Episode Transcript
Interviewer: If you're like a lot of people, as soon as you get a wound and you've got to clean it, first thing you do is go for the hydrogen peroxide. It's what your parents do. It's what you do. But is that such a good idea?
Dr. Troy Madsen is an emergency room physician at University of Utah Health. Is hydrogen peroxide what I should be using if I get a wound, a dirty wound to clean it up?
Should Hydrogen Peroxide be Used to Clean Wounds?
Dr. Madsen: It's not. And I know that may come as a surprise because you probably grew up having hydrogen peroxide available, and your mom gets it and pours it on your knee after you scrape your knee up or you get a laceration or something.
Interviewer: Right, and then it bubbles and it looks likes . . .
Dr. Madsen: And it bubbles.
Interviewer: . . . it's really doing a lot of great things, right?
Dr. Madsen: Exactly. Yeah, you assume it's bubbling and it's just killing everything in there and getting rid of all those germs in your wound. Well, the problem with hydrogen peroxide, it may be killing the germs, but it's also killing the healthy tissue in there too. So that's the biggest challenge with it is we think that we are sterilizing the wound and getting rid of all the bad stuff, but we're also then killing the good tissue in there as well, and that can then cause a larger wound than we would have had otherwise. And quite honestly, that whole process of sterilizing it and killing everything off isn't really necessary. You don't need that. You don't need to make this a completely sterile environment. The body is set up to fight off bacteria and help to heal things, so you're probably doing more harm than good with it.
Interviewer: So where did this notion that hydrogen peroxide is a good thing to use come from? And, you know, how did we arrive to this new conclusion?
Dr. Madsen: Well, I think in our minds it makes sense that we worry about germs and we have a wound, and then the germs get in through that wound, so we've got to get rid of all the germs. But over time and with experience, we've come to see that pouring that in there and just scrubbing that thing out a lot more with that than is necessary is really damaging the healthy tissue, number one. And then we've also done studies looking at very simple things we can do to clean wounds that work just great, and we don't have to use the hydrogen peroxide.
Interviewer: And damage that good tissue. So . . .
Dr. Madsen: Exactly.
The Most Effective Way to Clean a Wound
Interviewer: . . . how should I actually be cleaning out a wound then?
Dr. Madsen: Simple tap water. It's very simple. If you can just run that wound under tap water for like 5 minutes, 5 to 10 minutes, lukewarm water, just let that water run through it, clean it out, just kind of wash it out. You don't have to spray it on there. It doesn't have to be high pressure. You're just irrigating that wound, just washing it out with tap water and just . . .
Interviewer: And you're not scrubbing it or anything. You're just letting the water flow over it?
Dr. Madsen: That's right, exactly.
Interviewer: Okay.
Dr. Madsen: Just letting the water flow over it. You know, if it's on your hand or your arm, it's probably a little easier to get that under like a kitchen faucet or something. Other places, you know, you might be looking at, I don't know, trying to . . . If you've got like a handheld shower, you can take off. You don't have to have it high pressure. Just let it run over, like wash off your leg or your foot and just let that just kind of run over it. Studies have been done looking at that and have shown that works just great, just as well as anything else in terms of getting that wound cleaned out and avoiding infection.
Interviewer: And when you say tap water, is that tap water anywhere in the world? Or, I mean, does your tap water have to have some sort of cleanliness to it?
Dr. Madsen: Good question. I think most tap water, if you're able to drink it, if you're comfortable drinking the water, you're probably fine using it. Now, if you're in a place where you're not comfortable drinking it, if it's your best alternative, I would absolutely use it. You know, ideally in those situations, maybe you could have something that's a little more sterile, like some boiled water that then cools down, that's been sterilized through that process. Or I don't know, it'd be very expensive to try and get a bunch of bottled water to do that. But I think if you're okay drinking the water, I think it's perfectly fine to use it to clean out a wound.
Interviewer: And does this advice apply to everybody? So, I mean, some people might be more susceptible to infections than others.
Dr. Madsen: I . . .
Interviewer: Does this work for most people?
Dr. Madsen: It does, yeah. If you're more prone to infection with diabetes or other conditions that may affect your immune system, I would still use this same process. I would not use hydrogen peroxide. And the challenge is, in some of those other conditions, your body has a harder time healing, so you can imagine if you're pouring hydrogen peroxide on there and you're damaging that tissue, your body is going to have even a tougher time regenerating and healing that wound and that tissue versus someone who may not have those issues.
Tap Water is the Best Option for Wound Cleaning
Interviewer: So the takeaway here is hydrogen peroxide, even though we may have used it or our parents or grandparents may have used it to clean out wounds, actually could be doing more harm than good, that you do not have to have a complete germ-free environment in that wound. What is the goal of the tap water? What are we trying to wash out?
Dr. Madsen: Just trying to wash out debris that's in there. You know, maybe there are some bacteria in there. Something that you picked up from the ground, that tap water is just going to wash it right out and dilute it. So you are cleaning out some debris, maybe some rocks that got in there, some little pebbles, those sorts of things, and any sort of bacteria, it's going to wash it out.
Interviewer: And then after you're done doing that, just bandage it as normal, huh?
Dr. Madsen: That's right, bandage it. Certainly you want to look to make sure you don't need stitches. If it's a gaping wound, it's just not coming together well, you may need to go to an urgent care or an ER to get stitches there. Make sure everything is moving okay, fingers, toes, digits, everything. Make sure there's no sign of any tendon laceration. As long as you're good there and as long as the bleeding is controlled, just put a Band-Aid on it.