Why use saline when you could use super-oxidizing saline?
As hypochlorous acid (HOCl) emerges as a superior alternative to saline for wound irrigation, we must question the continued use of saline in wound care. Compelling research has made HOCl's superiority in wound care clearer than ever.
This article offers five bite-sized and evidence-backed reasons to make the switch. Learn how HOCl can revolutionize wound care practices and why it's time to move beyond the traditional reliance on saline.
For decades, saline has been the standard solution for wound debridement. However, emerging research suggests that healthcare professionals should move beyond this traditional approach toward innovative solutions like a specific saline solution with super-oxidizing properties: hypochlorous acid (also referred to as HOCl).
Pure hypochlorous acid is a molecule naturally created by our body's white blood cells as an immune response to injury or infection. Manufactured HOCl in a saline solution offers clear, measurable, and well-researched advantages over traditional saline's capabilities, begging the critical question: Why would you continue to use saline when using HOCl is just as safe but orders of magnitude more effective?
Follow the Evidence
There was a study¹ published in 2016 that compares HOCl and saline in ultrasonic wound irrigation for chronic wounds. As one way to help answer the question posed above, let’s take a quick dive into some of its key results which, without question, demand every wound care provider's attention.
1. HOCl Slashes Bacterial Load—and Keeps It Down
While both HOCl and saline initially reduced bacterial counts by 4–6 logs immediately after ultrasonic debridement, only HOCl sustained the reduction¹.
"By the time of definitive closure, the saline-irrigated wounds had bacterial counts back up to 10⁵, whereas the hypochlorous acid–irrigated wounds remained at 10² or fewer.¹" |
Sustained suppression of bioburden is critical for reducing infection risk and ensuring proper wound healing.
2. HOCl Reduces Wound Closure Failure
More than 80% of wounds irrigated with saline failed to heal properly post-closure¹. In contrast, only 25% of wounds treated with HOCl had postoperative complications¹.
"Wound closure outcomes suggest a remarkable reduction in wound complications after wound debridement using hypochlorous acid irrigation.¹" |
That’s a 3x improvement in wound healing success with HOCl.
3. HOCl is Non-cytotoxic, Unlike Common Antiseptics
While alternatives like Dakin’s Solution and chlorhexidine gluconate (CHG) can be cytotoxic to healthy tissue, HOCl is proven safe for cells essential to wound healing¹.
"Hypochlorous acid has been demonstrated to be non-cytotoxic, so was chosen as an irrigant in this study.¹" |
This makes HOCl a superior choice when balancing antimicrobial action with tissue preservation.
4. It Supports Better Clinical Judgment
Visually, wounds in both groups appeared ready for closure—but only HOCl-treated wounds were biologically ready¹.
"The wounds in group II patients that had been irrigated with saline had an increased bioburden and more than 80% of the wound closures were unsuccessful.¹" |
This disconnect underscores the value of using hypochlorous acid to ensure tissue is truly prepared for closure, beyond what the eye can see.
5. It’s an Easy Switch That Maximizes Outcomes
Clinicians don’t need to overhaul their procedures to benefit from HOCl. This study used standard ultrasonic debridement equipment and simply replaced saline with an HOCl solution.
"The clinical outcomes… were superior when HA* was used as an irrigant… compared with the more commonly used saline.¹" |
With minimal workflow disruption, providers can significantly improve healing trajectories.
*(HA = hypochlorous acid)
It’s Time to Move On From Saline
Science is clear: HOCl is not just another option—it’s a superior solution for wound irrigation. By adopting use of HOCl in your wound cleansing and debridement protocol(s), you’re not just irrigating; you’re actively preventing complications, improving surgical outcomes, and accelerating healing.
Let’s not settle for the age old standard, when we have the opportunity to do—and use—what’s best for our patients in both the short term, and the long term.
Looking to Make the Switch? Meet PureCleanse™
PureCleanse™ is a Canadian-made, pure and stable pure hypochlorous acid (HOCl) solution for the irrigation, moisturizing and debridement of wounds skin and burns. It’s scientifically formulated to safely and effectively cleanse wounds and prepare optimal wound bed healing conditions.
If you’re interested in learning more about how PureCleanse™ can enhance wound care for your patients, we invite you to explore our Wound Care solutions and read more about PureCleanse™.
References
- Hiebert, J. M., & Robson, M. C. (2016). The immediate and delayed post-debridement effects on tissue bacterial wound counts of hypochlorous acid versus saline irrigation in chronic wounds. Eplasty, 16, e32.
LEADING THE WAY IN HOCl FOR HEALTHCARE
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