Preparing the Wound Bed

Before a wound is dressed, it must be cleansed gently so as to not injure any new epithelial cells.

"The practitioner must always attempt to minimize wound trauma during wound cleansing."

• For cleansing a wound, normal saline is the cleanser of choice because it is isotonic and has no toxic effects on granulating growth cells. Sterile water or non-cytotoxic wound cleanser may be used for wound cleansing.
  
• Fluid used for cleansing should be warmed to at least room temperature.
  
  
• Betadine and Chlorohexadine should not be used as they are non-selective and cytotoxic.
  
  
• Irrigation with normal saline (or sterile water/non-cytotoxic wound cleanser) can be used in a wound to help loosen and remove debris. It is best accomplished with a force of 4-15 psi (ref. 60) which can be accomplished with one of the following:
  
  

  100cc NS bottle with irrigation tip	35 ml syringe with a 19 gauge angiocath

  
  
• Wound cleansers have surfactants that assist in removing surface slough and debris and are appropriate for wounds with a high amount of slough in the wound bed. See the following for example:
  
  

  Restore Wound Cleanser™ by Hollister	Spray on the wound	Gently wipe away ensuring that the skin around the wound is dry