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Posted: 1/5/2012 4:36:53 PM EDT
[Last Edit: 1/5/2012 4:37:39 PM EDT by SirSqueeboo]
I'm sure most of use can remember parents and grandparents using them on wounds, and thanks to threads here I've learned all there could be read about wound care. Water is best for irrigation, etc.

So knowing what I do, what (if any) reasons should I keep betadine, etc stocked?
Link Posted: 1/5/2012 4:43:15 PM EDT
alcohol is you best bet. no chance of an allergic reaction to it.
Link Posted: 1/5/2012 4:53:49 PM EDT
peroxide decomposes over time. I wouldn't bother.
Link Posted: 1/5/2012 5:02:22 PM EDT
Sure, there are lots of uses for things. What if you are going to create a wound, like cutting out a deep splinter or draining a cyst? Betadine the crap outta the area first so you don't introduce MRSA or something into your system. Peroxide is very useful for sterilizing things and killing/dissolving organic matter. Alcohols are useful for sterilization and as cleaners/solvents. Bleach will kill bacterial spores like C.diff or C. botulinum, that alcohols won't touch.
Link Posted: 1/5/2012 5:11:50 PM EDT
[Last Edit: 1/5/2012 5:12:41 PM EDT by ColonelHurtz]
You can still get the 30% peroxide and dilute it 1:10 for general use.
It has other survival uses that Satan would approve of but your mother wouldn't .

KMnO4 is still a great oxidizer. And it stores indefinitely if kept dry.
It also has many alternative uses.

Link Posted: 1/5/2012 5:12:25 PM EDT
I keep alcohol and betadine on hand; you can buy betadine cheaper in the farm supply places than your local CVS. Also google sugardine for more uses; it's popular with farmers and large animal vets.
Link Posted: 1/5/2012 6:57:07 PM EDT
We keep 91% iso alcohol in the plastic bottles around. Wife unit is allergic to betadine so we don't keep any.

Sometimes, people can be allergic to the adhesive in certain types of band-aids, too. So, we've had to find some that doesn't react badly when she has to wear one for a while. She's had a couple of surgeries where she's had to tell them not to use certain tapes or else when they go to pull them off, she loses rectangular patches of skin.
Link Posted: 1/5/2012 7:05:49 PM EDT
I just bought a bottle of betadine for general stocking. Didn't really think it out but I have it.

Remember the old school stuff, mom used to treat our cuts with tincture of merthiolate and add a dab of triple antibiotic ointment before covering with a bandaid?

I keep peroxide around, I just put some in my ear the other day as it seemed to have an ear infection. About an hour of fizzing and popping in my ear. The next day my ear had bunches of wax coming out. Feels loads better now.

I also have rubbing alcohol and use it periodically.
Link Posted: 1/5/2012 7:24:16 PM EDT
Check out 2% Chlorhexidine in the vet supplies

Or 4% sold for "humans"

Big price difference. You make the call but, we use this stuff in the OR all the time for both as a scrub and prep. It also has a residual effect that other antiseptics don't have.

Link Posted: 1/5/2012 7:39:21 PM EDT
Originally Posted By OlKev:
Check out 2% Chlorhexidine in the vet supplies

Or 4% sold for "humans"

Big price difference. You make the call but, we use this stuff in the OR all the time for both as a scrub and prep. It also has a residual effect that other antiseptics don't have.



I was going to post about chlorhexidine, but you beat me to it. It's the "new" betadine, just be careful around eyes and mucosal tissue.

I share the OP's question, though, outside of disinfection of intact skin, it certainly seems that all the usual things (alcohol, betadine, chlorhexidine, Zephiran)
aren't terribly useful based on current advice. Do you see anything used in the OR in this class wouldn't be covered by soap and water?

