The role of acetic acid in orthopaedic surgery.
Yousuf Hashmi, Andrew Kailin Zhou, Anam Jawaid and 4 others
PMID 34310234WHAT IT FOUND
Acetic acid may be used off-licence in orthopaedic wounds and iontophoresis for tendon or scar problems, but evidence is limited and optimal doses and soak times are unclear.
Key findings
011.0% acetic acid eradicated Staphylococcus aureus biofilm, and 0.5% or 1.0% acetic acid eradicated Pseudomonas aeruginosa biofilm, while hydrochloric acid had no effect on Pseudomonas aeruginosa and only partial effect on Staphylococcus aureus.
02At 5%, acetic acid eradicated 96.1% of biofilm-associated MSSA after 20 minutes.
03Acetic acid iontophoresis increased total active range of motion in 17 patients with trigger finger release scars.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a narrative review, not a systematic review, and the authors say the clinical evidence is very limited. Optimal acetic acid concentration, soak duration and iontophoresis settings are not established. Use in orthopaedics is off-licence, so consent and documentation requirements apply. The soft tissue studies are old, small, or lacked controls, so improvements cannot be confidently attributed to acetic acid iontophoresis. Biofilm results are laboratory findings and do not show patient outcomes.
Declared interests
No competing interests declared.
The easy way to misread this
Do not read this as proof that acetic acid or iontophoresis is licensed or effective for your patients. The review itself says the evidence is limited, mostly small or old studies, and optimal concentration and duration are unclear.