How to Clean a Wound
Superficial wounds and abrasions should be thoroughly irrigated with running tap water or sterile saline until all visible debris and foreign matter is removed, then covered with an occlusive dressing. 1
Irrigation Solution Selection
Use running tap water or sterile saline for wound irrigation rather than antiseptic agents like povidone-iodine. 1 The 2024 American Heart Association and American Red Cross guidelines give this a Class 2a recommendation with moderate-quality evidence.
Tap water has infection rates similar to sterile saline solution when used for wound irrigation. 1 Studies comparing tap water, boiled water, distilled water, and sterile saline show comparable infection rates across all solutions. 1
Antiseptic agents such as povidone-iodine have not demonstrated benefit over simple irrigation with water or saline. 1 Multiple studies failed to show improved outcomes with povidone-iodine cleansing compared to irrigation alone.
Irrigation Technique
Irrigate with sufficient pressure to remove bacterial contamination—simple rinsing may not provide adequate pressure. 1 While the guidelines note that evidence for irrigation reducing infection is limited, thorough cleansing to remove debris makes empirical sense and is universally recommended.
For chronic wounds like diabetic foot ulcers, clean regularly with clean water or saline and debride when possible to remove debris from the wound surface. 1
An irrigation pressure of 13 psi is effective for cleansing wounds and reducing infection without causing tissue trauma. 2
Wound Dressing After Cleansing
Cover clean superficial wounds with an occlusive dressing to promote wound healing. 1 Occlusive dressings such as film, petrolatum, hydrogel, and cellulose/collagen dressings result in better wound healing than dry dressings.
Select dressings primarily based on exudate control, comfort, and cost. 1 There is no indication that antibiotic or antibacterial dressings improve wound healing or decrease infection rates in clean wounds. 1
Simply covering the wound with a sterile, inert dressing to control excessive exudate and maintain a warm, moist environment promotes healing. 1
Special Wound Types Requiring Medical Evaluation
- Any wound caused by animal or human bite, or contaminated with human or animal saliva, should be evaluated in a medical facility as soon as possible. 1 These wounds carry increased infection risk, and early antibiotic administration appears to prevent infection from high-risk bites, particularly to the hand.
Monitoring for Infection
Remove the dressing and obtain medical care if the wound develops redness, swelling, foul-smelling drainage, increased pain, or fever. 1 These signs indicate possible wound infection requiring professional evaluation and potential antibiotic treatment.
Monitor the wound site daily for signs of bleeding, pain, erythema, induration, leakage, and inflammation. 3
Common Pitfalls to Avoid
Do not use occlusive dressings on wounds that are not yet clean, as they can promote moisture accumulation and skin maceration in contaminated wounds. 1
Avoid unnecessary wound cleansing with harsh antiseptics, as inappropriate use of cleansing solutions can negatively affect patient outcomes. 4
Do not rely on simple rinsing alone—adequate irrigation pressure is needed to remove bacterial contamination effectively. 1