Download Procedure for the use of Potassium Permanganate soaks in Primary

Procedure for the use of Potassium
Permanganate soaks in Primary Care
Guidance for Community–based Healthcare
Professionals
Julie Hewish, Tissue Viability Nurse
June 2012
The content and structure of this procedure have been adapted with kind permission from
Helen Harris, Tissue Viability Nurse, Bath and North East Somerset NHS Trust.
Procedure for the use of Potassium Permanganate soaks in
Primary Care
Background
What is Potassium Permanganate used for?
Precautions
Instructions for use
Audit and review
References
Procedure for the use of Potassium Permanganate soaks in
Primary Care
Potassium permanganate is often used for weeping, exuding skin or for blistered areas that
require drying up. Potassium permanganate must not be used as a first line, stand-alone
treatment. Investigations to identify and manage underlying causes of skin deterioration
and/or increased exudate levels must be carried out in order to implement a holistic
management plan. Potassium permanganate must only be used when all standard treatments
have been exhausted. This treatment is usually instigated under the guidance of Dermatology
or Tissue Viability.
1.0 BACKGROUND
Potassium permanganate is an oxidising agent with disinfectant, deodorising and astringent
properties. Its chemical formula is KmnO4. In its raw state potassium permanganate is an
odourless dark purple or almost black crystal, granular powder or tablet. The main form of
use is a potassium permanganate solution that is made by dissolving crystals or powder in
water. Within the Oxford Health NHS Foundation Trust the more convenient tablet form is
used to prepare topical solutions.
3.0 PRECAUTIONS

Potassium permanganate tablets and concentrated solutions are caustic and can burn
the skin. Even fairly dilute solutions can irritate skin and repeated use may cause
burns. Staff must therefore ensure that they wear the appropriate protective clothing
when working with potassium permanganate (see Section 4). Potassium permanganate
presents in tablet form which must not be handled as it can stain the skin and turn
nails brown but this does resolve.

Potassium Permanganate stains floor surfaces, clothing and carpets permanently.

Avoid contact with the eyes and buccal mucosa.

Do not use soap or detergent in conjunction with treatment as this will react with the
solution which will discolour and give off an unpleasant odour.
Procedure for the use of Potassium Permanganate soaks in
Primary Care
INSTRUCTIONS FOR USE
Potassium Permanganate should be used in practice according to the manufacturer’s
instructions and the patient’s prescription.
Equipment required: Disposable cups, washing up bowl or bucket, bin liner, (preferably
white to visualise colour of solution), disposable apron and gloves.
• Clean your hands (see standard infection prevention and control policy)
• Wear non sterile examination gloves to prevent contact of tablet with skin
• Drop one tablet into a disposable cup and fill with warm tap water to allow the tablet to start
dissolving.
Caution: Sometimes potassium permanganate tablets are halved for perceived smaller
amounts of solution. This must be carried out with extreme caution as the chemical is an
irritant to mucus membranes and splitting the tablets will affect the accuracy of the dilution.
• At all times ensure the tablet does not drop into the bowl or come into contact with the skin.
• Line a washing up bowl or bucket with a bin liner and fill with warm tap water.
• When the solution in the cup has gone very dark (the tablet will still be dissolving),
carefully add this concentrate to the washing up bowl or bucket.
• Do not allow the dissolving tablet to fall into the bowl
• The resultant colour in the bowl should be transparent rose pink/purple – NOT DARK
PURPLE.
• If the resultant solution is too light in colour, add more tap water to the remainder of the
tablet in the disposable cup and add to the solution in the washing up bowl.
• If the resultant solution is too dark in colour, discard some solution and add more tap water.
Procedure for the use of Potassium Permanganate soaks in
Primary Care
• Immerse the limb in the solution for 10 minutes.
• For any affected skin not immersed in the solution, apply Surgipads that are saturated in the
solution. Re-soak these frequently so they do not get cold.
• For treatment of areas other than the lower limb use the above technique.
• After the treatment, dispose of solution in the toilet. The dilute solution will not stain the
toilet as it is a weakened solution and the disposal is transient. After flushing, flush again.
• Disposal of the tablet and cup must be in clinical waste.
• Always clean hands after removal of protective clothing. (See standard infection prevention
and control policy.)
5.0 AUDIT AND REVIEW
• In the light of new evidence.
• Investigate any adverse events relating to the use of potassium permanganate as per
guidance above.