Wound pH: Low Hanging Wound Diagnostic Fruit?

We at SALSA have long been proponents of “theragnostics” (or theranostics if you’re agnostic to silent g’s). Schnieder and coworkers, in a superb review (way back) in 2007 reviewed the literature on this topic. In this manuscript, they outline proposed natural histories of wound pH for “normal” and “chronic” wounds. The answer is that wound pH changes over time depending on where in the cycle of healing we are. Bottom line: acute = low pH, chronic = high (alkaline) pH, trending toward neutral and acidic when epithelialized. However: a few tidbits directly from this manuscript:

• physiological milieu of the skin is acidic, which supports the natural barrier function and helps to counteract microbial colonization;

• chronic wounds and infected wounds with a high bacterial load characterized by a pH above 7.3;

• acute wounds, wounds with pus or necrotic tissue and chronic wounds that make progress in their healing process show an acidic pH;

• pH value in wounds is a dynamic factor that can change rapidly with therapeutic interventions;

* Split thickness skin grafts appear to “take” more readily in a high pH (alkaline) milieu.

Here is more discussion on the wider subject of wound diagnostics. 

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