Advancements in seawater immersion wound management: Current treatments and innovations

With advancements in naval warfare, the number and severity of seawater injuries have skyrocketed, necessitating effective seawater immersion (SWI) wound management. The unique marine pathogens, salinity, low temperature and alkalinity of seawater are the main environmental factors that can influence SWI wound healing. The current treatment strategy for SWI wounds follows a standard protocol based on terrestrial wound conditions, neglecting seawater conditions. The key requirements for ideal SWI treatment include good adhesion to the wound surface to minimize further exposure to seawater, enhanced wound healing properties to minimize wound healing time and antibacterial properties to prevent infections from marine pathogens. Current SWI wound-specific treatments range from elaborate techniques like vacuum-sealed drainage and vacuum-assisted closure for severe blast injuries to simple application of hydrogels or collagen dressings for minor injuries. This review discusses the current status and development of various treatment modalities for SWI wounds. The development of these treatment strategies and an understanding of their mechanisms of action make us better prepared to manage and treat SWI injuries.