Wound Care University

Acetic Acid
Feb 3, 2024

WARNING: VERY GRAPHIC IMAGES BELOW. PLEASE PROCEED AND SCROLL WITH CAUTION!

  • – Background and History
  • – Acetic acid (AC) is present in vinegar in 3-5% concentrations
  • – AC solution was used over 100 years ago for the treatment of war-wound infections, but AC itself has been used for more than 1000 years ago
  • – The first successful use in 1916 when 1% AC was used against Bacillus Pyocyaneus, which is now known as Pseudomonas Aeruginosa
  • – Generally, AC has been used to treat pseudomonas in wounds. Most microorganisms require a pH of 6 and above, application of AC leads to a reduction in protease activity, increase in macrophage and fibroblast activity and reduces toxicity of bacterial end products (hydrogen, lactic acid, etc.)
  • – Using 1% AC has been shown to be sufficient to halt the growth of most common bacteria and fungi.
    • – In one study, AC was found to be effective against multiple MDR Bacteria in both free-floating broth and biofilm. The study showed that most wounds would improve in 7-14 days.
    • – Another study showed complete eradication of pseudomonas and S. Aureus
  • – Can be used in NPWT as an irrigation agent
  • – Can be used in a variety of wounds DFU, VLU, post-op infection, chronic non-healing wounds
  • – Inexpensive
  • – Non-cytoxic compared to Betadine, Peroxide, and Dakins
  • – Minimal side effects; most report a stinging sensation

Case Study:

40 year old male. Significant medical hx of spina bifida, bed and wheelchair-bound. Unable to walk since he was 12. Developed Fournier’s gangrene, which required multiple debridements, partial penectomy, and right orchiectomy. Also noted to have osteomyelitis of the right foot and a pressure wound to the sacrum. Admitted to LTAC for wound care and ABX. STAC attempted NPWT, but the patient was unable to tolerate vac changes due to frequent seal leaks. Started on acetic acid dressing changes for his Fournier’s gangrene which was cultured for pseudomonas, proteus, and candida.

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