Antiseptics and Cleansing the Chronic Wound: Best Practice

Abstract

In the management of chronic wounds, the concept of “wound hygiene” has emerged to effectively manage biofilms, an obstacle to wound healing. The core principles of wound hygiene are wound cleansing, debridement, edge refashioning, and dressing. Cleansing is the first step in wound hygiene and should be performed at every dressing change to reduce the bacterial load and prevent biofilm formation. It is also performed to remove remaining debris after debridement. Cleansing should be performed not only on the wound but also on the surrounding skin. In addition, in order to break down rigid biofilm barriers, surfactants or antiseptics should be actively used at an early stage. Antiseptics should have excellent broad-spectrum antibacterial activity and low cytotoxicity while also being hypoallergenic. Octenidine dihydrochloride, polyhexanide, and povidone-iodine have these properties and are suitable for use as cleansing solutions. To effectively manage chronic wound biofilms, it is important to select an appropriate antiseptic and cleanse vigorously with sufficient time for the antiseptic to work. In addition, taking wound hygiene procedures for granted and repeating them regularly and frequently will lay the foundation for promoting wound healing.