The Role of Antiseptics in Wound Care: What Works and What Doesn’t
By: Tracey Aldis
Essentials
Table of Contents
What Are Antimicrobial, Antiseptic, and Disinfectant Products?
These terms are often used interchangeably, but they have different purposes:
Why Use Antiseptics?
Experts now recommend antiseptics—alongside other wound treatments like debridement (removing dead tissue) and specialised dressings—to manage wound infections more effectively than antibiotics.5 Antiseptics work externally to reduce the need for antibiotics, which is important as antibiotic resistance is increasing worldwide. While antiseptics do not commonly lead to antimicrobial resistance, they should only be used when infection is present or likely.4
When to Use Antiseptics on Wounds:
Signs of Infection in a Wound:
A wound may be infected if two or more of the following signs are present:
⚠️ Important:
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- Some redness around a new wound is normal in the first few days—it doesn’t always mean infection.1
- People with poor circulation or low immunity may not show typical signs of infection, so pay close attention.3
- If redness spreads beyond 2cm around the wound, the infection is getting worse, and antibiotics may be needed.3
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The Two-Week Challenge
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- Use an antiseptic for two weeks, then check if the infection has improved.5
- Stop using if the infection has cleared.5
- If the wound is improving but still infected, continue antiseptic use for another two weeks, then reassess.5
- If there’s no improvement after two weeks, see a wound care professional for advice.5
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Cleaning a Wound: What Works and What Doesn’t?
There are many wound cleansing solutions, but not all are effective or safe:1
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- Tap Water: May introduce germs. If infection risk is very low, tap water can be used, but it must be boiled and cooled before use. Not recommended for surgical wounds or people with low immunity.4
- Sterile Saline: Often used for cleaning wounds, but bacteria can grow in saline over time.5 Not recommended if a wound has been open for more than three days.2
- Antiseptic Cleansing Solutions: Recommended when a wound is infected or not healing.4 Many contain surfactants which help remove debris and dead tissue.5
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Antiseptic Cleansing Solutions
| Name | Pros | Cons |
|---|---|---|
| Povidone Iodine e.g. Betadine | Kills many bacteria, viruses5, fungi, spores and other microbes.1 Effective against biofilm.5 Anti-inflammatory.5 Cost-effective.5 | Does not work if there is lots of wound fluid.1 May need to be applied 2-3 times/day.3 Do not use on newborns, people with iodine allergy, thyroid and renal disease, or very large wounds.4 |
| Hypochlorous acid (HOCl) e.g. Microdacyn | Kills many bacteria, viruses, spores and fungi.5 Removes unhealthy tissue.5 Promotes wound healing.5 Anti-inflammatory.5 Fast acting.5 Non-toxic.5 Easy to use.5 Cost-effective.5 Reduces odour.1 | No lasting effect, must be used up to 3 times/day.5 |
| Polyhexamethylene biguanide (PHMB) e.g. Prontosan | Kills many bacteria, viruses, parasites, fungi and other microbes.5 Removes unhealthy tissue.5 Does not harm new tissue.5 Promotes healing.5 Reduces pain.5 Long acting.5 Use for up to 8 weeks after opening.1 | Must be left on wound for 15mins.5 |
| Chlorhexidine Gluconate Chlorhexidine gluconate & Cetrimide e.g. Savlon | Kills many bacteria.1 Recommended for cleaning hard surfaces and equipment.1 | Different strengths are available1 and some will damage healthy tissue.4 Therefore not recommended on wounds.3 Not effective against fungi, spores or viruses.1 Can cause allergic reaction.1 |
| Octenidine (OCT) | Quickly kills many bacteria, yeasts and fungi.1 Removes unhealthy tissue.1 Very safe, can be used on babies.4 Promotes wound healing.4 Anti-inflammatory.4 Sustained effect.4 Fast acting.1 Use for up to 8 weeks after opening.1 | |
| Sodium hypochlorite (NaOCl) e.g. Dakin’s solution, Eusol, Milton | Kills bacteria.4 | Only use on hard surfaces or equipment.1 Household bleach is a concentrated form.2 Can cause severe, permanent damage body tissues.1 Do not use on wounds.1 |
| Acetic acid (Vinegar) | Kills some bacteria.1 | Even very low strength can damage healthy tissue.4 Can cause pain and irritate surrounding skin.1 Not safe for wounds.1 |
| Hydrogen peroxide | Antimicrobial.2 Weak effect against some bacteria.1 | Very damaging to healing tissue.2 Not recommended for wounds.2 Can cause bleeding.1 |
| Manuka honey solution | Kills some bacteria.1 Anti-inflammatory.1 | Do not use if allergic to propolis.1 |
Antimicrobial Dressings: What You Need to Know
Choosing the right wound care products can be confusing. It’s important to seek advice from a wound care professional to ensure the best management for your specific situation. They can recommend the most suitable dressing based on your wound type and health needs.
