Irrigation with potable water versus normal saline in a contaminated musculoskeletal wound model

BACKGROUND: Although the use of potable water for wound irrigation is attractive in an austere environment, its effectiveness has not been tested. We sought to compare the effectiveness of potable water irrigation in reducing bacterial number with that of normal saline irrigation. METHODS: We used an established caprine model involving the creation of a reproducible complex musculoskeletal wound followed by inoculation with luminescent bacteria that allowed for quantitative analysis with a photon-counting camera system. Six hours after injury and inoculation, wound irrigations were performed using pulsatile lavage. Fourteen goats were randomized into two treatment groups: irrigation with 9 L potable water versus irrigation with 9 L normal saline. Images obtained after irrigation were compared with baseline images to determine the reduction in bacterial luminescence resulting from treatment. RESULTS: The irrigation in both groups reduced the bacterial counts by 71% from the preirrigation levels. CONCLUSION: Potable water reduced the bacterial load as effectively as normal saline in our model.