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January 1989

Débridement of Wounds With Dakin's Solution

Arch Surg. 1989;124(1):133. doi:10.1001/archsurg.1989.01410010143028

To the Editor.—The article in the April 1988 issue of the Archives by Kozol and colleagues1 recommended that we abandon the use of Dakin's solution in open, dirty, necrotic wounds. Unfortunately, this article, like many other reports based on laboratory studies in rats and rabbits, ignores the observations and lessons learned in clinical surgery over many years. A wound that is covered with dead, infected tissue must be débrided one way or another. Any technique, whether it is surgical débridement or frequent dressing changes, will damage normal underlying tissue. The purpose of using frequent dressing changes with half-strength Dakin's solution is to débride rapidly the dead, necrotic, infected tissue. Once this is done, healing can take place regardless of where the neutrophils migrate. Once the wound is clean, application of the dressings with Dakin's solution is stopped and the wound either is allowed to epithelialize or is surgically