Post on 07-Apr-2018
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Antiseptics
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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
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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
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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
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Everything that comes in
contact with the wound must
be disinfected.
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Types of antiseptics
physical
chemical
mechanical
biological
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Physical antiseptics
Scalding
use of dry heat or steam
BoilingIrradiation and creation of conditions forthe passage of liquid from the wound into
the dressingBurning
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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.
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Chemical antiseptics anddisinfection
iodopyrron (iodine compound withpolyvinylpyrrolidon)
Taurolin (a combination of taurin andformaldehyde)
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Chemical antiseptics anddisinfection
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.
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Disinfection of surgeons hands
Hygienic and surgical disinfection,
Fast disinfection of hands
Fast disinfection of skin.
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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
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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.
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Desinfecting agents
alcohol (70 % ethyl alcohol, 60% propanol,70% isopropanol),
mixed alcohol and iodophor (iodopyrron,iodonate),
performic acid or pervomur,
0.5% chlorhexidine solution.
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Mechanical disinfection
removal of necrotized unviable tissue,blood clots foreign bodies which canharbor microorganisms, from the wound.
initial surgical debridement (2 hoursafter the injury)
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Biological disinfection
antibiotics,
sulfanilamides,
nitrofuran derivatives,enzyme preparations,
vaccines and serums,
immunostimulators
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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.
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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.
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Ways of administration
To the wound surface: sponging thewalls of the wound or using dressingssaturated with disinfecting solution.
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Ways of administration
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.
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Ways of administration
Parenteral, intravenous, intra-arterial andendolymphatic introduction (deepdisinfection)
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Aseptics
method preventing microbial
invasion into surgical wound by
using physical factors, chemicalagents and measures.
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Aseptics
Sterilization
Physical methods include thermal andirradiation sterilization
Chemical methods include sterilizationwith ethylene oxide, peracetic acid, andalso chemical and thermal treatment.
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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.
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Sterilization
Steam sterilisation
Dry heat sterilising
Irradiation sterilisationChemical sterilisation
Ethylene oxide sterilisation
Sterilization with peracetic acid
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Control of sterilisation
is performed with special indicators
high sterility standards
special suits and helmetsbactericidal ultraviolet lamps are used withshort-wave radiation.