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WOUND DRESSING SOLUTIONS

Wound Care Training Module

Wound Care Training Module - National Wound Care Committee

Wound Care Training Module

Wound Care Training Module - National Wound Care Committee

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  1. Definition
  2. Non Antiseptic Solutions
  3. Antiseptic Solutions

Content

Wound Care Training Module - National Wound Care Committee

Content

Wound Care Training Module - National Wound Care Committee

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DEFINITION

  • Wound cleansing is a process of removing inflammatory contaminants from the wound surface. These contaminants can impede healing and increase risk of infection.

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  • The contaminants are:

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  • Necrotic tissues
  • Excess exudates
  • Foreign objects
  • Infected tissues

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  • Solutions used in wound cleansing can be either non-antiseptic or antiseptic.

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NON-ANTISEPTIC SOLUTIONS

  • Non-antiseptic solutions are used to clean the wounds.
  • Commonly used non-antiseptic solutions are:

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  • Normal Saline
  • Water for irrigation

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Normal Saline

  • Preferred cleanser for most types of wounds (physiologic and safe).
  • Less effective in dirty and necrotic wounds.
  • Not advisable in MRSA and Pseudomonas infected wound.
  • Once the container is opened, it should be used within 24 hours.

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Water for irrigation

  • Less physiologic compared to normal saline but still safe to be used.
  • Can be used in MRSA and Pseudomonas infected wounds.

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ANTISEPTIC SOLUTIONS

  • Antiseptic solutions are used to clean the wound which are dirty and infected.
  • Commonly used antiseptic solutions are:
  • Chlorhexidine gluconate 1:200 in Aqueous solution
  • Super-oxidized solution
  • Polyhexamethylene biguanide (PHMB) solution �

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Chlorhexidine gluconate 1:200 in Aqueous solution

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  • Effective against Gram positive bacteria, fungi and also enveloped viruses.
  • Less effective against Gram negative bacteria.
  • Has both bactericidal and bacterostatic action.
  • Readily available in healthcare setting.

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Super-oxidized solution

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  • Good bactericidal, virucidal, fungicidal and spongicidal.
  • Also blocks the inflammatory process.
  • May help in biofilm removal.
  • Two components in this solution are oxidized water and chlorine.
  • The oxidized water is broken down into oxygen, ozone and other oxidized species.
  • Costly.

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Polyhexamethylene biguanide (PHMB) solution

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  • Helps to soften and remove the slough.
  • It can remove and reduce the biofilm formation.
  • Less painful.
  • Costly.

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  • These solutions besides painful on application also cause harm to the normal tissues if used as dressing solutions (cytotoxic), however a short term use may be permissible 

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  • Povidone iodine
  • Hydrogen peroxide
  • Sodium hypochlorite
  • Acetic acid
  • Eusol

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REFERENCES

  • Atiyeh BS, Dibo SA, Hayek SN. Wound cleansing, topical antiseptics and wound healing. Int Wound J 2009; 6:420–430
  • Ennis WJ, Valdes W, Salzman S, Fishman D, Meneses P. Trauma and wound care. 2004;291-307.
  • Chisholm CD, Cordell WH, Rogers K, Woods JR. Comparison of a new pressurized saline canister versus syringe irrigation for laceration cleansing in the emergency department. Ann Emerg Med. Nov 1992;21(11):1364-7. [Medline].
  • Watt BE, Proudfoot AT, Vale JA. Hydrogen peroxide poisoning. Toxicol Rev. 2004;23(1):51-7. [Medline].
  • Leyden JJ, Bartelt NM. Comparison of topical antibiotic ointments, a wound protectant, and antiseptics for the treatment of human blister wounds contaminated with Staphylococcus aureus. J Fam Pract. Jun 1987;24(6):601-4. [Medline].

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THANK YOU

Wound Care Training Module - National Wound Care Committee