product profile: not wishy-washy about Vashe

Dec 28, 2024

2 min read

It's no surprise that hygiene is a cornerstone of wound care. Keeping a wound clean and free from infection is crucial for proper healing. However, the instinct to cleanse wounds as often as possible and with the strongest agents available is misguided.

As with much in health and healing, it is important to strike a balance. Other factors that also influence wound healing, such as temperature and environment pH, can be disrupted by over-cleansing. Furthermore, using agents that are too harsh can irritate surrounding skin and may have cytotoxic effects that ultimately slow healing.

A versatile cleanser that we use frequently is Vashe (rhymes with "wash"), which is hypochlorous acid (HOCl)-based, with a skin-friendly pH of 5.1-5.5. If that molecular formula looks familiar to you, that might be because the active ingredient in bleach (and Dakin's solution) is a salt of hypochlorous acid, sodium hypochlorite (NaOCl). Endogenous HOCl is used by the body's white blood cells (WBCs) to fight infection. Vashe has a wide range of applications and can be used to irrigate and moisten wounds, and provides some chemical debridement and biofilm disruption. In our practice, we have used Vashe both as a soak (usually for about 5-10 minutes) and a dressing component (e.g., soaking plain ribbon packing or plain gauze(s) with solution to lightly fill wound cavities). Vashe has an excellent safety profile, is safe for pregnant persons and neonates 23 weeks and older, and can be used on tendons, ligaments, cartilage, and bone, as well as around sensitive areas like the eyes, ears, and genitalia. However, it is incompatible with CHG; nor should it be combined with PHMB, as the two antiseptics can react in a manner that diminishes the effectiveness of PHMB.

As an interesting aside, I have recently noticed HOCl making inroads in the beauty/skin care space, often as an ingredient in facial mist. Although I think it could be helpful in certain cases (and many customers seem to agree), a word of caution: it is possible to have too much of a "good" thing! Despite the compelling marketing surrounding this ingredient, intact, healthy skin probably doesn't need a daily application of HOCl.

All in all, effective wound care requires a nuanced approach that balances cleaning with the body's natural physiology to create a healing environment. Each element of the care we provide as wound care NPs is selected with that principle in mind.

Eager to know more? The NSWOCC has an excellent presentation on Vashe:

P.S. I am thinking of making this a series to highlight certain products that are common in practice. Up next: Triad hydrophilic wound dressing!