Peroxide usage

I also use Peroxide to clean the cuts on my students. What information have you heard about peroxide use? Thanks.

I think that initial use of peroxide is fine depending upon what type of wound it is. The problem with peroxide is that it destroys new tissue formation so it shouldn't be used as a treatment of the wound after the initial cleansing.

Carly

Oops... I just realized the new nurse was offering opinion to the veteran! I hope that I didn't offend

Carly

Carly,

Your input is valuable and Thank you for stepping up !

No offense taken here. Thanks for your explanation Fireflies. I realize that there is always something new to learn so I was happy to jump in this discussion. :nuke:

I think that initial use of peroxide is fine depending upon what type of wound it is. The problem with peroxide is that it destroys new tissue formation so it shouldn't be used as a treatment of the wound after the initial cleansing.

Carly

this is a fact!

We stopped using H2O2 in the ED over 10 years ago because of the tissue damage. The hospital used ShurClense, which is too expensive for me to order in school. I use plain soap and H2O. If it is a wound that they can't clean at the sink, I use Bactine.

hydrogen peroxide is not used for wounds any longer and your district procedure manual should be revised if that is still the protocol.

there is an evidence based wound care clinical guideline specific to schools:

http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=10196&nbr=5380

"school age children presenting to the office for wound care will have wounds cleaned with liquid antibacterial soap and tap water only.....

solutions that should not be used for the treatment of wounds include: povidone-iodine, dakin's solution and hydrogen peroxide. these solutions are as likely to damage normal tissue as they are to destroy unwanted bacteria that may be present in or around the wound (atiyeh, et al., 2002. evidence grade = b1).

antibiotic creams and other topical medications should only be used if standing orders are on file."

hydrogen peroxide is not used for wounds any longer and your district procedure manual should be revised if that is still the protocol.

there is an evidence based wound care clinical guideline specific to schools:

http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=10196&nbr=5380

"school age children presenting to the office for wound care will have wounds cleaned with liquid antibacterial soap and tap water only.....

solutions that should not be used for the treatment of wounds include: povidone-iodine, dakin's solution and hydrogen peroxide. these solutions are as likely to damage normal tissue as they are to destroy unwanted bacteria that may be present in or around the wound (atiyeh, et al., 2002. evidence grade = b1).

antibiotic creams and other topical medications should only be used if standing orders are on file."

martha,

is there anything (solution) that can be purchased from a medical supply that can be used to flush out wounds ??

praiser

Martha,

Is there anything (solution) that can be purchased from a medical supply that can be used to flush out wounds ??

Praiser

My experience shows that a good wash under running, warm, water and a little soap (any), and gentle rub with gauze is the best cleaner/debrider.

I'm not a school nurse, but I recently read a study comparing wound irrigation solutions in the ER. Sterile saline was compared to sterile water and to tap water regarding incidence of resulting infection. The results were essentially identical even with tap water.

To write this government endorsed clinical guideline, a systematic review of all of the available literature was used to locate the best evidence, the best practice. Then their findings, their decisions, were reviewed by school nurse and wound care content experts.

They describe their methodology :

http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=10196&nbr=5380#s22

So once that happens, and until this clinical guideline is replaced with one that looks over research studies that will be performed in the future, you would have to make a strong argument and rationale for not following their recommendation of tap water. That is, there would need to be specific circumstances that would preclude the use of tap water or a specific reason why it could not be used on a particular child. By publishing and vetting these recommendations, they set the standard of care.

So in a school setting, with a tap water supply that is not compromised, you should flush the wound with tap water.

There are some other clinical guidelines for school nurses and for problems we treat in schools at http://www.guidelines.gov