I've got boatloads of Zephiran wipes, and a fair number of alcohol/chlorhexidine ones, and I'm not even sure they belong in a FAK anymore...
Link Posted: 1/5/2012 8:06:22 PM EDT
[Last Edit: 1/5/2012 8:07:21 PM EDT by Remyrw]
(edit) meant to be a reply/quote for the alcohol non allergy post, obviously (/edit)

bull shit.
Not as likely as some of them, but there are a fair number of people allergic to alcohol. It's generally not a huge issue even if they are as long as it's topical, but wiping down an injury near their airways could be a very bad thing.

All you can do is know who you're working with. I know no one in my immediate group has any allergies to the common drugs used. I'm allergic to some sulfa based drugs though. Thankfully that's not as big an issue now as it was in the past. I have a good friend that's allergic to alcohol though, very allergic. He's not local though, so it's not a concern in terms of prepping.
Link Posted: 1/5/2012 8:10:12 PM EDT
[Last Edit: 1/5/2012 8:14:48 PM EDT by Remyrw]
Interesting about the new one and having a residual effect. I'll have to check that out. I've generally liked my blue stuff but an upgrade's an upgrade and having some lasting effect would be good. I generally put a bit of neosporin or similar product on small cuts but it's not suited for deep stuff. Something to help keep out an infection is always good.

––edit to add––
wow, doing some reading, very interesting stuff. MUCH appreciated. I think a gallon of the 2% is on my list to pick up.
Link Posted: 1/5/2012 8:57:42 PM EDT
Link Posted: 1/6/2012 3:27:56 AM EDT
[Last Edit: 1/6/2012 3:30:15 AM EDT by Harvest123]
Betadyne on an open wound will cause severe irritation of the tissue. Betadyne Wash is another thing. It is great. Look up the application and uses on the chemical.

Typically, Betadyne is used to cleanse an area for a surgical incision. Everyone has seen a doctor in the movies wiping an area with red stuff. That is straight betadyne.

A best case scenario is irrigating the wound, picking the debris out if any exists, washing in and around a wound with betadyne wash, and then rinsing with 0.9% saline solution or clean water.

I gave myself the biggest scar of my life using Betadyne in the wrong way. Diluted, it may have great use, but I do not have the numbers on the ratio's to make it work.

Also can't go wrong with Hydrogen Peroxide (got tickled with the guy that knew his chemistry about 30% HP - Will go bang and make neat drugs your Dentist uses) or alcohol. Alcohol, although it stings, can be used to light fires. Dual use is always great in any item we use in an emergency, but the allergic effect is an issue. I would have Betadyne Wash on hand, water and Hydrogen Peroxide.
Link Posted: 1/6/2012 4:46:35 AM EDT
Peroxide is a terrible antiseptic. It's also chemically unstable and has a short shelf life. Don't bother - there is a reason it fell out of use.
Link Posted: 1/6/2012 5:17:47 AM EDT
Originally Posted By coolstuff:
peroxide decomposes over time. I wouldn't bother.


Did not know that. I keep peroxide everywhere
1) They are cheap
2) I have diabetes and must keep all wounds clear of infection
3) I use them horses when they are wounded.
Link Posted: 1/6/2012 12:17:52 PM EDT
One other thing to consider about peroxide is that it kills everything, including healthy tissue. That is generally not a good thing.
Link Posted: 1/6/2012 12:29:08 PM EDT
Originally Posted By ColonelHurtz:
KMnO4 is still a great oxidizer. And it stores indefinitely if kept dry.
It also has many alternative uses.



Big +1. Can be found at most hardware stores.
Link Posted: 1/6/2012 8:51:20 PM EDT
[Last Edit: 1/6/2012 9:02:08 PM EDT by Country_Boy]
Originally Posted By seek2:

I was going to post about chlorhexidine, but you beat me to it. It's the "new" betadine, just be careful around eyes and mucosal tissue.

I share the OP's question, though, outside of disinfection of intact skin, it certainly seems that all the usual things (alcohol, betadine, chlorhexidine, Zephiran)
aren't terribly useful based on current advice. Do you see anything used in the OR in this class wouldn't be covered by soap and water?

I've got boatloads of Zephiran wipes, and a fair number of alcohol/chlorhexidine ones, and I'm not even sure they belong in a FAK anymore...


