The Use of Lidocaine in Managing Wounds

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Lidocaine Chemical Makeup

by Aletha Tippett MD

Editor's note:This blog post is part of the WoundSource Trending Topics series, bringing you insight into the latest clinical issues and advancement in wound management, with contributions by the WoundSource Editorial Advisory Board.

What is Lidocaine?

Lidocaine is typically used to reduce sensation in tissue in a specific area. Lidocaine can be either injected or applied topically, depending on need. This topical anesthetic is popular because of its low cost and minimal side effects. Once applied, lidocaine typically takes about four minutes to begin affecting sensation, and effects can last for between a half hour and three hours, depending on dosage. One of the main benefits of lidocaine is its rapid onset of action; while stronger or longer-acting substances may be preferred for surgical procedures, lidocaine’s fast-acting nature makes it perfect for reducing pain in a wound.

Lidocaine has been my go-to product for wound care for over 20 years. I always use viscous lidocaine applied to any dressing. A patient might need systemic pain relief also, but the application of topical lidocaine is very effective to help alleviate local pain of wounds. Since I have used lidocaine so long for thousands of wounds I can say it definitely helps the healing of wounds. Having a nearly 100% healing rate speaks to that.

The newest thing that I found out about lidocaine was recently published in Wounds regarding lidocaine's bacteriostatic properties. A study was conducted with surgical wounds, some had lidocaine applied, others had saline applied. The post-surgical infection rate with the lidocaine wounds was much less than the wounds with saline application. This tells me why I rarely had wound infections in all the years treating wounds with lidocaine.

Tips for the Application of Lidocaine

To use lidocaine to treat pain in a wound, just apply a small amount, about 1-2 grams, of oral viscous lidocaine to the dressing. then apply this side to the wound. Because of its viscous nature, lidocaine can be used on any type of dressing. Apply the side of the dressing with the lidocaine to the wound. The affects should begin within a few minutes, providing pain relief to your patient. Change daily or as needed and provide further systemic pain relief if necessary.

So, if you have not used lidocaine for wound care, consider starting to use it. You will be very happy with the outcome.

References
1. Lidocaine Hydrochloride (Local)". The American Society of Health-System Pharmacists. Archived from the original on 2015-09-06. Retrieved Aug 26, 2015.
2. WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016.
3. "Lidocaine HCL". International Drug Price Indicator Guide. Retrieved 27 August 2015.
4. J. P. Nolan & P. J. F. Baskett (1997). "Analgesia and anaesthesia". In David Skinner, Andrew Swain, Rodney Peyton & Colin Robertson. Cambridge Textbook of Accident and Emergency Medicine. Project co-ordinator, Fiona Whinster. Cambridge, UK: Cambridge University Press. p. 194. ISBN 9780521433792. Archivedfrom the original on 2017-09-08.

About The Author
Aletha Tippett MD is a family medicine and wound care expert, founder and president of the Hope of Healing Foundation®, family physician, and international speaker on wound care.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

Comments

I have seen very good results on pediatric pts as well. With today’s opioid epidemic, this should be considered a go to med!!

Just wondering about the systemic effects of using Lignocaine.
How much is too much and how long can it be used for?

There are no systemic reactions. You are only using 1-2 grams of 2% viscous lidocaine per dressing, so not much systemic involvement.

I have used 5% Lidocaine Ointment successfully in treating the complications of neuropathic pain, burning and shooting pain in the feet, of my diabetic patients. Once I have ruled out radicular pain, tarsal tunnel syndrome and local nerve entrapment in the 2nd or 3rd interspaces in the foot, I test the Lidocaine by applying a "dab" of the Lidocaine Ointment on both the dorsal and plantar aspects of the forefoot. If the patient's pain is neuropathic in nature it "disappears" within a few moments. Patients also note that their feet feel warmer with the application of Lidocaine Ointment.

If my patients have neuropathic foot pain that keeps them from sleeping, I suggest applying the Ointment before retiring, cover that site w/plastic wrap and put on a clean sock. Most patient's suffering from neuropathic pain get a reasonable night's sleep using this method.

Thank you. That is very helpful.

Is there anything with lidocaine that can be used with foot sores from chemo?

I would make my own dressing/topping using 2% viscous lidocaine. You can get that prescribed for a sore throat.

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