----- Original Message -----
From: "Jel Coward"
> So can I pick the brains of the list please and ask,
> what are the best 'detergent' like solutions and is there any evidence
> (at whatever level) to support them?
There is actually precious little scientific "evidence" to help choose
between the various agents, and in the absence of such evidence it makes
sense to use logic or common sense! Any of the agents that contain
chlorhexidine or cetrimide are quite suitable for wound decontamination.
Again common sense dictates that using warm solutions considerably improves
the detergent action of these agents. Some even advocate industrial cleaners
such as Swarfega for oily contamination - certainly these wounds will never
clean up with water alone, no matter how much you use! Finally I would avoid
iodine based solution, firstly as they have little detergent action, and
secondly as they discolour tissues. This makes it difficult to visualise
contamination for example, to distinguish healthy from devitalised tissue,
or to appreciate areas of inflammation. Orthopods seem to have a fixation on
iodine based solutions, while most plastic surgeons avoid them...and you all
know which of the above is the better judge of soft tissue viability!
Adrian Fogarty
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