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PubMed1984

[Comparison of 2 antiseptic soaps used for preoperative showers].

This study was carried out in cardiovascular surgery wards and a single operating room. Two different antiseptic scrubs, A and B, were used for two showers given 48 and 24 hours respectively prior to surgery. A scrub (chlorhexidine digluconate 40 mg/ml) was used in 61 patients and B scrub (benzalkonium chloride 5 mg/ml) in 52, for a total of 113 participants. Clinical and bacteriological evaluations show statistically significant superiority of A scrub.

Antisepsis↗

PubMed1981

Retrograde urography with a new antiseptic contrast contrast material. An experimental study.

A new antiseptic contrast material, composed of sodium diatrizoate-meglumine diatrizoate and PVP-iodine solution, was prepared and tested for retrograde cystography. It was tested in vitro and in dogs, showed satisfactory radiological features and rapid wide bactericidal action without detectable side effects. Septic complications following radiological demonstration of the urinary tract may be reduced.

Animals↗

PubMed1990

Effective inactivation of human immunodeficiency virus with chlorhexidine antiseptics containing detergents and alcohol.

The antiseptics 4% chlorhexidine gluconate detergent formulation containing 4% isopropyl alcohol (Hibiclens/Hibiscrub) and 0.5% chlorhexidine gluconate in 70% isopropyl alcohol with emollients (Hibistat/Hibisol) efficiently inactivated human immunodeficiency virus (HIV) produced in cell culture within 15 seconds. These antiseptics were completely effective at 1:100 and 1:5 dilutions, respectively. Therefore, use of these products according to the manufacturer's instructions (i.e. undiluted) for routine disinfection of hands following contact with HIV-contaminated materials, as well as immediate disinfection of abrasions or cuts exposed to HIV, should have significant protective effects.

1-Propanol↗

PubMed1978

Reassessment of the surgical scrub.

This study was designed to reassess the efficacy and necessity of the preoperative ten minute, two brush scrub method currently required for all personnel at this hospital. Three scrub methods-the tem minute, two brush technique with an iodophor, Betadine surgical scrub; a five minute, no brush iodophor scrub with a new iodophor iodine scrub, and a three minute, no brush scrub with plain soap and Septisol Foam-were compared. Fingertip culture results obtained prescrub, immediately postscrub and one hour after wearing gloves revealed no significant differences in the three methods. The findings suggest that, one hour after scrubbing, a shorter, no brush scrub procedure with any of the antiseptics used in this study is as effective in reducing bacterial growth of the hands as the standard longer two brush method. By deletion of the use of scrub brushes and the improved efficiency from the reduced scrub time alone with the additional less likelihood of skin trauma and dermatitis, substantial financial savings may be realized.

Anti-Infective Agents, Local↗

PubMed2002

Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HIPAC/SHEA/APIC/IDSA Hand Hygiene Task Force.

The Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis in health-care settings. In addition, it provides specific recommendations to promote improved hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and personnel in health-care settings. This report reviews studies published since the 1985 CDC guideline (Garner JS, Favero MS. CDC guideline for handwashing and hospital environmental control, 1985. Infect Control 1986;7:231-43) and the 1995 APIC guideline (Larson EL, APIC Guidelines Committee. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251-69) were issued and provides an in-depth review of hand-hygiene practices of HCWs, levels of adherence of personnel to recommended handwashing practices, and factors adversely affecting adherence. New studies of the in vivo efficacy of alcohol-based hand rubs and the low incidence of dermatitis associated with their use are reviewed. Recent studies demonstrating the value of multidisciplinary hand-hygiene promotion programs and the potential role of alcohol-based hand rubs in improving hand-hygiene practices are summarized. Recommendations concerning related issues (e.g., the use of surgical hand antiseptics, hand lotions or creams, and wearing of artificial fingernails) are also included.

Alcohols↗

PubMed2002

Guideline for Hand Hygiene in Health-Care Settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force.

Alcohols↗

PubMed2002

Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America.

The Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis in health-care settings. In addition, it provides specific recommendations to promote improved hand-hygiene practices and reduce transmission ofpathogenic microorganisms to patients and personnel in health-care settings. This report reviews studies published since the 1985 CDC guideline (Garner JS, Favero MS. CDC guideline for handwashing and hospital environmental control, 1985. Infect Control 1986;7:231-43) and the 1995 APIC guideline (Larson EL, APIC Guidelines Committee. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251-69) were issued and provides an in-depth review of hand-hygiene practices of HCWs, levels of adherence of personnel to recommended handwashing practices, and factors adversely affecting adherence. New studies of the in vivo efficacy of alcohol-based hand rubs and the low incidence of dermatitis associated with their use are reviewed. Recent studies demonstrating the value of multidisciplinary hand-hygiene promotion programs and the potential role of alcohol-based hand rubs in improving hand-hygiene practices are summarized. Recommendations concerning related issues (e.g., the use of surgical hand antiseptics, hand lotions or creams, and wearing of artificial fingernails) are also included.

Alcohols↗

PubMed2000

The early history of arthroplasty in the United States.

Arthroplasty is defined in the broadest sense as a reconstructive procedure that alters the structure or function of a joint. The first recorded procedures done in the United States in the early nineteenth century and the introduction of modern total joint replacement in the 1970s will be discussed. Although major surgical procedures occasionally were performed in the early 1800s, it was not until the introduction of general anesthesia and antiseptic techniques during the latter half of the nineteenth century that the field of surgery could be developed. Procedures involving the major joints of the upper and lower extremities are described. These procedures include resection and interposition arthroplasties, joint debridement, procedures done to correct complications of hip fractures and developmental dysplasia of the hip, cup arthroplasties, endoprosthetic replacement, hinge arthroplasties, resurfacing procedures, and early total joint replacement.

Anesthesia↗

PubMed2004

Zero tolerance to shunt infections: can it be achieved?

OBJECTIVE: To evaluate the rigid application of a technique of shunt placement aimed at the eradication of postoperative shunt infection in neurosurgical practice. METHOD: All shunt procedures were performed or closely supervised by the senior author (MSC). The essentials were the use of intravenous peri- and postoperative antimicrobials, rigid adherence to classical aseptic technique, liberal use of topical antiseptic (Betadine), and avoidance of haematomas. RESULTS: Of 176 operations, 93 were primary procedures; 33 patients underwent revisions, some multiple. Only one infection occurred, seven months postoperatively, secondary to appendicitis with peritonitis. The infecting Streptococcus faecalis appeared to ascend from the abdominal cavity. CONCLUSION: A rigidly applied protocol and strict adherence to sterile technique can reduce shunt infections to a very low level.

Adolescent↗

PubMed1990

[Comparative study of 2 methods to determine the in vivo bactericidal activity of antiseptics].

In France in 1990, there is no standardized method to study the bactericidal activity in vivo of antiseptics. A comparative study of the Williamson-Kligmann techniques (on the epidermis of the forearm) and of the bag of Gaschen (on the hands) has been carried out by using 11 products and 10 volunteers for each of them. On the forearm, the rates of reduction of the number of bacterias numbered in decimal logarithms are significantly much higher to those measured on the hand. After having stated the advantages and drawbacks of each of these two techniques, an account fort the differences in the activity that have been observed is suggested. None of these two techniques is universal and one or the other has to be used according to the therapeutic prescription (antisepsy of the normal skin or of the hands) of the patent medicine.

Analysis of Variance↗

PubMed2002

[Carl von Reyher's studies of wound therapy].

Carl von Reyher (1846-1890), a young Russian army surgeon of the late nineteenth century, established the principle of repeated debridements on a scientific basis. After a visit to Lister's clinic, acquainting himself with antiseptic wound management, von Reyher was the first to present a controlled study of debridement in contaminated gunshot wounds. He was able to show that the combination of primary debridement and antiseptic treatment decreased the mortality rate of gunshot injuries from 66% to 23%. Although published in more than 16 papers and presented at international congresses, Reyher's contribution was completely negated. Finally more than 30 years later in World War I, the Inter-allied Surgical Conference officially endorsed primary excision with delayed wound closure as the rule for treatment of gunshot wounds.

