(LR-005) Why is soaking with gauze saturated with hypochlorous acid cleanser one of the best ways to deliver this type of cleanser to the wound?  What does the science and chemistry say when studied rigorously?

It is now well known that pH controlled, mildly acidic pure Hypochlorous Acid (pHA) based cleansers produce visibly clean wounds, that also can be shown to have lower bioburden as measured by punch biopsies.  However, preclinical data also show that the best effects of germ removal are seen when the cleanser is allowed to remain in contact with the contaminated wound for about 5-10 minutes.  Thus, the means to deliver such exposure times is critical.  Fortunately, it happens that one of the lowest priced disposable wound gauze, is resistant to degradation by the pHA solution, and vice versa, allowing its use as a very desirable delivery mechanism for the cleanser.  We report chemical measurements of the hypochlorous acid over time when it is used to soak medical grade gauze.

Methods:

Square gauze of the 10 X 10 cm size was soaked with 15 ml of pHA based cleanser containing 300 ppm of hypochlorous acid (HOCl).  A polyurethane foam was also used for such soaking as a potential and more expensive alternative to gauze, but one that may be preferred as a more advanced material than gauze.  The HOCl level in the dressings was measured over time.

Results:

The polyurethane foam exposure to Vashe led to rapid degradation of the HOCl over the time measured, which was a period of 20 minutes.  The HOCl level fell to zero within four minutes, with >90% of the degradation occurring in approximately one minute.  In contrast there was no observable degradation of the antimicrobial preservative in the cleanser, HOCl, over time, upto  the experimental time of 20 minutes.

Discussion:

It is clear that the best way to achieve the cleansing is to maintain contact with the wound with a cleansing product that does not degrade within the delivery system/soaking dressing used. Based on this data, it is useful to note that the most basic wound care product, the sterile gauze, provides an ideal delivery mechanism of the cleanser. This has been observed in clinical practice, but it is comforting to know that there is scientific proof now that this is a sound way to retain the original property of the cleanser for the desired period at the wound interface. On the other hand, polyurethane foams of the type tested was too reactive with the cleanser and would not be appropriate for soaking.

Trademarked Items: Vashe

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