Clinical Guideline for Cleansing and Antisepsis in Chronic Wounds
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Keywords

Chronic wounds
Wound cleansing
Antisepsis
Irrigation solutions
Wound biofilm

DOI

10.26689/jcnr.v9i12.13411

Submitted : 2025-12-16
Accepted : 2025-12-31
Published : 2026-01-15

Abstract

This guideline summarizes evidence-based recommendations for cleansing and antisepsis in chronic wounds. It defines target populations, assessment and decision frameworks, preferred cleansing solutions and pressures, indications and limits for antiseptics, biofilm-oriented strategies, pain control, and adaptations for high-risk patients and low-resource settings. The aim is to optimize wound bed preparation, protect viable tissue, reduce infection and iatrogenic injury, and standardize outpatient and home-care practice.

References

Pisarik P, 2016, Choosing Tap Water vs. Sterile Saline for Wound Irrigation. American Family Physician, 94(2): 83–84.

Daeschlein G, 2013, Antiseptics for the Treatment of Infected Wounds. Skin Pharmacology and Physiology, 26(6): 227–238.

Fernandez R, Griffiths R, 2012, Water for Wound Cleansing. Cochrane Database of Systematic Reviews, 2012(2): CD003861.

Gethin G, Cowman S, 2008, Bacteriological Changes in Sloughy Venous Leg Ulcers Treated with a Polyhexamethylene Biguanide (PHMB)-Impregnated Dressing. Journal of Clinical Nursing, 17(15): 2012–2019.

Goldberg M, Rosenthal A, Nemetz C, 1981, Effect of Washing Closed Head and Neck Wounds on Wound Healing and Infection. American Journal of Surgery, 141(3): 358–359.

Griffiths D, Fernandez S, Ussia A, 2001, Is Tap Water a Safe Alternative to Normal Saline for Wound Irrigation in the Community Setting. Journal of Wound Care, 10(10): 407–411.

International Wound Infection I, 2016, Wound Infection in Clinical Practice. London: Wounds International.

International Wound Infection I, 2022, Wound Infection in Clinical Practice: An International Consensus Update. London: Wounds International.

Kramer A, Dissemond J, Kim S, et al., 2018, Consensus on Wound Antisepsis: Update 2018. Skin Pharmacology and Physiology, 31(1): 28–58.

Leaper D, Durani P, 2008, Topical Antimicrobial Therapy of Chronic Wounds Healing by Secondary Intention Using Iodine Products. International Wound Journal, 5(2): 361–368.

Leaper J, Schultz G, Carville K, et al., 2012, Extending the TIME Concept: Wound Bed Preparation and Beyond. International Wound Journal, 9(Suppl 2): 1–19.

Metcalf G, Bowler G, Hurlow J, 2014, A Clinical Algorithm for Wound Biofilm Management: A Consensus Document. Journal of Wound Care, 23(3): 137–142.

National Institute for H, Care E, 2014, Pressure Ulcers: Prevention and Management (CG179). London: NICE.

National Institute for H, Care E, 2015, Diabetic Foot Problems: Prevention and Management (NG19). London: NICE.

Pilloni A, Piraccini B, De Angelis R, et al., 2019, Use of Hypochlorous Acid Solution in the Management of Chronic Wounds. Journal of Wound Care, 28(6): 351–356.

Schultz S, Sibbald G, Falanga V, et al., 2003, Wound Bed Preparation: A Systematic Approach to Wound Management. Wound Repair and Regeneration, 11(Suppl 1): S1–S28.

Weiss A, Oldham G, Lin M, et al., 2013, Water Is a Safe and Effective Alternative to Sterile Normal Saline for Wound Irrigation Prior to Suturing: A Prospective, Double-Blind, Randomised, Controlled Clinical Trial. BMJ Open, 3(1): e001504.

Wolcott D, Rhoads D, 2008, A Study of Biofilm-Based Wound Management in Subjects with Critical Limb Ischaemia. Journal of Wound Care, 17(4): 145–155.

World Union of Wound Healing S, 2008, Wound Infection in Clinical Practice: An International Consensus. London: MEP Ltd.

World Union of Wound Healing S, 2007, Principles of Best Practice: Wound Exudate and the Role of Dressings. London: MEP Ltd.