Pediatric Pilot Study: Irrigation and Scrubbing in Facial and Scalp Wounds
| Status: | Withdrawn |
|---|---|
| Conditions: | Other Indications |
| Therapuetic Areas: | Other |
| Healthy: | No |
| Age Range: | Any - 20 |
| Updated: | 4/21/2016 |
| Start Date: | April 2009 |
| End Date: | April 2010 |
A Pilot Study of Noncontaminated Facial and Scalp Wounds in the Pediatric Population: Getting Away Without Irrigation and Scrubbing
Most pediatric lacerations occur indoors and are considerably noncontaminated. Wounds that
occur outside of the house where dirt often enters the laceration, irrigation and scrubbing
with soap has been proven effective at decreasing post-laceration infections. To date there
are no pediatric prospective studies addressing a less aggressive approach to face and scalp
wound preparation in pediatrics. We argue that wiping wounds with sterile gauze soaked in
sterile saline will not increase infection rates as compared to our current practice. In our
emergency departments, the current standard of care for all lacerations is aggressive wound
preparation: irrigation and scrubbing. This occurs regardless if the wound is contaminated
or not. Research has proven that irrigation and scrubbing is unwarranted in adults with face
and scalp lacerations. We want to perform a pilot/feasibility study comparing our two
emergency campuses. One campus will serve as the control site, while the other will be the
intervention site. In this pilot study, our goal is to demonstrate the feasibility of the
intervention and provide data that a less aggressive approach to wound preparation is just
as effective as our standard of care. We hope this project leads to further discussion about
how we manage noncontaminated lacerations and provides a stepping-stone to a larger,
appropriated powered study.
occur outside of the house where dirt often enters the laceration, irrigation and scrubbing
with soap has been proven effective at decreasing post-laceration infections. To date there
are no pediatric prospective studies addressing a less aggressive approach to face and scalp
wound preparation in pediatrics. We argue that wiping wounds with sterile gauze soaked in
sterile saline will not increase infection rates as compared to our current practice. In our
emergency departments, the current standard of care for all lacerations is aggressive wound
preparation: irrigation and scrubbing. This occurs regardless if the wound is contaminated
or not. Research has proven that irrigation and scrubbing is unwarranted in adults with face
and scalp lacerations. We want to perform a pilot/feasibility study comparing our two
emergency campuses. One campus will serve as the control site, while the other will be the
intervention site. In this pilot study, our goal is to demonstrate the feasibility of the
intervention and provide data that a less aggressive approach to wound preparation is just
as effective as our standard of care. We hope this project leads to further discussion about
how we manage noncontaminated lacerations and provides a stepping-stone to a larger,
appropriated powered study.
Inclusion Criteria:
1. facial and scalp wounds acquired by blunt trauma,
2. wounds incurring within a house or indoor gym,
3. all ages, 1 month to 20 years of age.
Scalp is defined as the skin covering the head. The face is the area anterior to the ears,
below the chin and extending to the hairline of the forehead. Wounds requiring deep
sutures will also be included.
Exclusion Criteria:
1. Patients presenting with wounds that occur outdoors,
2. Wounds greater than 12 hour old,
3. Immunocompromised, malnourished or a diabetic,
4. Intoxicated,
5. Currently on antibiotics,
6. Sickle cell anemia,
7. Collagen vascular disease,
8. Wounds requiring plastic surgery,
9. Wounds from human or animal bites,
10. Wounds not on the face or scalp,
11. Patient's just discharged from the hospital within 72 hours,
12. Wounds with foreign bodies or grossly contaminated,
13. No suture nurses are present or available to suture.
We found this trial at
1
site
Click here to add this to my saved trials