Antisepsis↗

PubMed1993

The antiseptic effect of a quick drying rubbing type povidone-iodine alcoholic disinfectant solution.

A quick drying rubbing type disinfectant of non-water non-towel type is an antiseptic method suitable for practical use in intensive care units where emergency situations are common. We determined the antiseptic efficacy and safety of a quick drying rubbing type povidone-iodine alcoholic disinfectant solution (HAD Hand Wash) in comparison with benzalkonium chloride alcoholic lotion. The bacterial reduction rate obtained by hand washing with a single 3 ml application was 93.8% for HAD Hand Wash and 94.1% for benzalkonium chloride alcoholic lotion. Thus, excellent antiseptic efficacy was obtained with both disinfectants. Roughening of hand skin which appeared in association with HAD Hand Wash solution was transient and mild in nature in all of the cases, indicating the high safety of this disinfectant. It is justified to say from these findings that HAD Hand Wash is useful as a hand and finger disinfectant.

Antisepsis↗

PubMed1993

Efficacy and safety of a quick drying rubbing type povidone-iodine alcoholic disinfectant solution.

The efficacy and safety of a quick drying rubbing type disinfectant (HAD Hand Wash) composed of a povidone-iodine (PVP-I) and ethanol were evaluated in the disinfection of transient skin flora on fingers of 30 medical staff of our department. Three millilitres of HAD solution was rubbed onto the hands for three minutes several times a day over a four week period. Bacteriological effects were evaluated twice, on the first day and after four weeks, by the palm stamp method. The rate of colonies sterilized (bacterial reduction rate) after the use of HAD Hand Wash was 86.9 +/- 21.2% (mean +/- SD) on the first measurement, and 91.5% +/- 12.8% at four weeks. Staphylococcus epidermidis was isolated most frequently and this was eradicated in 83.3% of subjects, the bacterial reduction rate 99.7%. Staphylococcus aureus was originally isolated in 14 subjects and was eradicated in 13; the bacterial colony reduction rate was 99.9% showing high antiseptic efficacy. Although the bacterial reduction rate for Bacillus sp. was a rather low, 75.8-100%, this result was not considered problematic from the clinical standpoint. There were no side effects like chapping in spite of an average 104 applications of HAD Hand Wash during the 4-week test period. From these results, HAD Hand Wash was considered highly effective and safe.

Antisepsis↗

PubMed1990

[Experimental development of aseptic adhesive films].

Antibacterial activity of surgical adhesive films containing various antiseptics in the adhesive layer was studied experimentally. It was shown that the adhesive films containing 0.1 to 1% (in terms of active iodine) of iodopyrone had a stable bactericidal action and were effective against to the main causative agents of surgical infections, i. e. Staphylococcus spp., E. coli, Klebsiella spp., Pseudomonas aeruginosa and others.

Anti-Infective Agents, Local↗

PubMed2004

Localisation and William Macewen's early brain surgery Part I: the controversy.

Neurosurgery for the removal of brain tumours based on localising signs is usually dated from the 1884 operation by Bennett and Godlee. However, within weeks of that operation claims were made on behalf of William Macewen, the Glasgow surgeon, to have been the real pioneer of such surgery. According to Macewen's protagonists, he had conducted seven similar operations earlier than Bennett and Godlee and, in a notable 1888 address, Macewen described these seven pre-1884 cases and a number of others operated on after 1884. This paper, which is in two parts, contains an evaluation of the claims made for the priority of Macewen's pre-1884 operations. Part I deals mainly with Macewen's work in fields other than brain surgery that are relevant to it and sets out the facts of the controversy. It begins with a brief biography of Macewen, describes his pioneering work in antiseptic and aseptic surgery, his work on osteotomy and bone regeneration, and his use in brain surgery of the knowledge so gained. Part I concludes with an examination of the battle waged in the newspapers between Macewen's and Bennett's and Godlee's supporters, and of previously unpublished correspondence between Macewen himself, David Ferrier and Hughes Bennett. The primary records of the patients on whom Macewen operated, together with other materials relevant to the controversy, are examined in Part II.

