Portail Guide

6. How should you clean wounds?

Treating a wound should involve “clean” actions, i.e. wearing personal protective equipment (surgical masks, gloves), although it does not need to be sterile.

The first step in the management of a wound is cleaning it with soap and water. This cleaning process should be taught to everyone and it is never contraindicated in any wound. The aim is to remove foreign bodies, coagulated blood and non-adherent necrotic tissue from the wound, thus limiting as far as possible the risk of infection. The use of sterile isotonic saline compared to tap water has not been shown to offer any extra benefit.

The use of antiseptics plays no role in the treatment of chronic wounds. Dressings can therefore be applied directly after washing with soap and water. Antiseptics can also be harmful due to the risk of allergic contact dermatitis or irritant dermatitis, which can delay healing.

After washing with soap and water, antiseptic does not need to be applied in acute wounds treated early and not requiring any invasive procedure. However, antiseptics do have a role to play in invasive procedures such as suturing [4]. Many classes of antiseptics are available such as betadine (povidone-iodine), which comes in several forms, and should be used as the first line of defence. Iodine products, chlorhexidine and their derivatives should not be used in infants aged under 1 month and should only be used for short times and in limited applications in infants between the ages of 1 and 30 months.

Finally, in common with any wound it is essential to check the tetanus vaccination status of the patient.


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