I know that H2O2 is a chemical with high oxidative potential. It can deliver nascent oxygen which can destroy bacteria.

I understand that open wounds have cells that are dividing at a fast rate to effect healing. Is it good to add a substance that can cause damage to cell membrane and possibly cause mutation in the DNA of these fast growing tissues?

Can H2O2 be safely used to sterilize wounds?

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    $\begingroup$ H₂O₂ is used only at the time of first cleaning afaik; good against Clostridia. For regular dressing it is not generally prescribed. $\endgroup$ – WYSIWYG Jan 9 '15 at 8:23

There will be few rapidly-dividing cells in a fresh wound (which is the wound to which H2O2 is applied). In general, it is a good idea to avoid applying irritants to rapidly dividing tissue.

Hydrogen peroxide is a weak mutagen. It is produced in many body tissues, ingested in drinks, produced by mouth bacteria, etc. It may well cause some cancers. Some OSHA-mandated literature does warn that it is a mutagen and must be handled with care, but these are warnings to people who work with concentrated solutions.

However, a relatively weak hydrogen peroxide solution, even if it is mutagenic, would need to be left in place and active (or renewed) for a long period of time to produce skin cancer. As it has been a staple of first aid kits for decades, and this association has never been made clinically, my best guess is that the benefit (as a bacterocidal agent) far outweighs the risk in the treatment of minor wounds. As in all things, however, prudence is advised. (I myself don't use it because soap and a lot of water is quite effective. Nor is it used in the care of wounds in Emergency Rooms where it is considered to be detrimental to wound healing. If I were in a country where clean water and soap were in short supply, I might well use it if necessary.)

Because it is an irritant (and many irritants can be considered mutagenic), it is actually used to treat precancerous skin lesions, the finding being that it affects the more rapidly dividing pre-cancerous cells than the rest of the epithelium.

Far more potent peroxides have been used topically, which may increase the risk of skin cancer.

Interestingly, one of the responses of skin cells to H2O2 is the generation of an oxygenase to fight the effects.

Topical sulindac combined with hydrogen peroxide in the treatment of actinic keratoses
Effects of Peroxides on Rodent Skin: Epidermal Hyperplasia and Tumor Promotion
Heme oxygenase is the major 32-kDa stress protein induced in human skin fibroblasts by UVA radiation, hydrogen peroxide, and sodium arsenite
Recent Advances in Wound Care, Michael K. Abraham, MD, MS, and Jason S. Oh, MD

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    $\begingroup$ Nice answer. I shouldn't ask new questions, but what about chronic repeated exposure to peroxides via mouth wash, given that epithelial cells in the mouth are quite rapidly dividing? $\endgroup$ – AliceD Jan 9 '15 at 11:42
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    $\begingroup$ @ChrisStronks - Almost any irritant has the potential to be mutagenic. One weighs risks to benefits. When there are specific benefits (to whiten teeth, for example), it's unlikely to do more damage than good. But where there's little benefit, I wouldn't do it on a daily basis. $\endgroup$ – anongoodnurse Jan 9 '15 at 11:48
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    $\begingroup$ @ChrisStronks the epithelial cells in your mouth also shed fairly quickly, so even if a cell were to develop enough mutations to become cancerous, it likely wouldn't be around long enough to start dividing into a tumor. $\endgroup$ – MattDMo Jan 9 '15 at 17:53
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    $\begingroup$ @MattDMo - while it's true that epithelial cells in the mouth have a high rate of turnover, it's also true that oral cancers occur still. 43,250 Americans will be diagnosed with oral or pharyngeal cancer this year, of those, only slightly more than half will be alive in 5 years. Alcohol has long been a risk factor because it is held in the mouth, and it's an irritant. So, no pleasant daydreams about this are helpful. I've seen people with their lower jaw removed due to oral cancers. :-O (Not recently, though.) $\endgroup$ – anongoodnurse Jan 9 '15 at 20:57
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    $\begingroup$ @MattDMo - also, hydrogen peroxide is readily absorbed into tissue, which means it can easily reach more permanent cells. I'm not a cancerphobe. I think the risk from using a peroxide mouthwash is lower than alcohol and smoking, but as they have been on the market for far less time, we don't know their long-term safety. The good thing I can say is that it is produced by our own bodies, and we seem to have means to fight it. But, prudence in all things is not bad advice. $\endgroup$ – anongoodnurse Jan 9 '15 at 21:08

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