Hydrogen Peroxide & Wounds

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Hi all,

Just a quick question regarding Hydrogen Peroxide. I am currently working as a locum within the NHS and I have come across a few people using Hydrogen Peroxide on Diabetic foot wounds.
I wanted to know if anyone uses this, why and what are the effects. I have worked at many different wound care hospitals and have never seen it used before as i would of thought it would be quite potent to put on a wound. The wound im referring to is a full thickness, probe to bone, infected plantar 1st MPJ foot wound.
Any feedback would be appreciated

Eva

 

The only thing we have ever use H2O2 for is to help remove a bloody (dried) bandage.
Steve

 

Hi Eva,

I have been using H2O2 for many years, on wounds as well as shallow diabetic ulcers. It is a good way to "clean out" the wound. Remember, use a weak soloution, say 10 volume as anything higher than that could be detrimental to the healing process. Hope this helps. regards, Vernon.

 

I have believed the following to be the reasons peroxide is no longer use in wound care.This info was quickly found info and I know there is a lot more literature out there.

Hydrogen Peroxide in Wound Care.

Action is the mechanical cleansing and debridement by effervescent action. Considerations when using are:

1. Can cause ulceration of newly formed tissue
2. Toxic to fibroblasts
3. Should never be used to pack sinus tracts: can cause air embolism
4. Should not be used for forceful irrigation; can cause subcutaneous emphysema, which mimics gas gangrene

Data from Cooper, D: Fundamental; products and their usage. In Guide to Wound Care, Chicago, 1983

Many studies have documented that the use of hydrogen peroxide in open wounds is not only cytotoxic to bacteria, but also to white blood cells and vital wound healing cells such as fibroblasts. This is because their primary mechanism of action is to destroy cell walls regardless of the identity of the cell. The use of cytotoxic agents in wounds should be weighed in light of this. In addition to the absence of clinical benefit, antiseptics may also encourage the development of resistant organisms.

Doughty 1994 Hellewell, et al, 1997: Hess 1990; Nwomeh, Yager, and Cohen 1998

 

Eva,

I think that's crazy and have never seen it in the literature. HP is ok initially to kill bacteria but it also damages good cells.

 

Hi ,
I believe that in the presence of tissue catalase, H2O2 is broken down into water and oxygen is liberated causing the wound-cleansing effervescence:
2H2O2+catalase=2H2O+O2
Stronger strength H2O2 - 20vol+ is cytotoxic, but the 10 vol solution has had wide application over the years to clean dirty wounds. I would be very cautious in using even 10 vol solution on a diabetic ulcer.
Regards to all.

 

Hi,

Thanks to all who answered my post. I think it is safe to say that i will not be following in my collegues footsteps and using it in wound care! I'll stick to other and less cytotoxic ways of cleansing a wound!

Thanks again