Liquid Paraffin Should Not Be Used on Open or Infected Wounds
Liquid paraffin is not recommended for use on open or infected wounds as it can interfere with proper wound healing and may increase infection risk.
Proper Wound Management for Open Wounds
Initial Wound Cleansing
- Saline without additives is the strongly recommended solution for cleaning open wounds 1
- Antimicrobial solutions, clean water, or normal saline should be used to gently cleanse wounds 2
- Avoid using irritants such as perfumes, deodorants, or alcohol-based lotions on wounds 2
Appropriate Dressing Selection
- For open wounds, apply a non-adherent dressing directly to the wound (such as Mepitel or Telfa) 2
- Secondary dressings such as foam dressings (e.g., Exu-Dry) should be used to collect exudate 2
- Change dressings every 2-3 days unless excessive exudate requires more frequent changes 2
Management of Infected Wounds
Infection Assessment
- Monitor for signs of infection including:
- Increasing pain
- Erythema extending >5cm beyond wound margins
- Temperature >38.5°C
- Heart rate >110 beats/minute 2
Infection Treatment
- Systemic antibiotics are only indicated if there are signs of disseminated infection or systemic symptoms 2
- For open fractures and traumatic wounds, cefazolin or clindamycin is recommended as prophylaxis 1
- For Type III open fractures, additional gram-negative coverage is preferred 1
- Local antibiotic strategies may be beneficial as adjuncts in certain cases 1
Why Liquid Paraffin Is Not Appropriate
While one study showed that liquid paraffin as an adjuvant therapy improved healing in residual burn wounds 3, this is not generalizable to all open or infected wounds. The evidence for this specific application is limited to a single retrospective study with only 29 patients in the treatment group.
For open wounds, especially those that are infected:
- Liquid paraffin may create an occlusive environment that prevents drainage
- It can potentially trap bacteria within the wound
- It may interfere with the action of antimicrobial agents
- It doesn't provide antimicrobial properties needed for infected wounds
Alternative Approaches
For Moist Wound Healing
- Hydrocolloid dressings have proven superior to saline gauze or paraffin gauze for chronic wounds 4
- Alginate dressings are better for debriding necrotic wounds 4
- Hydrofiber and foam dressings reduce healing time for acute wounds compared to traditional dressings 4
For Infected Wounds
- Antiseptics such as polihexanide are classified as agents of choice for critically colonized and infected chronic wounds 5
- For MRSA-colonized wounds, 0.1% octenidine dihydrochloride/phenoxyethanol solution is suitable due to its deep action 5
- For chronic wounds, preparations with 0.05% octenidine are preferable 5
Special Considerations
For Diabetic Foot Wounds
- Cleanse with clean water or saline solution and perform debridement of necrotic tissue 2
- Ensure adequate offloading to minimize trauma to the ulcer site 2
- Consider negative pressure wound therapy for closed fractures to mitigate risk of surgical site infections 1
For Traumatic Wounds
- Irrigation with saline without additives is strongly recommended 1
- Bring patients with open fractures to the OR for debridement and irrigation ideally before 24 hours post-injury 1
- Wound coverage fewer than 7 days from injury date is suggested 1
Remember that proper wound care management significantly impacts morbidity, mortality, and quality of life outcomes. Using inappropriate substances like liquid paraffin on open or infected wounds may delay healing and increase the risk of complications.