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At least 235 records · Page 13Linked to original sources
PubMed2004

Use of the 'ex vivo' test to study long-term bacterial survival on human skin and their sensitivity to antisepsis.

AIMS: To determine bacterial survival on human skin and their sensitivity to antisepsis. METHODS AND RESULTS: An 'ex vivo' protocol which uses human skin samples placed into diffusion cells, and electron microscopy (EM), were used to study the growth of Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa inoculated onto skin samples over a 46-h incubation period at 32 degrees C. Concurrently variation in skin pH was evaluated at different time intervals during this period. In addition the antimicrobial activity of three antiseptics against the incubated micro-organisms was assessed quantitatively with the 'ex vivo' test, while their detrimental effects against bacteria were observed by EM. All three bacteria were still present in high number after 46 h inoculation on skin, although the concentration of E. coli and S. aureus were reduced by 2.74 and 1.58 log(10) reduction, respectively, over this period of time. Electron micrographs showed clear evidence of cell division and some bacteria appeared to be embedded into the skin layers. The antiseptics tested had some antibacterial activity against bacteria incubated on skin for 3 and 10 h, and EM evidence showed some morphological damages including cellular blebbing and the presence of fibrillar material around the cells. All micro-organisms had an acidifying effect on skin samples. CONCLUSIONS: Here, it was shown that bacterial pathogens can survive and grow when incubated on human skin. In addition, it is possible that they can penetrate the stratum corneum, which can provide some protection against antisepsis. SIGNIFICANCE AND IMPACT OF THE STUDY: The apparent low bactericidal activity of biocides attributed in part to bacterial protection from skin layers is particularly important to assess in order to ensure antisepsis efficacy.

2-Propanol↗
PubMed1981

Surgical wound infections: an overview.

There have been three major avenues by which control over infection has been increased: (1) Preservation of host defenses, (2) antisepsis and (3) asepsis. Despite the major successes we have had, infection remains the major limitor of surgical horizons. Asepsis, the newest but long the mainstay of infection control, has probably been developed to nearly its greatest capacity. Its forefronts lie in laminar flow ventilation, ultraviolet radiation and operating theater design, all expensive and relatively inefficient. Cost and the problem of endogenous bacteria limit further advances. Antisepsis, including preventive antibiotics, is also reaching its zenith. Resistant organisms, toxicity and cost limit further applications. We desperately need a "social contract" among surgeons to limit, by defined rules, the choice of agent, the total dose and the indications for use. Controlled studies of the effects of "preventive antibiotics" on hospital ecology and infection are needed. A return to antiseptics is being and should be explored. Preservation and enhancement of host defenses is the oldest but the most neglected of these ideas. It appears to be the most exploitable now. Enhancement by nutrition, maintenance of tissue perfusion, oxygenation and immune stimulation appear to have contributed to reduction of infection rates. More success in this area seems distinctly possible.

Anti-Bacterial Agents↗
PubMedDate not supplied

[How I prevent erysipelas and its consequences and recurrences].

Erysipelas is a serious infection of the skin. In case of delay in initiating adequate antibiotic treatment, complications, sometimes dismal, can supervene. In addition, erysipelas shows a tendancy to recurrences. The prevention of an episode of erysipelas calls for correct personal hygiene and adequate use of topical antiseptics in case of skin effraction, even when minimal. When erysipelas is established, a rapidly initiated antibiotic treatment for a prolonged period prevents streptococcal gangrene complications. Elastic contention of any leg edema from venous or lymphatic origin and prophylactic antisepsis of discrete wounds help in preventing erysipelas recurrences.

Erysipelas↗
PubMed1991

[The prevention of suppuration of postoperative wounds].

A method to prevent operative wound suppuration is offered. An experimental animal model of operative wound suppuration was elaborated to specify rational antibiotic-antiseptic prophylaxis and adequate wound drainage. This yielded a complex of measures to prevent purulent complications on the part of the operative wound. In addition, an original turbidimetric technique to assess the resistance of the biological fluid microflora to antisepsis was elaborated. The complex prophylaxis against suppuration of infected wounds was clinically tested on 124 patients operated on for different acute surgical conditions of abdominal organs. The wound process was controlled by means of an original endoscopic-bacteriologic technique. The postoperative period was complicated by the wound suppuration in two of the 124 patients (1.6 per cent). The postoperative hospital stay in most cases lasted 5-7 days.

