Bleach baths for MRSA wounds

[StNeotser, ASN, RN]

Hello all,

I recently found an order for bleach baths 3 x per week for a patient who has a basal cell carcinoma wound infected with MRSA. Also on an oral ATB.

I had never heard of bleach baths, apparently it's half a cup of bleach in a full bath tub. I did google it but couldn't really find much information on it's effectiveness and wondered it anyone else had experience with this treatment.

[llg, PhD, RN]

My mom used to make us kids do that when we were covered with poison ivy. Chlorine bleach kills germs and dries things out. As long as it's not too strong ...

[Melina]

I recently read a study in which nasal application of 2% mupirocin and bleach baths were found to be more effective at eradicating Staphylococcus aureus colonization than other interventions. You can find the report here.

[kdhnursern]

Dakin's solution is an older treatment for wounds made from household bleach, baking soda, and tap water. This can be made as full, 1/2, 1/4, 1/8 strength. It's been around since World War I to treat infected wounds. As recently as a month ago, I had a patient who had this prescribed by a wound care doctor. So bleach baths make sense.

[RyanSofie]

Can Dankins be used on a diabetic heel ulcer with an eshcar over it? The eschar is split and the heel smells necrotic. The patient cannot afford the Santyl ordered by the podiatrist for her foot. We did get her on an oral antibiotic but how to deal with the wound now? I am using a hydrocolloid to keep the wound moist and loosen the eschar but I suspect this heel wound is deep. I was wondering if Dankins would help decrese the bacterial load in the wound.

[kdhnursern]

Dakin's solution helps to separate the dead tissue from the viable tissue without damaging living tissue. Might be a good choice for your wound. Was used on eschar covered diabetic wound.