The Continued Utility and Viability of Dakin’s Solution in Both High- and Low-resource Settings

Document Type : TECHNICAL NOTE

Authors

1 Yale School of Medicine, Department of Orthopaedics and Rehabilitation, New Haven, Connecticut, USA

2 Harvard Combined Orthopaedic Residency Program, Harvard Medical School, Boston, Massachusetts, USA

3 Tufts University School of Medicine, Boston, Massachusetts, USA

4 Hôpital de l’Université d’É􀆵 tat d’Haï􀇅ti (HUEH), Port-Au- Prince, Haiti

5 Hospital l’Universite de La Paix (HUP), Port-Au-Prince, Haiti

6 Harvard Medical School, Boston, Massachusetts; Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, Massachusetts, USA

Abstract

Healthcare is expensive and often inaccessible to many. As a result, surgeons must consider simple, less expensive
interventions when possible. For wound care, an older but quite effective cleaning agent is Dakin’s solution (0.5%
sodium hypochlorite), an easily made mixture of 100 milliliters (ml) bleach with 8 teaspoons (tsp) baking soda into a
gallon of clean water or 25 ml bleach and 2 tsp baking soda into a liter of water. Gauze is then wet with this solution,
placed on the wound, and replaced every 24 hours as needed. Our team of surgeons in Haiti and the United States
is currently using Dakin’s solution for wound care following orthopedic surgery and finds it to be a low-cost, safe, and
effective treatment for post-surgical wound care for both resource-limited and non-resource strained environments.
This report aims to update the current literature and encourage the consideration of Dakin’s solution for modern
wound care.
Level of evidence: III

Keywords

Main Subjects

References

to reduce bacterial colonization of surgical drains
after breast and axillary operations. Ann Surg. 2013;
258(2):240-7.
8. Higgins KR, Ashry HR. Wound dressings and topical
agents. Clin Podiatr Med Surg. 1995; 12(1):31-40.
9. Doughty D. A rational approach to the use of topical
antiseptics. J Wound Ostomy Continence Nurs. 1994;
21(6):224-31.
10. Duarte B, Cabete J, Formiga A, Neves J. Dakin’s
solution: is there a place for it in the 21st century? Int
Wound J. 2017; 14(6):918-20.
11. Cyr SJ, Hensley D, Benedetti GE. Treatment of field
water with sodium hypochlorite for surgical irrigation.
J Trauma. 2004; 57(2):231-5.
12. Piskin B, Turkun M. Stability of various sodium
hypochlorite solutions. J Endod. 1995; 21(5):253-5.
13. Jarbrink K, Ni G, Sonnergren H, Schmidtchen A, Pang C,
Bajpai R, et al. The humanistic and economic burden
of chronic wounds: a protocol for a systematic review.
Syst Rev. 2017; 6(1): 15.
1. Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso
N, Ameh EA, et al. Global Surgery 2030: evidence and
solutions for achieving health, welfare, and economic
development. Lancet. 2015; 386(9993):569-624.
2. Rezayat C, Widmann WD, Hardy MA. Henry Drysdale
Dakin: More than His Solution. Curr Surg. 2006;
63(3):194-6.
3. Keyes M, Thibodeau R. Dakin Solution (Sodium
Hypochlorite). Treasure Island (FL): StatPearls
Publishing; 2019.
4. Levine JM. Dakin’s solution: past, present, and future.
Adv Skin Wound Care. 2013; 26(9):410-4.
5. McCullough M, Carlson GW. Dakin’s solution:
historical perspective and current practice. Ann Plast
Surg. 2014; 73(3):254-6.
6. Lewandowski L, Purcell R, Fleming M, Gordon WT.
The use of dilute Dakin’s solution for the treatment of
angioinvasive fungal infection in the combat wounded:
a case series. Mil Med. 2013; 178(4):e503-7.
7. Degnim AC, Scow JS, Hoskin TL, Miller JP, Loprinzi
M, Boughey JC, et al. Randomized controlled trial 
to reduce bacterial colonization of surgical drains
after breast and axillary operations. Ann Surg. 2013;
258(2):240-7.
8. Higgins KR, Ashry HR. Wound dressings and topical
agents. Clin Podiatr Med Surg. 1995; 12(1):31-40.
9. Doughty D. A rational approach to the use of topical
antiseptics. J Wound Ostomy Continence Nurs. 1994;
21(6):224-31.
10. Duarte B, Cabete J, Formiga A, Neves J. Dakin’s
solution: is there a place for it in the 21st century? Int
Wound J. 2017; 14(6):918-20.
11. Cyr SJ, Hensley D, Benedetti GE. Treatment of field
water with sodium hypochlorite for surgical irrigation.
J Trauma. 2004; 57(2):231-5.
12. Piskin B, Turkun M. Stability of various sodium
hypochlorite solutions. J Endod. 1995; 21(5):253-5.
13. Jarbrink K, Ni G, Sonnergren H, Schmidtchen A, Pang C,
Bajpai R, et al. The humanistic and economic burden
of chronic wounds: a protocol for a systematic review.
Syst Rev. 2017; 6(1): 15.
The Archives of Bone and Joint Surgery
Volume 8, Issue 2
March 2020
Pages 198-203

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History

  • Receive Date: 13 September 2018
  • Revise Date: 17 February 2019
  • Accept Date: 22 August 2019

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