Antiseptics a Sep Tics

8/3/2019 Antiseptics a Sep Tics

1/26

Antiseptics


2/26

History

Pringle in 1750

Ancient India, Palestine and Greece :Doctors hands and everything that

comes in contact with the wound must beclean

Hippocrates used only boiled water


3/26

History

40-s of XIXth century N.I.Pirogov used solutions of

carbolic acid, silver nitrate,zinc sulphate, alcohol, iodine

tincture in his practice ofwound repair


4/26

History

The Hungarian doctor I.Zimmelweiss -solution of chloride lime for washing handsand treatment of instruments.

D. Lister proposed using 2.5 5%solution of carbolic acid


5/26

Everything that comes in

contact with the wound must

be disinfected.


6/26

Types of antiseptics

physical

chemical

mechanical

biological


7/26

Physical antiseptics

Scalding

use of dry heat or steam

BoilingIrradiation and creation of conditions forthe passage of liquid from the wound into

the dressingBurning


8/26

Chemical antiseptics anddisinfection

Agents for gentle disinfection are usedon the skin;

Agents for intensive disinfection are used

on very dirty objects and materials whichhave a large amount of organicsubstances (bedpans, washbasins etc).

Agents for disinfection of enclosedpremises and objects contained there.

Agents for air disinfection.


9/26


iodopyrron (iodine compound withpolyvinylpyrrolidon)

Taurolin (a combination of taurin andformaldehyde)


10/26


Instrument desinfection

triple solution (2 % formalin, 0.3 % fenol, 15 %sodium bicarbonate)

0.5 % chloramine B solution3% hydrogen peroxide solution,

0.1 % desozone-1solution,

dichlor-1,

0.1 % sulfachlorantine.


11/26

Disinfection of surgeons hands

Hygienic and surgical disinfection,

Fast disinfection of hands

Fast disinfection of skin.


12/26

Requirements

Kill off pathogenic flora on the skinsurface quickly

Kill off microorganisms in the glove liquidquickly and reliably, so that the handsare sterile during the whole surgeryprocedure


13/26

Requirements

Have a cumulative effect: frequent use ofone disinfecting agent should reduce theamount of bacteria so that the surgeons

hands are bacteria free in the periodbetween disinfection procedures

Non-irritant for the skin.


14/26

Desinfecting agents

alcohol (70 % ethyl alcohol, 60% propanol,70% isopropanol),

mixed alcohol and iodophor (iodopyrron,iodonate),

performic acid or pervomur,

0.5% chlorhexidine solution.


15/26

Mechanical disinfection

removal of necrotized unviable tissue,blood clots foreign bodies which canharbor microorganisms, from the wound.

initial surgical debridement (2 hoursafter the injury)


16/26

Biological disinfection

antibiotics,

sulfanilamides,

nitrofuran derivatives,enzyme preparations,

vaccines and serums,

immunostimulators


17/26

Administering antimicrobial therapy

The therapy should be started early enough. Atherapy begun too late or at the end of thedisease is less effective.

One should take into considerationsusceptibility of the infecting agent to thepreparation.

The preparation should be administered insuch a way that it contacts the infecting agentdirectly and creates therapeutic concentrationin the focus of infection.


18/26

Administering antimicrobial therapy

The therapy should not be interrupted until theinfecting agent is destroyed.

The duration of therapy should be optimum.

One should take into consideration toxicity ofthe preparation, adverse affects and takemeasures to prevent or correct them.

The drugs administered together with theantibiotic should be chosen well.


19/26

Ways of administration

To the wound surface: sponging thewalls of the wound or using dressingssaturated with disinfecting solution.


20/26


Introducing the drug into body cavities: forprevention and treatment of suppurativeprocesses the drug is introduced into the

pleural and abdominal cavity, into thelumen of joints.


21/26


Parenteral, intravenous, intra-arterial andendolymphatic introduction (deepdisinfection)


22/26

Aseptics

method preventing microbial

invasion into surgical wound by

using physical factors, chemicalagents and measures.


23/26

Aseptics

Sterilization

Physical methods include thermal andirradiation sterilization

Chemical methods include sterilizationwith ethylene oxide, peracetic acid, andalso chemical and thermal treatment.


24/26

High temperature sterilization

Heating time

Stabilisation time

Extermination timeCooling time

If sterilization was interrupted in one of itsworking stages, the whole process has tobe repeated.


25/26

Sterilization

Steam sterilisation

Dry heat sterilising

Irradiation sterilisationChemical sterilisation

Ethylene oxide sterilisation

Sterilization with peracetic acid


26/26

Control of sterilisation

is performed with special indicators

high sterility standards

special suits and helmetsbactericidal ultraviolet lamps are used withshort-wave radiation.

Documents

Antiseptics a Sep Tics