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Wound Cleaning and Wound Healing: A Concise Review

Wilkins, Robert G. MBChB, FRCA; Unverdorben, Martin MD, PhD

Advances in Skin & Wound Care: April 2013 - Volume 26 - Issue 4 - p 160–163
doi: 10.1097/01.ASW.0000428861.26671.41

ABSTRACT Chronic wounds present a significant societal burden in their cost of care, and they reduce patient quality of life. Key components of wound care include such measures as debridement, irrigation, and wound cleaning. Appropriate care removes necrotic tissue and reduces wound bioburden to enhance wound healing. Physical cleaning with debridement and irrigation is of documented efficacy. Wounds may be washed with water, saline, or Ringer’s solution or cleaned with active ingredients, such as hydrogen peroxide, sodium hypochlorite, acetic acid, alcohol, ionized silver preparations, chlorhexidine, polyhexanide/betaine solution, or povidone-iodine—the majority of which are locally toxic and of limited or no proven efficacy in enhancing wound healing. Although the consensus opinion is that these topical cleaning agents should not be routinely used, recent clinical evidence suggests that polyhexanide/betaine may be nontoxic and effective in enhancing wound healing. Further well-designed studies are needed.

This review is based on a literature search for studies discussing cleaning or cleansing of chronic wounds.

Robert G. Wilkins, MBChB, FRCA, is Consultant, Health Care Consulting, Basking Ridge, New Jersey. Martin Unverdorben, MD, PhD, is former Senior Vice President Medical Scientific Affairs and Chief Medical Officer, B. Braun Medical Inc, Allentown, Pennsylvania. Dr Wilkins has disclosed that he is/was a consultant/advisor to B. Braun Medical Inc. Dr Unverdorben was an employee of B Braun Medical Inc. Financial support was provided by B. Braun Medical Inc for the execution of this review.

Submitted April 20, 2012; accepted in revised form September 27, 2012.

© 2013 Lippincott Williams & Wilkins, Inc.