Some wound dressings contain antiseptic or antimicrobial agents that help prevent infection and support healing. These dressings work by:
Antimicrobial Dressings
| Active ingredient | Pros | Cons |
|---|---|---|
| Activated charcoal e.g. Actisorb, Zorflex | Absorbs odour, bacteria and exudate.1 | Does not kill microorganisms.1 May need a secondary dressing.1 |
| Cadexomer iodine e.g. Inadine, Iodasorb | Kills many bacteria, viruses5, fungi, spores and other microbes.1 Effective against biofilm.5 Anti-inflammatory.5 Cost-effective.5 Long acting – slowly releases Iodine into the wound.1 Promotes moist wound healing.1 Available as paste, powder or impregnated gauze.1 Reduces malodour.1 Removes unhealthy tissue.1 | Needs a secondary dressing.1 Do not use: Iodine sensitivity, thyroid disease, very large wounds, pregnant/lactating women, children under 12 years.1 Should not be used continuously for more than 3 months.1 |
| Silver | Kills many bacteria, viruses, fungi.1 Available in many forms – follow manufacturers’ recommendations.1 | Extended use may lead to microbial resistance.1 Can be expensive. |
| Polyhexamethylene biguanide (PHMB) e.g. Prontosan | Kills many bacteria, viruses, parasites, fungi and other microbes.5 Does not harm new tissue.5 Long acting.5 Does not lead to bacterial resistance.3 Available as gel or absorbent foam. Gel can be used for up to 8 weeks after opening.1 | Gel requires secondary dressing.1 |
| Medical grade honey (gamma irradiated.3) | Antimicrobial.1 Promotes moist wound healing and debridement.1 Controls odour.1 | Requires a secondary dressing.1 Can cause maceration.1 |
| Enzyme Alginogel (Flaminal gel) | Kills bacteria.3 No bacterial resistance reported.1 Not harmful to healing tissues.3 Removes dead tissue.1 Long acting.1 | Do not use in combination with silver.1 |
| Dialkylcarbamoyl Chloride (DACC) Impregnated Dressings e.g. Sorbact | Reduces the number of bacteria, viruses, and fungi5 by trapping them in the dressing, rather than killing them.3 No risk of microbial resistance.1 Available in many forms.1 | |
| Tea tree oil e.g. Wound Aid, Burn Aid | Available as gel or hydrogel dressing.1 Kills some bacteria.1 Anti-inflammatory.1 Reduces pain.1 Cost effective.6 Reduces malodour.6 | May cause mild skin irritation.6 |
| Octenidine (OCT) | Available as gel.5 Broad spectrum antimicrobial.5 Promotes healing, reduces scarring.5 | Requires secondary dressing. |
Wound care can be complex, and choosing the right treatment depends on the type of wound and individual health factors. Always consult a wound care professional for the best approach, especially if infection is suspected or healing is slow.
Tracey Aldis
Clinical Nurse Consultant
Tracey is a Clinical Nurse Consultant with over 30 years of experience. She has completed a Bachelor of Nursing (RN) and holds advanced qualifications in palliative care, chronic disease management, stomal therapy, continence, and wound management. Tracey is passionate about empowering individuals on their health journeys through holistic support and education and is also certified as a trainer and assessor.
References
1. Carville, K. (2023). Wound care manual (8th ed.). Silverchain Foundation.
2. Hotaling, P.B., & Black, J. (2024). Top ten tips: putting medications in their place. Wounds International, 15(1), 6-8. https://woundsinternational.com/wp-content/uploads/2024/03/WINT-15-1_6-8_TTT-black-NEW.pdf
3. International Wound Infection Institute. (2022). Wound infection in clinical practice. Wounds International. https://woundsinternational.com/wp-content/uploads/2023/05/IWII-CD-2022-web.pdf
4. International Wound Infection Institute. (2025). Therapeutic wound and skin cleansing: Clinical evidence and recommendations. Wounds International. https://woundsinternational.com/wp-content/uploads/2025/03/IWII_2025_Wound-cleansing-web-2.pdf
5. Nair, H.K.R. et al. (2023). International consensus document: Use of wound antiseptics in practice. Wounds International. https://woundsinternational.com/wp-content/uploads/2023/10/MULTI23_CD_Antiseptic_WINT_WEB-v3-1.pdf
6. Haesler, E., & Carville, K. (2021). WHAM evidence summary: effectiveness of tea tree oil in managing chronic wounds. WCET Journal, 41(3), 44-47. https://journals.cambridgemedia.com.au/application/files/5216/3244/8180/wham_-_en.pdf