From the Guidelines
Saline (sodium chloride) solution is the recommended choice for cleaning wounds, not hydrogen peroxide. For wound cleaning, use a 0.9% saline solution, which can be purchased as sterile saline or made at home by dissolving 1 teaspoon of salt in 2 cups of clean water and boiling for 15 minutes. To clean a wound, gently irrigate the area with saline using light pressure, removing debris and contaminants while preserving healthy tissue.
Key Points to Consider
- Hydrogen peroxide is no longer recommended for routine wound care because it damages healthy cells and delays healing 1.
- It destroys fibroblasts and keratinocytes needed for tissue repair and can cause air embolisms in deep wounds.
- Saline is effective at removing contaminants while being gentle on healing tissues, maintaining the moist environment necessary for optimal wound healing.
- The wound should be cleaned regularly with water or saline, as stated in the guidelines for wound and wound-bed management of diabetic foot ulcers 1.
- For infected wounds or special circumstances, a healthcare provider may recommend specific antiseptic solutions, but saline remains the standard first-line cleaning solution for most wounds.
Wound Care Recommendations
- Clean the wound regularly with saline solution to promote healing and prevent infection.
- Use a sterile, inert protective dressing to control exudate and maintain a moist wound environment.
- Consider regular debridement with a scalpel or other agents to clean the wound bed, as needed.
From the Research
Wound Cleaning Solutions
- Hydrogen peroxide and saline are two commonly used solutions for cleaning wounds.
- The choice between these two solutions depends on various factors, including the type of wound, its location, and the patient's overall health.
Comparison of Hydrogen Peroxide and Saline
- A study published in 2023 2 found that hydrogen peroxide was more effective than saline in promoting granulation tissue formation and wound healing.
- The study reported that granulation tissue appeared earlier in the hydrogen peroxide group (mean 6.3 days) compared to the saline group (mean 9.3 days).
- However, another study published in 1995 3 suggested that saline is a preferred choice for wound cleaning due to its non-toxic nature, whereas hydrogen peroxide can be tissue toxic.
Safety and Efficacy of Hydrogen Peroxide
- A review published in 2019 4 discussed the safety and beneficial effects of hydrogen peroxide in surgery, highlighting its hemostatic and antimicrobial properties.
- However, the review also noted that hydrogen peroxide can have negative effects on wound healing and can be cytotoxic in higher concentrations.
- Another study published in 2013 5 found that physical cleaning with debridement and irrigation is effective in enhancing wound healing, but the use of topical cleaning agents like hydrogen peroxide is not routinely recommended due to their potential toxicity.
Current Recommendations
- The current consensus opinion is that saline is a safe and effective choice for wound cleaning, while hydrogen peroxide should be used with caution due to its potential toxicity 3, 5.
- A recent review published in 2023 6 discussed the importance of antimicrobial dressings in wound care, but did not specifically compare hydrogen peroxide and saline.
- Further studies are needed to determine the optimal wound cleaning solution and to establish clear guidelines for the use of hydrogen peroxide and saline in wound care 5.