Cleaning Wounds

Terry O’Connor, MD

Anesthetizing and Cleaning a scalp wound inflicted by a bar brawl at Everest Base Camp, Tibet. For reals. .

What’s the Magic Cleanser for wounds?

Bottom line:

Turns out it’s water . .  .  and lots of it.

In this  meta analysis of 11 studies, tap water, distilled water, cooled boiled water, and normal saline were evaluated. The studies included wounds in kids and adults. Wound type included lacerations (five trials), chronic wounds (one trial), surgical wounds (four trials), and open fractures.

Tap water was compared to saline, and the relative risk of infection was 0.63.4 Thus, if tap water was utilized, infection was less likely than with saline irrigation. Same goes for cooled boiled water.

Should you use iodine or Betadine?

Turns out additive are not really helpful and concentrations >1% may actually be toxic to the skin!

Wound check . . . and a hangover the next day

REFERENCES

Goldenheim PD. An appraisal of povidone-iodine and wound healing. Postgrad Med J. 1993;69 Suppl 3:S97-105.

Rogers DM, Blovin GS, O’Leary JP. Povidone-iodine wound irrigation and wound sepsis. Surg Gynecol Obstet. 1983;157:426-430.

Cooper ML, Laxer JA, Hansbrough JF. The cytotoxic effects of commonly used topical antimicrobial agents on human fibroblasts and keratinocytes. J Trauma. 1991;31:775-784