Pure Hypochlorous Acid Preserved Wound Cleanser (HAPWOC*) in the Management of Acute or Chronic Complex Wounds When Using Standard Negative Pressure Wound

Introduction: Hypochlorous Acid Preserved Wound Cleanser(HAPWOC)* has improved wound outcomes as described in evidenced-based practice. The product formulation allows efficient removal of wound debris/microbes. We standardized for the management of acute or chronic complex wounds as an irrigation medium when using Standard Negative Pressure Wound Therapy(NPWT).

Subjects and Settings: 454-bed metropolitan Level I Trauma Center in the Midwestern United States. HAPWOC was adopted by the Certified Wound Ostomy & Continence Nurse(CWOCN) services for all wounds. Patients, 18 years or older with pressure injuries, trauma/lacerations/surgical standard conditions indicative for NPWT were treated with HAPWOC. Observations of the patients were conducted May and June 2021. NPWT application, and during dressing changes, HAPWOC irrigation used 50-60ml in a 10ml syringe. HAPWOC was provided to the bedside RN via hospital material supply. We present three cases to illustrate use in conjunction with standard NPWT.

Results: 50 patients had HAPWOC pre-application/during changes of NPWT. Use demonstrated a return to a healthy-stable tissue base. Wounds remained moist and non-malodorous when cleansed with HAPWOC. Use was suggested as the irrigation for home or outpatient until wound resolution.

Conclusion: Healing is a complex process. for the human body. Requiring hydration, nutrition, microclimate, protection, and pH balance. HAPWOC with known efficacy against biofilms is ideally formulated for use in conjunction with NPWT via effective debris/microbe removal. HAPWOC standardized use demonstrated no complications as evidenced by the high number of patients managed (50 patients) in a short period. Increased access to RNs as opposed to CWOCN “only” accounts for proper use and standardization. Due to short stay many patients are discharged without full wound closure. This typical short length limits the long term assessment and gauging of wound resolution. Further, limits acute care/inpatient hospital based wound care studies. We suggest continued use of HAPWOC post-inpatient discharge be done by Long Term Care Hospitals, Home Care Agencies and Rehabilitative Centers to maintain wounds on the same healthy trajectory that we see during HAPWOC use during hospitalization.