When is wound cleansing necessary and what solution should be used?


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Abstract

This article has been double-blind peer reviewedIn this article…• Circumstances in which wound cleansing is appropriate• How to select a wound cleansing solution• When to use topical antiseptic solutionsAuthorAnnemarie Brown is lecturer in nursing, University of Essex.Routinely cleansing wounds at every dressing change can do more harm than good, as scrubbing the granulating wound bed with gauze swabs may disrupt fragile tissue growth and damage new capillaries. The body may perceive this as a new injury and re-launch an inflammatory response, which will only delay the healing process. Cleansing wounds is, therefore, not recommended unless the wound shows signs of infection, presents with slough or is visibly contaminated with faecal material or debris. This article explains the circumstances in which it is appropriate to cleanse a wound, when it is appropriate to use tap water and when a sterile solution is recommended. It also discusses the re-emergence of antiseptic solutions - which are becoming more popular, particularly for infected or heavily contaminated wounds - and offers guidance on when to consider using them to cleanse wounds.CitationBrown A (2018) When is wound cleansing necessary and what solution should be used? Nursing Times; 114: 9, 40-43.Key pointsWounds are often cleansed without proper consideration of whether this is necessaryWound cleansing can interrupt the healing process by damaging new tissue or reducing the temperature of the wound bedPotable tap water is as safe and effective as normal saline for wound cleansing, although saline should be used on post-operative woundsAntiseptic solutions are increasingly used to cleanse wounds showing signs of critical colonisation and when the presence of a biofilm is suspected

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