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Page updated 30 April 2007

Wound Cleansing

Prior to cleansing the wound the nurse should consider the following issues:

 

Introduction

Although there is now a general move away from mechanical cleansing of the wound surface there are occasions when it is necessary to remove residues of slough or other debris from the wound or surrounding skin. The routine use of antiseptic solutions has little place in wound management (Value for Money Unit, 1996).

Wound Cleansing Agents

For routine wound cleansing, normal saline 0.9% is the preferred solution of choice. It should be warmed to body temperature (Thomas, 1990) before use to avoid lowering the temperature of the wound and impairing the healing process. However, the use of tap water for cleaning chronic wounds has been shown to have no detrimental effects to healing in any way (Young, 1995). To ensure fibres are not left in the wound irrigation should be carried out rather than swabbing the wound surface. However too low a pressure for irrigation may not be useful in removing exudate while too high a pressure may cause damage to granulating tissue. A variety of irrigation products are available and include steripods, sachets, aerosols, and syringes. Always read manufacturers instructions before use.

In some circumstances, the medical staff may request unfamiliar wound cleansing solutions. The following information should assist you with selecting the appropriate solution for wound cleansing based on current research based evidence. Notice that most are BAD for wound healing.

Acetic Acid 3%

Solutions containing cetrimide (e.g. Tisept, Cetrimide, Savlon)

Chlorhexidine

Hexachlorophane

Chlorinated solutions (e.g. Eusol, Dakin's solution)

Dyes (e.g. Brilliant green, gentian violet, mercurochrome, potassium permanganate)

Hydrogen Peroxide

Povidone Iodine (e.g. lnadine, Betadine, Videne, etc)

Silver Nitrate 0.5% - 0.25% aqueous solution

Sugar (50% caster, 50% icing sugar mixed to a paste with sterile water)

Varidase

Sodium Chloride (e.g. 0.9% solution)

Tap Water