Alcohol is useful for disinfecting injectable drug containers, and medical instruments. Disinfection of intact skin BTW, covers both the patient and care giver. You also probally want hand sanatizer for sick family members/pandemic flu. In theory BZK is the only antimicrobial known to kill rabies, so it may be worth keeping. You also have to consider in cases of minor wounds you may want to clean at all costs (ie possable exposure to rabies, blood born pathogens, possable fecal contamination (getting cut arround farm animals).

I keep gel alcohol, 91% alcohol, PVP iodine, PVP Iodine surgical scrub, and Hibclens at home, and PVP iodine, gelled alcohol, and BZK in the truck

I have lysol and pinesol for general purpose disinfecting, however at work we are stocking a product called Vircon S in case we have top respond to bird flu. (We have construction crews with backhoes and bulldozers, who have at least minimal HAZMAT training and could respond to help with animal kills, plus we may supply C3 or logistics teams to assist.) It's similar to the role envisioned for contract and federal firefighting crews. I know one of our local farmers uses it for foot dips prior to entry into a class A pountry house. It's easy to mix (comes as a tablet), and changes color as the solution gets too old.


Link Posted: 1/6/2012 8:53:06 PM EDT
Originally Posted By Maine_11B_to_Nurse:
One other thing to consider about peroxide is that it kills everything, including healthy tissue. That is generally not a good thing.


Not at 2%m(drug store strength). You can wash your mouth with it. But it's not so good at killing microbes either.

Link Posted: 1/6/2012 9:19:39 PM EDT
[Last Edit: 1/6/2012 9:20:00 PM EDT by Bubbatheredneck]
Big fan of betadine.

Straight betadine in a wound can actually impair healing by damaging normal tissue.

For wound irrigation, just a cc or so in a liter or two of water or saline is bacteriostatic without harming normal tissue too much.

Go for a very weak tea color.

Betadine can be used for water sterilization too.

Be sure to go with a the plain 10% not the 'Scrub' version which has detergents/soaps in it IIRC.

Link Posted: 1/6/2012 11:25:51 PM EDT
Originally Posted By Maine_11B_to_Nurse:
One other thing to consider about peroxide is that it kills everything, including healthy tissue. That is generally not a good thing.

+1 Peroxide may be OK for cleansing a laceration immediately after it's sustained, but don't keep using it. It kills the cells which are trying to migrate into and heal the wound. I have had patients with lacerations which wouldn't heal- because they were putting peroxide on it every day.

Chlorhexidine gluconate 2% or 4% (Hibiclens) is great for wound cleansing, and does not kill human tissue. However, AVOID using it around the eyes. It can cause serious inflammation of the eyes.

Bleach in water: 1 part bleach, 39 parts water, which is Dakin solution 1:40, is safe for cleansing wounds. It does not kill cells/tissue- does not interfere with healing. It is used in burn units.

Be careful with antibiotic ointments such as neosporin and polysporin. About 10-15% of the population can become allergic to it.

And don't forget good old plain soap and water. Antibacterial soap, such as Dial or Lever 2000 is good, but not absolutely necessary- plain soap is usually adequate. For most cuts/abrasions and lacerations, wash with soap and water, then apply a small amount of petrolatum and cover with a bandage. Repeat this daily.
Link Posted: 1/7/2012 2:10:38 PM EDT
anybody know the shelf life of Chlorhexidine ?
Link Posted: 1/7/2012 3:25:20 PM EDT

.

Link Posted: 1/7/2012 4:07:51 PM EDT
Any one ever hear of dettol, it was very popular with a indian girl I dated in college for a antiseptic.
Link Posted: 1/7/2012 5:33:05 PM EDT
It contains a topical antimicrobial kind of like Dial soap has Triclosan. In fact the same antimicrobial is used in some commerical liquid hand washing soaps in the US

I'd don't think it's quite as well tested or as effective as betadyn, alcohol, BZK or hibclens.

This is second hand from a CDC briefing.
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