Salt footbaths

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This is my first post (apart from an introduction - I am a pod student) so I hope I am doing it correctly!

I have a question with regard to the advice of using salt footbathing or soaks to reduce inflammation and prevent infection. This advice comes frequently with onychocryptosis - but I can't find any rationale for it. There is some research which dismissed the practice of using 'salt baths' particularly as it is a good medium for staph. au. but this is quite old now (Austin 1988, Aycliffe 1975).

So my question is really does anyone know of more recent research/evidence to either support or not the use of salt bathing? Thank you for any advice.

Helen

 

Hi,

I have yet to discover any "good" research regarding this issue, as it is not a sexy subject.

Practically wise, every trust / pod / surgeon has a differing opinion on post op nail surgery regime.

If your in your final year, it may be a good research thesis??

 

hmb

Saline solution is an old remedy but its primary advantage is to provide an antiseptic hypertonic solution which is compatable with human tissues. Check pharmacopaes for more detailed information. Yes it will harbour growth of micro-organisms which only confirms the problem in finding an ideal medium to bath broken skin. Usually the spectrum of antiseptics/antibiotics used post operatively in standard foot lesion care is wide and has an instant effect. So the combination of sterile saline solution and post op care may negate colonies of pathogens from forming in wounds. (that might be a topic worth researching?).

One other advantage warm saline solution is compatible with granulating tissue, whereas some of the synthetic alternatives have been shown to be less so.

So there is a definate potential risk in using saline soln (especially is unsterilised) but this is likely to be low enough to be insignificant. Of course there is no data (as far as I am aware) to confirm or reject the hypothesis.

toeslayer

 

Regular tap water (boiled or unboiled) is just fine for wound cleansing:

Fernandez R, Griffiths R. Water for wound cleansing. Cochrane Database of Systematic Reviews 2002, Issue 4


LL

 

Thank you for your replies.

The area I'm particularly interested in is the pracitice of advising to use salt in warm water as a soak. I know in UK hospitals salt was dispensed by the Pharmacy for use in bath water but this practice was stopped, I think in the late 80's - probably as a result of the research by Austin and others. What I would really like to know is whether podiatry uses this practice on a purely traditional basis or whether there is some evidence to support it.

I'm not in my final year yet - but perhaps this would make a good research project!

 

I think it also has something to do with the pH of the salt footbath and the pH of the skin, so this falls in line with Toe slayer and protection of normal 'protective' skin flora and reduction of foreign bacteria and fungi. Hence the need to get correct measures of spoonfuls of salt to pints of water! That said, I don't know of any evidence to back this up and my chemistry is a bit too shaky to explain! Can anyone elaborate on this further?!

 

Hi Helen,

a useful resource: ?http://www.saltinstitute.org/15.html~
(links from there give useful background)

Salt is also deliquescent - draws moisture from the atmosphere. Stops dry skin drying out too much, thus keeping it supple. This is why we cannot feel dry just by towelling and like to shower in fresh water after swimming in the sea.

'Sodium chloride' as a Google search brings up several ads that extol the virtues of salt and offer formulae for bath strengths.

I must ask 'does podiatry use it', as you suggest? Or is it used mostly by beauticians/therapists?

 

[Check4SPAM] RE: URL Attempt

Wow - all you ever need to know about salt! A genuinely interesting website, thank you, but I spent far too long looking at it (I am avoiding assignments)

There is a link from that webpage which leads to:
http://www.chemheritage.org/EducationalServices/pharm/antibiot/readings/salt.htm

This page refers to "salt the first antibiotic" - but includes this quote:
"While salt was good at keeping bacteria from attacking meat, it's not really useful for treating human disease"

I have mostly come across podiatric 'salt soak' recommendation in nail surgery post op advice.

 

Hello again, Helen

Truth is that we have so many better antiseptic agents than salt, so that salt foot baths are probably an anacronism.

Dressings containing Crystacide (1% hydrogen peroxide) or Anaflex (10% polynoxillan resin) are far more appropriate following nail surgery.

In my experience, keeping the toe dry for 48 hrs post op is the finest formula for prevention of infection, with nothing more than Videne (Betadine) applied. Getting an operation site wet is in my real experience, one almost reliable way of introducing an infection.

 

Good thread, and website, thanks Johnpod.

Do you have any references for data indicating that Crystacide and Acriflex are a better alternative to salt baths? I tend to use Crystacide (after flushing with warmed saline solution) for the x 3 surgery redressings post nail surgery and advise pts to do salt baths thereafter.

Also agree that most important advice is to keep the area dry. Only time i have seen post op infection is where pt has managed to make the dressing wet e.g. running outside to get the washing in when it starts to rain.....

Cheers,
Bel