Acetic Acid 0.5–1% Solution

How it works

It lowers wound-surface pH, disrupting bacterial cell-wall integrity and metabolism; the acidic environment is unfavourable to Pseudomonas and some other Gram-negative organisms.

Prescribing in practice

• This is for topical/wound use only and must never be confused with concentrated glacial acetic acid, which causes chemical burns — the dilute working strength must be confirmed before application.
• Application to extensive or deep wounds may cause stinging and local pain, so adequate analgesia and gentle application are advisable.
• It is an adjunct to wound bed preparation and debridement, not a substitute for systemic antibiotics where invasive infection is present.

Monitoring

Monitor the wound bed for response, signs of irritation, and clinical evidence of resolving or progressing infection.

Counselling the patient

• Expect a mild stinging sensation when the soaked dressing is applied.
• Tell the team if pain becomes severe or the surrounding skin becomes inflamed.

Evidence & guidelines

Topical acetic acid for Pseudomonas-colonised wounds is a long-standing practice supported by clinical experience and microbiological rationale rather than large randomised trials.