A patient arrives in the emergency department after a bicycle–automobile accident with multiple dirty abrasions. Which product might be used initially to cleanse this patient's wounds?
a. Hydrogen peroxide
b. Isopropanol (isopropyl alcohol)
c. Povidone iodine (Betadine)
d. Soap and water
ANS: A
Hydrogen peroxide does not have good antiseptic properties, because the antimicrobial component is destroyed by catalase in tissues. It is useful initially because the frothing that occurs when catalase liberates oxygen loosens debris and facilitates cleansing of a dirty wound. Isopropanol is irritating to the skin. Povidone iodine is used on intact skin. Soap and water can be used, but hard scrubbing is necessary on a dirty abrasion and can be painful.
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