Antiseptics & Wound Care

[lovelie_skittle]

Do you think the use of antiseptics such as hydrogen peroxide a practice issue in caring for patients with wound or ulcers?

[boggle, ASN, RN]

H2)2 is disruptive to healing tissue in open wounds, but it can (and is) safely used to clean debris/drainage from incision lines, around sutures and staples.

[nursemaa]

Peroxide, betadine, etc have been shown to be effective on intact skin, which is why betadine is often used to prep surgical areas prior to incision. However, broken skin can be damaged (with the wound bed disrupted) when you use these products. Even with sutures/staples, some studies have recommended not using them. Normal saline is generally recommended for wound cleansing, and keeping the wound covered promotes granulation.

[nursemary9, BSN, RN]

Hi

To cleanse a wound, wound cleanser or normal saline is best. There are a number of commercial wound cleansers around. Normal saline is cheaper then the cleansers, usually.

Peroxide is too harsh & interfers with healing.

Mary Ann

[JamiRN]

We are taught not to use peroxide on any wound because it affects the healthy tissues (cytotoxic). Use normal saline for cleansing most pressure ulcers. If you can irrigate the area with a 35mL syringe and a 19 gauge needle or angiocath it should remove bacteria without causing trauma to the wound bed. We have used a product by 3M ... I can't think of its name....

[nosonew, BSN, RN]

we had a local surgeon who preferred Hydrogen Peroxide, but after going to some wound treatment seminars, it was stated that Hydrogen peroxide HURTS the wound healing process, so we stopped using it. They surgeon was not happy about it, because these people started to heal twice as fast and his $ went down. If it heals faster, they don't have to see him as much, right?

Of course, I still use hydrogen peroxide to INITIALLY clean off a wound on my kids, but that is it.

[apaisRN, RN, CRNA]

Of course, I still use hydrogen peroxide to INITIALLY clean off a wound on my kids, but that is it.

Out of curiosity why do you do this since we know it is cytotoxic?

I've never used or been ordered to use it - we use saline if a wound needs irrigation and might pack with Dakins or whatever else is ordered. Personally I usually just wash my own wounds with soap and water. I try to avoid antibacterial soap at home too, since we hear so much about resistant bugs.

[nosonew, BSN, RN]

Because when I went through that training, they stated for initial irrigation/cleaning it was okay for SMALL wounds. My kids just get a scraped knee or something. Anything deeper than that I would not use it! And, old habits are hard to break!

[leslie :-D]

at the last facility where i worked, the wound specialist stated that hydrogen peroxide was cytoxic to healthy cells so would never be used in cleaning wounds.

now just the other noc, the sdc was showing me a cleaning solution they use (as opposed to ns) because ns has a very short life once opened...never knew that.