Adult↗
PubMedDate not supplied

Wound colonization and infection: the role of topical antimicrobials.

Infection and bacterial colonization are important factors in compromised wound healing, particularly in chronic wounds. The current "best practice" for controlling these factors is still unclear. Systemic antibiotics are generally accepted as being the preferred choice for treating infection, provided that ischaemia does not interfere. However, their widespread systemic and topical use is leading to the emergence of resistant bacterial strains such as methicillin-resistant Staphylococcus aureus. Colonization of wounds presents a double problem: possible delayed healing if out of balance with the immune system; and as a source for cross-infection. Managing colonization is not yet defined in best practice. The judicious use of dressings, notably those containing certain antiseptic agents, can be valuable in infection control and in promoting healing. This review states the case for taking the antiseptic route as part of the concerted approach to local wound management and infection control.

Anti-Infective Agents, Local↗
PubMed1997

Povidone-iodine liposomes--an overview.

In recent years, liposomes have been increasingly explored as novel drug delivery systems, and several liposome-based drug products have been approved in Europe, the USA and Japan. Depending on size, composition and surface characteristics, liposomes interact specifically with biological structures. Liposomal drug products provide a topical activity at the desired locus of action and are deemed more effective and less toxic than conventional drug formulations. The combination of povidone-iodine (PVP-I) and liposomes unites the exceptional microbicidal activity of the antiseptic substance with the excellent tolerability and lack of immunogenicity of liposomes; in addition, liposomes provide a moist molecular film for the wound environment. The multilamellar vesicles act as microreservoirs hence prolonging the release of the active ingredient. Although no commercial product for repeated application on the eye is currently available, PVP-I has been used in ophthalmology not only for pre- and postoperative antisepsis, but also for the treatment of bacterial and viral conjunctivitis and for prophylaxis against ophthalmia neonatorum. For these indications, liposomal formulations with 2.5 and 5.0% PVP-I were developed. These eye drops are isotonic with tear fluid at pH 6. First in vitro tests demonstrated an excellent antimicrobial efficacy, and a placebo-controlled clinical study on volunteers showed a very good local tolerability. A study on rabbits demonstrated positive results of the PVP-I liposome eye drops compared to placebo and the broadspectrum antibiotic Polyspectran in a standardized model of Staphylococcus aureus deep eye infection. The other aim is a well-tolerated liposomal PVP-I hydrogel for improved antiseptic wound treatment with moisturizer. It has been reported that liposomes are enriched at the wound bottom for direct action against infection and support of wound healing. An animal study on the efficacy and tolerability of different formulations of a hydrogel with PVP-I liposomes in deep dermal burn wounds has indicated an outstanding quality of wound healing with smooth granulation tissue, less inflammation, less wound contraction and no hyperkeratotic reactivity, especially with the 3% PVP-I liposome formulation.

Administration, Cutaneous↗
PubMed1996

Microbial contamination of antiseptics and disinfectants.

BACKGROUND: There have been a number of reports on microbial contamination of antiseptics and disinfectants. At present, however, the necessity of measures to prevent contamination do not seem to be fully appreciated. We investigated microbial contamination of antiseptics and disinfectants that are used in our hospital. METHODS: Fifty-one samples of benzalkonium chloride and chlorhexidine gluconate that were being used in the hospital were examined. Viability of the contaminants detected in these samples was also tested in the agents. Then we examined measures to prevent contamination of these agents. RESULTS: Microbial contamination was detected at 10(2) to 10(7) CFU/ml in the following samples: 6 of 23 samples of cotton balls soaked in 0.02% benzalkonium chloride kept in a canister for antisepsis and disinfection (26.1%); 7 of 13 samples of 0.02%, benzalkonium chloride or 0.02% chlorhexidine gluconate in an irrigation apparatus kept at 37 degrees C for vaginal douching (53.8%); and 9 of 15 samples of 0.02% benzalkonium chloride or 0.05% chlorhexidine gluconate for storage of suction catheters in a plastic bottle (60%). The major contaminants were Burkholderia cepacia, Pseudomonas aeruginosa, Xanthomonas maltophilia, and Pseudomonas fluorescens. The first two organisms examined grew in the agents. After improvements in the handling of the antiseptics and disinfectants, no microbial contamination was observed. CONCLUSIONS: It is necessary to check microbial contamination of diluted benzalkonium chloride and diluted chlorhexidine gluconate that are in use. Such products are not recommended as antiseptics.

