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Objectives and questions: This paper proposes that topical HOCl antisepsis might be a protocol improvement over antibiotic administration for battlefield casualties in remote and contested environments.

Material and methods: HOCl solutions are generated electrochemically at a physiologic pH between roughly 4.5 and 6, preserving pure molecular HOCl without the alkaline counterpart. Concentrations suitable for field care (150–350 ppm free available chlorine) maintain stability for more than a year in sealed containers without degradation. HOCl is biocompatible with wounded tissue yet expresses broad-spectrum antimicrobial efficacy. Laboratory studies confirm microbicidal activity against a wide range of pathogens, including Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, spores, fungi, and enveloped viruses, and it’s effective across a wide ambient temperature, so suitable for teams downrange and in the field. It can be applied by irrigation, spray, soak, or impregnated gauze, and it requires no dilution, refrigeration, or specialized handling. In Ukraine, where blast and burn wounds are often first treated under contaminated, cold, and power-deficient conditions, far-forward caregivers report that HOCl allows for rapid and consistent wound decontamination without the pain, blanching, or exudative stimulus common to other antiseptics.

Results: Septic trauma wounds showed improved metrics and accelerated healing with HOCl vs povidone-iodine. There is also growing evidence of biofilm disruption by HOCl with equal or better efficacy than the standard-of-care with less cytotoxicity. At Ukrainian triage stations when formal surgical debridement is delayed, topical HOCl irrigation and dressings reduced wound malodor, pain, and exudate volume within 48 hours, tolerating delayed evacuation with minimal infection progression. In the field, HOCl can function as an immediate therapy at the point of injury or a battalion aid station, reducing microbial load before dressing or transport. In delayed evacuation, the periodic application of HOCl continues to kill pathogens topically when systemic therapy is unavailable.

Discussion and conclusions: Ukraine’s ongoing conflict has produced a new wound archetype: presentation after delayed evacuation of massive blast injuries from pinpoint-accurate drones that drive environmental pathogens that are already resistant deep into tissue and bone. Laboratory data confirm its potency against bacteria, viruses, and fungi; clinical studies demonstrate acceleration of granulation and epithelialization; operational deployments in Ukraine, disaster zones, and trauma hospitals validate its safety, utility, and practicality under duress. For NATO and partner nations, the inclusion of HOCl in far-forward doctrine might be a low-cost and high-impact modernization that strengthens medical interoperability and readiness. Hypochlorous acid should be evaluated as an option for far-forward battlefield trauma antisepsis.