Researchers found that citric and other acids promote efficient wound healing.

Common sense might dictate that acids would have a negative effect on the skin and may even hinder wound healing, as they have a reputation for eating away at tissue. However, acids such as citric, ascorbic, acetic, boric and alginic have been long used as a topical application to promote recovery and stave off infection. In the past, studies into the use of acid on wounds have been largely inconclusive, but a new review provides more definitive proof.

Foundation for the review

The review, published in the journal Wounds, delved into the relationship between acidic environments and wound healing. Researchers from the Maharashtra Institute of Medical Sciences & Research Medical College in India conducted a literature search of the PubMed database and used 45 found materials, as well as other relevant reviews, to summarize the role of acidic environments in wound healing. They hoped to build on the medical community’s current knowledge of pH activity during recovery.

“[It has] been observed that wounds with a high alkaline pH have a lower healing rate in both acute and chronic wounds as compared to wounds with a pH closer to neutral,” the review explained. “Wound healing progression decreases when pH is elevated to alkaline condition. The environment of acute as well as chronic wounds progresses from an alkaline state to a neutral state and then to an acidic state when healing begins.”

The results

This understanding has prompted the use of acid to promote healing, and the findings of the review support the use of acid to reduce alkaline pH levels for more efficient tissue regrowth. The evaluation of the studies showed that acidic environments created with the use of topical applications helps to defend against wound infection while increasing antimicrobial activity. It also spurs the release of toxicity from bacterial end products, such as ammonia released by the enzyme urease, and enhanced the angiogenesis and epithelization processes.

“[The results] suggest that monitoring wound pH may help in the evaluation of treatment progress,” the review stated. “The authors conclude that creating an acidic environment in a wound bed has an additional benefit that positively influences the wound healing process.”

Another benefit found by the researchers is that the acidic environment helps the body destroy abnormal collagen in the wound bed that can hinder healing.

Is acid treatment right for you?

The specific wound care methods for each person depends on his or her specific situation. In the case of chronic or non-healing wounds, a clinician may suggest that a patient apply topical acid to complement the dressing. Additionally, wounds with a high presence of bacteria or heightened risk of developing infection may benefit from an acidic environment. In any case, pH monitoring as suggested by the researchers can help clinicians ensure that the wound is healing at optimal efficiency. Talk to your clinician about pH monitoring and the potential for acid treatment.

Advanced Tissue is the nation’s leader in delivering specialized wound care supplies to patients, delivering to both homes and long-term care facilities.