UMEM Educational Pearls

Category: Orthopedics

Title: Wound Care

Keywords: Wound Care, Antiseptics (PubMed Search)

Posted: 6/5/2010 by Michael Bond, MD
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Wound Care:

Patients and many providers want to irrigate or wash a wound with an antiseptic solution in order to decrease the risk of infection.  Most studies have shown that irrigation whether with tap water or sterile water is effective enough in reducing bacterial counts in a wound so does adding an antiseptic solution offer any additional benefit.

It turns out that hydrogen peroxide, and iodine based solutions can actually hinder wound healing as they causes delays in the migration and proliferation of fibroblasts at concentrations that are not even bactericidal.  Chlorhexidine, and silver containing antiseptics [i.e.: silver sulfadiazine and silver nitrate] are bactericidal at concentrations that do not affect fibroblasts.

So in the end, if you feel the need to use an antiseptic, use chlorhexidine or a silver containing antiseptic.  The use of hydrogen peroxide and iodine based solutions should be abandoned as they are not even bactericidal at concentrations that have profound affects on the fibroblasts.

References

Thomas, GS. Mechanisms of Delayed Wound Healing by Commonly Used Antiseptics. J Trauma 2009; 66:82-91