The report by Schneider and Hebert,1 "Subcutaneous Gas From Hydrogen Peroxide Administration Under Pressure," encourages us to speak out on certain practices commonly utilized in the preparation of open wounds. While some object to "pressurized anything," we do not. We find the surgical version of the Water Pik (Teledyne Aqua Tec, Fort Collins, Colo) to be indispensable in cleaning asphalt particles out of deep road rashes, and for garden-variety lacerations, we teach that 20 mL of saline solution ejected forcefully through a 21-gauge needle does a better job of cleaning a wound than 2 L of saline solution down the tube. Our objection is to putting antiseptic agents, specifically hydrogen peroxide or povidone iodine, onto living tissue.
While United States Pharmacopeia hydrogen peroxide (3%) diluted 1:1 seems to do little harm to oropharyngeal mucosa as a mouthwash and even undiluted hydrogen peroxide does not appear to harm a healing
Oberg MS, Lindsey D. Do Not Put Hydrogen Peroxide or Povidone Iodine Into Wounds! Am J Dis Child. 1987;141(1):27–28. doi:10.1001/archpedi.1987.04460010027015
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