Medical Myth Busters: New Studies Expose Nine Long-standing ‘Truths’
By Jennifer Larson, contributor
Nurses and other health care practitioners are highly educated and well trained--not the type of people who would believe a myth, right? Yet some commonly held medical beliefs that are practiced in health care facilities and even passed on to patients may be just that. Researchers continue to test assumptions and provide new evidence that calls some of these “truths” into question.
Here are just a few long-standing medical myths that research has recently shown to be untrue--or at least not true in every situation:
1. A surgical incision should not get wet before the sutures can be removed.
Patients are traditionally sent home after surgery with strict instructions not to get their surgical incisions wet, often for at least 48 hours. The rationale: keeping the incisions dry will prevent infection. However, a new study involving more than 2,000 foot and ankle surgery patients found that bathing before suture removal did not increase the risk of postoperative infection or other complications. "The results of these studies showed that no basis exists for recommending that a patient avoid showering or bathing a surgical incision site as part of their normal daily hygiene during the healing process," said researcher Dr. Paul Dayton. The findings appear in the Journal of Foot and Ankle Surgery.
This data backs up earlier studies such as a 2006 British Medical Journal (BMJ) study that found most minor incisions will be just fine if they get wet within that 48-hour time frame. The researchers found no major difference in outcome among patients who kept their incisions covered and dry and those who didn’t.
2. Women in labor should be given an enema to avoid infection complications.
A recent review from the Cochrane Collaboration found that enemas didn’t significantly affect infection rates (such as a perineal wound infection). The researchers found no solid evidence that would recommend giving a woman an enema during labor. But your mother or your grandmother might tell you she had quite a different experience years ago.
3. People need to work out at least three times per week to receive any health benefit.
Three times may be a charm, but not for everyone. A new study published in The Journal of Strength and Conditioning Research explains that “a little bit of exercise can go a long way” for older women, many of whom have trouble sticking to an exercise regime over the long haul. Researchers from the University of Alabama at Birmingham concluded that a combination of aerobic exercise training (AET) and resistance exercise training (RET) just once a week could help women over age 60 build strength and endurance, and enhance their quality of life.
4. Patients should fast and have their bowels cleansed prior to having major abdominal surgery.
A new study from the Mayo Clinic examined the outcomes of women who had recently had complex gynecological surgery. They looked at the women who had undergone certain pre-surgical preparations and compared them to women whose care was managed by a protocol called an Enhanced Recovery Pathway, or ERP, which eliminated that pre-surgical bowel cleansing and greatly shortening the period of fasting. The ERP women had faster recoveries. According to the researchers, using the ERP helped the patients regain bowel function more quickly after surgery, speeding up the recovery process--and patients rated it favorably, too.
5. Care led by doctors is superior to care led by nurses.
On the surface many nurses may not believe this statement to begin with, but now they can point to recent study results about the care for people with rheumatoid arthritis (RA), which was published in Annals of the Rheumatic Diseases. Researchers found that nurse-led care (NLC) proved to be more effective in managing people with RA than care led by a rheumatologist, partly because of more time that the NLC patients spent with clinicians. The patients managed by nurses tended to experience fewer changes in medication or dosage--and the care was more cost-efficient, too.
6. Women who received care from midwives are more likely to have a complicated birth.
This isn’t necessarily true, either. The Cochrane Library recently reviewed 13 studies from various countries and found that, in fact, women who were cared for by midwives were 23 percent less likely to have premature births. Additionally, the researchers found that the rate of Cesarean-section births were approximately equal among women receiving midwife-led care and those receiving medical-model care. However, women with high-risk pregnancies or substance abuse problems were excluded from this study. “The main takeaway for women should be that a team of coordinated caregivers monitoring them throughout pregnancy is the best choice," the lead researcher said. Differences in licensed and lay midwives were also discussed.
7. It is always a good idea for patients to get a chest X-ray prior to undergoing surgery.
Not according to the American College of Radiology. Many patients, especially the low risk patients, do not need to undergo this particular test to get cleared for surgery. While an X-ray is not extremely expensive, many see it as a waste of money and an added risk (through low levels of radiation exposure) if it is unnecessary. Unless a person has heart or lung disease, or symptoms of them, or is over 70 years of age, they probably don’t need a pre-surgical chest X-ray.
8. Bed rest is best for women with high-risk pregnancies.
Many of us know someone who was confined to her bed, either at home or in the hospital, during the last weeks or months of a high-risk pregnancy, and in fact may care for some in the maternity wards at your assignment hospitals. But a recent article in Obstetrics & Gynecology explains that therapeutic bed rest is actually unnecessary for many conditions such as pre-eclampsia, hypertension, pre-term birth, etc. And the authors noted several comprehensive studies that back up their conclusions.
9. People should drink at least 8 glasses of water a day for optimal health.
This popular advice can still be found in a variety of health publications and heard in health care facilities across the country. A BMJ article from 2007 points out the idea of drinking at least 64 ounces of water each day may have started with a recommendation from as far back as 1945, but most people aren’t aware that the medical expert added, “Most of this quantity is contained in prepared foods.”
Other endorsements of this practice have come from nutritionists and medical professionals, but a review by Heinz Valtin in the American Journal of Physiology in 2002 found no real evidence to support drinking that much water in addition to a normal diet. In fact, existing studies suggest that adequate fluid intake is usually met through typical daily consumption of juice, milk, and even caffeinated drinks. Patients with kidney disease and other conditions may need higher levels of fluid intake, however.
More medical myths exposed:
Earlier this year, researchers from the Mayo Clinic published a list of 146 contemporary medical practices that have recently been reversed. The team analyzed 10 years’ worth of articles on standards of care that were published in the prestigious New England Journal of Medicine and found that many were unnecessary and unhelpful to patients. And the Choosing Wisely Campaign launched by the ABIM Foundation has worked on publicizing lists of common practices that physicians and patients should question.
Conclusion:
Don’t assume that certain medical practices--even reasonable-sounding ones--will remain unchanged forever. As nurses, it’s important for to stay abreast of the latest research so you’ll know whether the advice you hear, and pass on to others, is backed up by evidence or not.
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