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Questions for Dr. Kennedy
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Hydrogen Peroxide as a Wound Disinfectant
Posted by: Renee Wilson
Date: March 23, 2002 4:54 PM

I am interested in the use of hydrogen peroxide for stage 1 and stage 2 wounds. Do you have any input in this topic for me?

RE: Hydrogen Peroxide as a Wound Disinfectant
Posted by: Ron Kennedy, M.D.
Date: March 23, 2002 8:10 PM

Topical hydrogen peroxide is used as a disinfectant as 3% in the U.S. and 6% in Europe. It is bacteriocidal on contact and at these dilutions is quite safe except perhaps around the eyes. Food grade H2O2 is 35% and must be diluted to at least 6% before use as it will produce burns if used at full strength. In fact, white blood cells use hydrogen peroxide to kill bacteria. They locate the bacteria, scoot up beside it and secret H2O2.

For our readers, and for the record, I will record the definitions of wound staging below:

Stage I is nonblanchable erythema of intact skin -- the heralding lesion of skin ulceration. Reactive hyperemia is the reddening or deepening of skin color that is normally observed once pressure to an area has been relieved. This type of hyperemia is blanchable and will resolve in approximately 1/2 to 3/4 the amount of time that the area was exposed to pressure. For example, a patient who is repositioned every two hours may experience reactive hyperemia over a boney prominence for as long as 11/2 hours following the position change. This is a normal process and should not be misclassified as a Stage I pressure ulcer.

Stage II is partial thickness skin loss involving epidermis and/or dermis. The ulcer is superficial and presents clinically as an abrasion, blister, or shallow crater.

Stage III is full-thickness skin loss involving damage or necrosis of subcutaneous tissue that may extend down to, but not through, underlying fascia. The ulcer presents clinically as a deep crater with or without undermining of adjacent tissue.

Stage IV is full- thickness skin loss with extensive destruction, tissue necrosis or damage to muscle, bone, or supporting structures (for example, tendon or joint capsule). Undermining and sinus tracts may also be associated with Stage IV pressure ulcers. This staging system has been incorporated by HCFA into the curriculum used to train Medicare-approved nursing home surveyors.



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