It is beneficial to wash a fresh wound to remove visible debris in order to allow inspection, and it may be necessary as healing occurs to remove slough and exudate. However, irrigating a wound is considered unlikely to remove bacteria or reduce infection.

Studies have suggested there is no additional benefit to using an antiseptic or normal saline wash compared to using tap water. Indeed, it has been suggested that antiseptic solutions can even damage tissue, delaying the healing process.²

NICE recommends the use of 0.9 per cent saline or tap water for irrigating superficial burns and scalds. As tap water is easily accessible and unlimited, it is probably the simplest method to use for simple cuts and grazes, but it should be lukewarm rather than cold. Using fibrous materials such as cotton wool or gauze swabs should be avoided as they can shed fibres, as well as damage any granulating tissue.^2,9

Potentially up to half of acute wounds become infected and infection in a wound can be the most likely cause of delayed healing.^10,11 In chronic wounds a biofilm will form, delaying the healing process. This is a layer of colonising bacteria and/or fungi existing in a protective matrix of secreted proteins, polysaccharides and lipids, and is often described as slime.

The longer this biofilm is allowed to get established the more firmly it attaches to the wound.¹² This means that when it comes to cleaning the biofilm away, the underlying healing process may be disturbed. Targeting the biofilm matrix early on can therefore improve healing.¹³

Best practice guidance has indicated that topical antimicrobials should be used only when signs and symptoms suggest that the wound bioburden is interfering with healing.

Topical antimicrobials should not be used for patients being treated with standard care who have no signs of infection. If topical antimicrobials are considered appropriate, then they should be used individually, not in combination.¹⁴