Anti-Infective Agents, Local↗
PubMed2000

Moisturizing alcohol hand gels for surgical hand preparation.

With the use of novel formulary technology, unique moisturizing hand gels have been developed that offer significant advantages in perioperative and other health care settings. These advantages include the time-saving capabilities of a waterless formulation, the persistence and effectiveness of a surgical scrub, and the moisturization and protective properties of a lotion. Extensive laboratory and clinical studies, involving in vivo antimicrobial activity against resident and transient flora, skin moisturization on normal and dry skin, and compatibility with latex gloves, have supported these advantages. Nondrying alcohol hand gels can be used for antiseptic hand washing, hand scrubs between procedures (i.e., reentry scrubs), brushless surgical scrubs, moisturizers, and glove-donning aids.

Antisepsis↗
PubMed1997

[Local antiseptic and anti-endotoxin measures in intra-abdominal infections].

With standardized operating strategies, a lethality rate of 10.2% was achieved following intra-abdominal administration of taurolidine in 352 cases of severe intra-abdominal infection. The extent and type of antibacterial therapy were determined on the basis of the clinical severity, the patient's age, and the original site of the infection. Local antisepsis includes tactical surgery and the use of locally and systemically acting taurolidine. Antibiotics were used for systemic antibacterial therapy. After laparoscopical clearance of the focus of infection (appendix, gall bladder) the operating time was significantly extended compared with that required for open surgery, while the postoperative complication rate and the length of stay in hospital were significantly reduced.

Adult↗
PubMed1987

Prevention of wound infection after elective colorectal resection.

Various operative wound handling techniques have been proposed to prevent wound infections after elective colorectal resection, including pelvic drains, wound wicks, topical antibiotics, and subcutaneous drains. Review of 243 consecutive elective colorectal resections performed between 1977 and 1983, in which 64 percent of the patients had significant underlying medical problems, 27 percent were over age 70, and 45 percent had concomitant abdominal procedures, revealed that consistent application of a uniform perioperative protocol emphasizing aseptic and antiseptic techniques minimizes wound and anastomotic infectious complications. Simple wound closure in this setting is sufficient to prevent incisional wound infections.

Anti-Bacterial Agents↗
PubMed2006

Antiseptics, iodine, povidone iodine and traumatic wound cleansing.

Wound cleansing is an integral part of the management of acute traumatic wounds. There is consensus that it reduces infection rates. However, the choice of cleansing agent remains controversial, especially the use of antiseptics has been questioned. This article reviews the current literature on the use of antiseptics particularly povidine iodine in traumatic wound cleansing and discusses the beneficial and harmful effects of such practice.

Acute Disease↗
PubMed1995

Decreased bacterial adherence and biofilm formation on chlorhexidine and silver sulfadiazine-impregnated central venous catheters implanted in swine.

OBJECTIVE: To determine if antiseptic central venous catheters impregnated with silver sulfadiazine and chlorhexidine (antiseptic) reduce bacterial adherence and biofilm formation without producing local or systemic toxicity. DESIGN: Prospective, randomized, controlled trial. SETTING: Experimental laboratory in a university teaching hospital. SUBJECTS: Ten outbred New Hampshire pigs. INTERVENTIONS: Nonimpregnated (control) and antiseptic-impregnated catheters were inserted intravascularly into swine for 7 days. After explantation, the catheters were assessed for bacterial adherence and biofilm formation, and the surrounding tissue was assessed for signs of toxicity. Before retrieval, systemic concentrations of antimicrobials were determined. MEASUREMENTS AND MAIN RESULTS: Sequential roll plate and centrifuging were used to detect moderately and tightly adherent bacteria on the outer and luminal surfaces of the catheter. The presence of biofilm was detected by scanning electron microscopy. Tissues surrounding the catheters were examined histopathologically; systemic concentrations of chlorhexidine, sulfadiazine, and silver were determined by atomic absorption and high-performance liquid chromatography. As compared with the controls, antiseptic catheters had significantly (p < .01) fewer moderately and tightly adherent bacteria on outer and luminal surfaces, and fewer adherent bacteria when outer surfaces alone were examined (p < .01). Scanning electron microscopy showed bacterial biofilm and adherence on the control catheters but not on the antiseptic catheters. There were no abnormal histopathologic changes associated with the test catheter, and serum concentrations of the antibacterial agents were shown to be within nontoxic ranges. CONCLUSION: The antiseptic-impregnated catheters prevented bacterial adherence and biofilm formation and produced no local or systemic toxicity.

