When I first passed my certification exam and entered into wound care consultation practice at a hospital, I knew nothing of its generic name – hypochlorous acid (HOCL). I first learned of it through its brand names: Puracyn, Vashe, SkinSmart, Anasept. My first chance to recommend it to patients came years later when I started working at a large, non-profit hospital.
Fortunately, this hospital could afford a wealth of options for wound treatment. There, I had a variety of “old standby” (Xeroform, Dakin’s Solution, medical honey) and newer products at my disposal, but hypochlorous acid was a gold standard among my team. Soon enough, I was using it for all kinds of lesions. Many patients I encountered with hard-to-heal wounds showed marked improvements within the two or three weeks of treatment I got to oversee. In the past, I’ve selected hypochlorous acid for patients who suffered from:
Necrotic wounds – wounds with significant amounts of dead tissue
Infected wounds
Wounds at significant risk of contamination, which could lead to infection
Wounds with odor
Wounds with exposed muscle, tendon, or bone
Ulcers that occur due to internal immune or circulatory compromise
Chronic wounds that had failed treatment with other products
And the best part? I never had to worry about causing a distressing allergic reaction or a toxic overdose from application to the skin or an open wound.
This is because of HOCl’s impressive safety profile; hypochlorous acid is non-toxic, non-allergenic, and non-corrosive to human skin and wounds. It is so safe, in fact, that our bodies utilize it on the regular!
How could that be? The answer lies in our own immune systems. HOCl is a weak acid that is present (endogenous) in all mammals. In the human immune system, Myeloperoxidase (MPO) – an enzyme in white blood cells – is constantly on the lookout for pathogens. When it spots an invader, MPO reacts with cellular fluid to form HOCl, disrupting the offending microbe's structural integrity. It can also disrupt colonies of bacteria that have formed protective films (biofilms) on surfaces.
Nowadays, you may also hear of wound surgeons choosing to use hypochlorous acid as an adjunct to Negative Pressure Wound Therapy (NPWT). An NPWT machine can be programmed to periodically wash deep or large wounds with hypochlorous acid (or another solution) on a consistent schedule for days or weeks, providing continuous protection from microbial invaders. For that reason, HOCl and its use in “installation therapy” for large wounds has emerged as a hot topic among modern wound care professionals.
HOCl’s reputation as a powerful disinfectant has led to its use as a treatment for acne and eczema. It even kills a range of coronaviruses and can be purchased as a surface sanitizer. Every now and then, I’ll see a hypochlorous acid-based skin, wound, or cleaning product on the shelves and think of the patients it’s already helped. I can easily recall instances where HOCl impressed me:
An obese person with tragically severe swelling, ulceration, inflammation, and maceration of both lower legs. I recommended HOCl solution for daily cleansing, with gentle absorbent dressing changes for the weeping. The inflammation and odor were significantly reduced within one week, and the patient could tolerate dressing changes without intense pain.
Someone with chronic alcohol abuse who sustained a necrotic pressure injury on the bottom from sitting in a deck chair for long hours. I recommended HOCl gel with a cover dressing, and the wound was free of necrotic tissue and well on its way to closing.
I’ve met physicians who remember what it was like to make their own supply of hypochlorous acid in their offices – one can do so by using an electrolysis generator with water and non-iodized salt.
Now that stable HOCL products have reached the consumer market, I’m fascinated to see the potential of this product.
I expect it – and other high-level dressings such as collagen matrices – to define the future of enhanced wound care and provide a much-needed solution for many types of problematic wounds.
Disclaimer: This is not a sponsored article. The text is for informational purposes only and is not a substitute for individualized advice from a licensed medical professional.
References
https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.887220/full#B34 Assessed and Endorsed by the MedReport Medical Review Board