When Removing Oil from Wounds, Remember 'Like Dissolves Like'

Surgical Rounds®June 2014

Injured workers and bystanders often suffer oily wounds in accidents that must be cleaned prior to surgery.

When most people think about oil-contaminated wounds, they envision gloved volunteers washing oily birds with dish soap in the aftermath of an oil spill. However, oil-related injuries in humans can occur in other venues, since petroleum is present in all types of fuels, , roofing tar, plastics, and asphalt and road oil.

In the United States, approximately 200,000 people currently work in the oil and gas extraction industry — a field that is expanding rapidly, yet extremely dangerous. As a result, injured workers and bystanders often suffer oily wounds in accidents that must be cleaned prior to surgery.

Researchers from Denver Health Medical Center in Colorado developed an expert opinion review in the May 2014 edition of Patient Safety in Surgery to help guide the decontamination of injuries exposed to petroleum compounds — especially crush injuries, which are both common and difficult to treat because the excision of the affected area may be impossible.

Currently, there is no standard of care for effective cutaneous oil decontamination. After analyzing case reports, animal models, and in vitro studies, the reviewers determined that water and soap cleansing might be inappropriate, and instead recommended “like dissolves like” decontamination using lipophilic, petroleum-derived solvents to attract and dissolve oil contaminants.

The researchers also discussed various oil-based cleansers, including petrolatum, petroleum-based solvents, and a 1% surfactant made from the stool softener dioctyl sulfosuccinate, which they noted is significantly better than traditional chlorhexidine.

Although the authors endorsed the use of a petrolatum-based cleanser, they made no specific recommendations on products.

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