Saline soaks in wound care. Sacred cow? More harmful then good?

Nurses General Nursing

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There seems to be a lot of mixed opinions over the prescribing of saline soaks for wounds. Say for example, someone has an infected toe. Some people are of the opinion that it will be remedied by daily or twice a day soaking of the affected area in a saline bath. I wonder what is the theory is on what this is supposed to do?

Thanks for replying so quickly. I will call the emts today as today is sunday and tomorrow is a holiday she wont be able to see her wound care specialist or her dr. I was asking for advice, here even though I know I'm not supposed to but I am worried. My reason for the hesitatition is I have taken her before to the hospital for things and they roll there eyes and act as if I'm paranoid. But I'm my daughters best advocate. I have to take her per ambulance because I cannot get her there by car. She has alot of problems and it is impossible to lift into a car. That is why I usually try to assess her first. Thanks again I feel so much better. I'll write back and tell you what happened if thats ok.:balloons:

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My reason for the hesitatition is I have taken her before to the hospital for things and they roll there eyes and act as if I'm paranoid. But I'm my daughters best advocate.

I'll write back and tell you what happened if thats ok.:balloons:

Well, yeah! You better!

And roll your eyes right back at them.

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Wet to dry isn't used very often here anymore. It isn't considered best practice. Sure it debrides but it also takes off healthy tissue and delays healing and is painful to the patient. Using mechanical debridement with a scalpel or a chemical debrider and irrigating with a syringe( 30 cc) and a 18 guage needle and saline are a lot more effective. We don't use h2o2 for the same reason. I like saline as a wound care cleanser but I am not a huge fan of soaks. For some things it helps but for the most part it isn't needed.

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Okay silly question here:

so an order for "saline soaks" is to be interpreted as soaking the existing dressing with saline before removing as to not remove the new granulating tissue? Not to soak the affected area for a specific amount of time in a bowl of saline?

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Okay silly question here:

so an order for "saline soaks" is to be interpreted as soaking the existing dressing with saline before removing as to not remove the new granulating tissue? Not to soak the affected area for a specific amount of time in a bowl of saline?

It depends. I often will apply a saturated 4x4 to the wound. Depends on where it is. Obviously a toe can be put in a bowl of ns but say a wound further up would be sort of difficult of do that;). We sometimes see vinegar soaks. I have one patient who is resistant to every antibiotics and we have a standing order to apply vinegar soaks when the discharge becomes green or foul. Not much else we can do at this point. Plus it seems to do the trick with pseudomonas.

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Okay silly question here:

so an order for "saline soaks" is to be interpreted as soaking the existing dressing with saline before removing as to not remove the new granulating tissue? Not to soak the affected area for a specific amount of time in a bowl of saline?

you need to clarify with the doctor.

soaks, per se, are essentially a means of cleaning an already clean wound.

saline is indicated for wounds with pink, viable tissue.

unless it's a w-d, where debridement is necessary.

but this is an outdated method of debridement.

if debriding isn't necessary, then you soak the dsg before removing.

how long does one soak for? 15 min? half hr? 5 min?

i don't know.

if the wound is to be 'soaked', then dressed, that's a different story.

there are saline gels, but i'm not in love w/those either.

what type of wound is this for, anyway?

leslie

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oh my god. this website prettymuch saved my daughters life, as well as the wonderful nurses who had the knowledge to help me on this website yesterday!! I did see my daughter this morning in her home and the minute I saw the black dead tissue i just knew. she had a temp, surrounding tissue hard and red and she had the chills but she was adament not to go, I said you will go and called the emts to transport, got her to the ER and they wisked her past everyone, assess and said to her you need to go now and she said I just want to go back home and my mom can repack etc. I will never forget the DRS. comment He said "Dawn yes you are your own gaurdian, and It leagely not up to your mom but, you will be dead by morning. you are septic! anyways sorry to take up this thread that was not meant for this sort of discussion, I just wanted to thank you all from the bottom of my soul for your gifted opioion. I will never forget.

The Surgeon removed the dead tissue and she is in ICU as I speak but doing very well. The DR did alot of Tissue samples to find out why in 5 days It became so toxic, since all the other bedsores I have maintained so welll never esculated so fast as this one, perhaps another entity a nasty bactirea or something. I am thinking after my RN to go into wound care. Thank you all again and please know when you lay your head down tonight I am thanking God for you, from a small town in Maine. :balloons::balloons::balloons::balloons:

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sorry one more comment. I have learned more on this thread about wound care than the last 15yrs of my involvement in my daughters life I know it is all confidental and just opinions but thanks. And I also promise to take spelling lessons soon LOL.

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And I also promise to take spelling lessons soon LOL.

Cathleen, I am so glad you got her there! And thanks for letting us know.

(And no one gives the proverbial flying one about your spelling, girl.)

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cathleen, i'm glad to hear your dtr is getting medical attn.

you know your dtr better than anyone else.

keep on fighting for her.

bless you both.

leslie

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Okay silly question here:

so an order for "saline soaks" is to be interpreted as soaking the existing dressing with saline before removing as to not remove the new granulating tissue? Not to soak the affected area for a specific amount of time in a bowl of saline?

Our order read saline soak dsg BID or TID. So two or three times a day we pack the wound with saline soaked gauze or tape, then cover. If the dsg has dried out by the next change, we've been instructed to moisten for removal.

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So two or three times a day we pack the wound with saline soaked gauze or tape, then cover

And talk about rubbing salt into a wound. Saline-soaked packs hurt.

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