Animals↗
PubMed1975

Handwashing practices for the prevention of nosocomial infections.

Handwashing is generally considered the most important procedure in preventing nosocomial infections, because many types of these infections may be caused by organisms transmitted on the hands of personnel. Personnel should wash their hands before and after significant contact with any patient. The risk of personnel acquiring transient hand carriage of organisms is usually greatest after contact with excretions, secretions, or blood; patients at greatest risk are those undergoing surgery, those with catheters, and newborn infants. Although handwashing with an antiseptic agent between patient contacts is theoretically desirable, handwashing with soap, water, and mechanical friction are sufficient ro remove most transiently acquired organisms. Antiseptic agents may produce excessively dry skin if used frequently, and any regimen of handwashing that leads to dermatitis negates the purpose of handwashing. We favor antiseptics for handwashing before surgery and other high-risk invasive procedures and in the care of newborn infants but prefer soap and water for other handwashing.

Antisepsis↗
PubMed2005

Microbial contamination of antiseptics and disinfectants.

OBJECTIVE: To study the bacterial contamination of antiseptics and disinfections in-use and the risk factors for contamination. MATERIAL AND METHOD: Bacterial contamination of antiseptics and disinfectants was done by culturing in-use solutions. Eight commonly used solutions were studied: alcohol 70%, chlorhexidine 4%, and 0.5%, povidone iodine 7.5% and 10%, tincture iodine 1-2%, lysol 2% and sodium hypochlorite 0.5%. RESULTS: The following risk factors for contamination were found : preparation by unskilled personnel, improper containers and prolonged use. Contamination with bacteria were found in 1.8% of 16,142 samples tested Highest rate of contamination was found in Lysol 2%. There was no contamination of povidone iodine 10% and tincture iodine 1-2%. Bacterial contamination of antiseptics and disinfectants was highest in provincial hospitals and was not found in university hospitals. The rates of contamination correlated with the duration of use. Most bacteria isolated were those found in the environment. CONCLUSION: The contamination of in-use antiseptics and disinfectants was as high as 1.8%. Risk factors for contamination were improper preparation and prolonged use.

Anti-Infective Agents, Local↗
PubMed2001

Office management of minor wounds.

OBJECTIVE: To review office interventions for minor wounds not requiring sutures, such as abrasions, bites, and lacerations. QUALITY OF EVIDENCE: Most information on minor wound management comes from descriptive studies. Few comparative studies examine the effectiveness of topical antisepsis for minor wounds. Several clinical trials have demonstrated that tissue adhesives produce short- and long-term cosmetic results equivalent to those achieved with suture materials. MAIN MESSAGE: Sterile saline is the least toxic solution for wound irrigation. Chlorhexidine (2%) and povidone iodine (10%) have been the most investigated antiseptic solutions. Systemic antibiotics are unnecessary for wounds unlikely to be infected. All bite wounds require special attention. Primary closure of bite wounds is indicated in certain circumstances: less than 12-hour-old nonpuncture wounds, uninfected wounds, and low-risk lesions (such as on the face). In spite of their many advantages, skin tapes should be used for low-tension wounds only. The popularity of tissue adhesives has greatly increased. Since the advent of newer products (with increased bonding strength and flexibility), adhesives are used to manage most lacerations except those in areas of high tension (e.g., joints) and on mucosal surfaces. CONCLUSION: Minor wounds not requiring sutures can be managed easily in the office.

Anti-Bacterial Agents↗