Acidic Treatments to Expedite Wound Healing

1. Acidic Treatments to Expedite Wound Healing Though acids are considered dangerous for skin tissue, acidic treatments are there that can expedite wound healing.Acids such as citric, ascorbic, acetic, boric and alginic have been long used as a topical application to assist in wound healing and ward off infection. Even though several studies were conducted regarding the use of acids in wound healing,most of them have been largely inconclusive. However, a new review by a group of researchers from India has come up with more definitive proof. The review published in the journal Wounds explores the relationship between acidic environment and wound healing. As part of the review, the researchers conducted a literature search of the PubMed database and used 45 found materials, as well as other relevant reviews. They point out that wounds (both acute and chronic) having high alkaline pH show a lower healing rate when compared to wounds having a pH closer to neutral. There would be a decrease in wound healing progression when pH is elevated to alkaline condition. The environment of acute and chronic wounds progresses from alkaline state to neutral state and then acidic state when healing starts. www.woundemr.com 855-968-6394

2. According to the review, the application of acid plays a significant role in the wound healing process in the following ways:  Infection Control –Infection impairs healing and increases the chronicity of wounds. Most of the pathogenic bacteria with infected wounds in humans require a pH value greater than 6. Lower pH values inhibit their growth. The application of acids to the wound surface lowers the pH value and hinders the growth and multiplication of bacteria.  Increase in Antimicrobial Activity –Various acids have been shown to increase the antimicrobial activity of topical antimicrobials (for example, iodine, silver) incorporated into wound dressings. For example, alginate wound dressings with alginic acid can make the wound environment slightly acidic, which improves the performance and bioavailability of ionic silver present in alginate wound dressings.  Alteration of Protease Activity –Proteases that are enzymes having the ability to cleave proteins and their end products are toxic to wound tissues. Lowering pH to a more acidic environment minimizes the activity of proteases and reduces the formation of their end products.  Release of Oxygen –Release of oxygen is quite important for the survival of cells in the human body and therefore oxygenation of wounds is critical for the wound healing process. Lowering the pH value and creating an acidic environment leads to Bohr-effect or an increase in the amount of available oxygen in cells.  Reduction of Toxicity of Bacterial End Products –Bacterial end products such as ammonia are toxic to wound tissue and lead to alkaline condition. Acidic environment and lower pH values reduce the toxicity of these end products. www.woundemr.com 855-968-6394

3.  Epithelization and Angiogenesis –It was shown in a histopathological study on chronic wound infections that the use of citric acid enhances epithelization and boosts fibroblastic growth and neovascularization to increase microcirculation of wounds that enables the formation of healthy granulation tissue, which helps in faster healing. In addition to all these, the acidic environment enhances the destruction of abnormal collagen in the ulcer bed, increases macrophage and fibroblast activity and controls the activities of various enzymes participating in the wound healing process. The researchers suggest pH monitoring is quite important to ensure that the wound is healing at optimal efficiency. However, the wound care methods for each person depend upon his or her specific situation. A clinician may advise a patient to apply topical acid to complement the dressing in case of chronic or non-healing wounds. Wounds having high presence of bacteria or heightened risk of developing infection may actually benefit from an acidic environment. This implies that the severity of infection for each patient along with all the details of the wound such as pain or tenderness, presence of slough and more should be documented well to start an acidic treatment. Only if the physicians and nurses understand the real characteristics of wounds, acidic treatment may benefit the patient. With a wound specific wound EMR, clinicians can access the information they want quickly as the system supports wound specific templates. Wound EMR that comes with physician and nurse interfaces can further expedite the wound assessment process as the required information can be exchanged very quickly. www.woundemr.com 855-968-6394