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Should detergents, hydrogen peroxide and concentrated povidone-iodine be used to irrigate wounds?

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تم إضافة السؤال من قبل Naveed Mughal MD , Urgent Care Medical Director , Urgent Care for Kids Corporate Headquarters
تاريخ النشر: 2016/10/02
ABY BOVAS
من قبل ABY BOVAS , Registered staff Nurse , al sahraa recruitment services(Al qassimi)

YES diabetic wound cases we can use both

ابراهيم عبد الله طلبة
من قبل ابراهيم عبد الله طلبة , General Practitioner _ GP , university Diabetes Center / King Saud Medical City

 

Wound irrigation is the steady flow of a solution across an open wound surface to achieve wound hydration, to remove deeper debris, and to assist with the visual examination. The irrigation solution is meant to remove cellular debris and surface pathogens contained in wound exudates or residue from topically applied wound care products. Compared to swabbing or bathing, wound irrigation is considered to be the most consistently effective method of wound cleansing. 

Normal wound healing is characterized by 3 interrelated phases: inflammatory, proliferative or fibroplastic, and remodeling. In normal wound healing, infectious microorganisms, foreign debris, and necrotic tissue are removed from the wound during the inflammatory phase due to vascular and cellular responses to trauma. However, weaknesses in the body’s inflammatory response can cause deficits in its ability to overpower surface microorganisms. This can lead to delayed angiogenesis and granulation tissue formation, as well as infection. Contaminating microorganisms can upset collagen synthesis and modify matrix metalloproteinases, leading to anoxia and impeding neutrophil and macrophage function.

Combined with debridement, irrigation is a critical step in facilitating progression from the inflammatory to proliferative phase of wound healing by removing debris that can impede the healing process. When performed properly, wound irrigation can aid in wound healing from the inside tissue layers outward to the skin surface. It may also help prevent premature surface healing over an abscess pocket or infected tract. [2] The goal of irrigation is to clean the wound while avoiding trauma to wound bed and minimizing risk of driving bacteria further into the wound bed.

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