiple Systematic Reviews)比較兩種溶液在傷口清潔的系統性文獻回顧結果,並評價系統性文獻本身之品質。方法:本研究收集了系統性文獻回顧文章來了解自來水與生理食鹽水在傷口清潔上的差異。共搜尋PubMed, EMBASE, CINAHL及Cochrane Database of Systematic Reviews等資料庫,不限開始時間,收集至2016年10月,不限制語言,納入傷口清潔的系統性文獻回顧,由兩位作者分別檢視文獻、摘要,並利用AMSTAR評價研究品質。結果:共收集七篇系統性文獻回顧文章,其中有四篇未做統合分析,整體來說,所收錄的研究有3篇(42.86%)屬於高品質(AMSTAR ≥8分)。在所收錄之七篇系統性文獻中,針對壓傷傷口癒合情形部分,其中有兩篇研究比較自來水與生理食鹽水並無顯著差異;在慢性傷口部分,其中有兩篇研究指出感染情形並無增加且傷口癒合速度亦無差異。最後,其中有四篇研究提到使用自來水清潔急性傷口在感染率上跟生理食鹽水並無差異。結論與實務應用:本研究之高品質系統性文獻回顧的文章都指出使用自來水與生理食鹽水在急性、慢性及壓傷傷口感染及癒合情形兩者皆未有顯著影響。本研究使用AMSTAR來協助判斷系統性文獻文章之品質,然而,許多研究均一致表示自來水與生理食鹽水在傷口清潔上無顯著差異,但臨床上卻鮮少執行,所知和所做仍有挑戰,實證醫學在執行上需要評估病患需求與價值觀,並分享醫療決策。

KW - 傷口清潔

KW - AMSTAR

KW - 系統性文獻回顧

KW - 自來水

KW - Wound cleansing

KW - Systematic review

KW - tap water

U2 - 10.6615/HAR.201703.79.08

DO - 10.6615/HAR.201703.79.08

M3 - 文章

SP - 91

EP - 101

JO - 弘光學報

JF - 弘光學報

SN - 1025-0662

IS - 79

ER -