Wound Cleaning & Management
Wilderness Wound Cleaning: Why It Matters and How to Do It Right
When you’re out in the backcountry, miles from advanced care, how you clean a wound can be the difference between full recovery and a life-threatening infection. In this lesson, we walk you through field-proven techniques for cleaning wounds in austere environments where resources are limited and evacuation may not be immediate.
Video Summary:
In the video above, you’ll learn:
- How to evaluate a wound for depth, contamination, and debris
- The step-by-step process for irrigating wounds using field-expedient tools
- The importance of water pressure and volume in wound cleaning
- When and how to debride wounds safely in the field
- What to avoid — including common but harmful myths like using alcohol or hydrogen peroxide directly on open wounds
Key Takeaways:
1. Irrigation Is Your Best Friend
Forget fancy antiseptics — the real magic is in mechanical cleaning. Flushing a wound with clean, pressurized water removes bacteria, dirt, and foreign material. Ideally, use a 60cc syringe with an 18-gauge catheter or similar device to generate enough pressure (7–10 psi is ideal). No syringe? Flush with a povidone iodine solution. Poking holes in the top of a water bottle is great for surface cleaning but cannot generate enough pressure to blast out debris.
2. More Water, More Better
Volume matters. Aim to flush with at least 500ml to 1L of water, more for large or visibly contaminated wounds. Even clean-looking wounds can harbor microscopic debris, especially in dusty or muddy environments.
3. Soap Can Be Helpful—But Use Wisely
Mild soap can assist in reducing bacteria on the skin around the wound, but it should not be introduced into the wound itself. Clean the surrounding area gently without scrubbing inside the wound.
4. Don’t Use Hydrogen Peroxide or Alcohol in the Wound
These may look impressive with all the fizz and sting, but they cause more tissue damage than they prevent. Save these agents for disinfecting tools, not treating tissue.
5. Debridement? Please Get Some Kind of Training
Removing dead tissue (debridement) is sometimes necessary, especially for wounds that won’t be seen by a provider for several days. However, this can do more harm than good if done incorrectly. Only attempt basic debridement if you’ve been trained, are comfortable cutting and snipping on people, and the tissue is clearly nonviable.
6. Wound Packing and Dressing
After cleaning, loosely pack wounds that can’t be closed, especially deep punctures or wounds with potential for anaerobic infection. Dress with clean, non-adherent material, and monitor closely for signs of infection: increased redness, swelling, pus, warmth, or systemic symptoms like fever.
Real-World Application
Cleaning wounds in the wild is a practical survival skill — not just something for medics. In our experience (and as emphasized in the video), the single most important intervention you can do in the field is proper cleaning. It’s far more important than dressing choice or the type of bandage you have.
When in doubt, clean aggressively, dress smartly, and reassess often.
Need the tools shown in this lesson?*
Check out our curated Wilderness First Aid Kits — purpose-built for scenarios just like this.
Stay sharp, stay safe, and remember: good medicine is clean medicine.