Antisepsis↗

PubMed1995

Comparison of 10% povidone-iodine and 0.5% chlorhexidine gluconate for the prevention of peripheral intravenous catheter colonization in neonates: a prospective trial.

The purpose of the study was to compare the efficacy of 10% povidone-iodine with that of 0.5% chlorhexidine gluconate in 70% isopropyl alcohol for the prevention of peripheral intravenous catheter colonization in neonates. This was a multicenter, nonrandomized prospective study in a tertiary neonatal intensive care setting in which povidone-iodine and chlorhexidine gluconate were each used as antiseptic skin preparations over sequential 6-month periods. During the first 6 months of the study when povidone-iodine was in use 9.3% (38 of 408) of catheters were colonized. During the second 6 months of the study when chlorhexidine gluconate was in use, catheter colonization occurred in 4.7% (20 of 418, P = 0.01). Catheter-related bacteremia occurred during only 0.2% (2 of 826) of all catheterizations. Heavy skin colonization before catheter insertion (relative risk, 3.6; 95% confidence interval, 1.9, 7.0), catheterization > or = 72 hours (relative risk. 2.0; 95% confidence interval, 1.01, 3.8) and gestational age < or = 32 weeks (relative risk, 1.8; 95% confidence interval, 1.02, 3.3) increased colonization risk. Ampicillin infusion (relative risk, 0.4; 95% confidence interval, 0.2, 0.7) and 0.5% chlorhexidine gluconate cutaneous antisepsis (relative risk, 0.4; 95% confidence interval, 0.2, 0.8) were factors associated with decreased colonization risk. We conclude that 0.5% chlorhexidine gluconate in 70% isopropyl alcohol appears to be more efficacious than 10% povidone-iodine for the prevention of peripheral intravenous catheter colonization in neonates.

Analysis of Variance↗

PubMed2000

[Spanish disinfectants for the 21st century].

There are two chemical disinfectants patents from Spain that permit to obtain advantageous products on other disinfectants: Nduopropenide (two iodures of quaternary ammonium) and "Peroxidine" (hydrogen peroxide that active to lactic acid and a surfactant mixture). The first product is used as an antiseptic or disinfectant, but the second, only act as disinfectant. DISINFECTION: It is studied (by germ-carrier methods), the microbicide effect on different microorganisms (Gram positive cocci, Gram negative bacilli, fungus, Mycobacteria and B subtilis spores), comparing these two products with different disinfectants as 2% glutaraldehyde, 1/8 phenate-glutaraldehyde, peracetic acid compounds, 11% oxygen peroxide and 2% sodium hypoclorite. It is obtained that 1/4 Peroxidine in 5 minutes or 1/6 Peroxidine in 10 minutes, are the most effective disinfectant on all microorganisms used (includes the most resistant) since it produces destruction of 4 log-10 of spores and 5 log-10 of Mycobacteria. Moreover, it can destroy, completely, the inoculum of commercial spores, routinely used for sterilization process evaluation, in 20 minutes, when 2% glutaraldehyd needs 3-10 hours. ANTISEPSIE: It is studied the "hygienization" and surgical handwashing with Nduopropenide solution, in comparison with classical washing methods (neutral soap in routinely handwashing and 5% chlorhexidine or 10% iodine-povidone in surgical washing): 1) Nduopropenide and alcohol solution is more effective that routinely handwashing. 2) This product is more effective and persistent, after surgical washing that chlorhexidine or iodine-povidone. Moreover, it does not must be applied with brush. 3) The mixture Nduopropenide and chlorhexidine makes a synergy, then it can be used in hand or skin washing, on heath personnel or patient people, being advantageous on the other products.

Anti-Infective Agents, Local↗

PubMed2006

Safety of neonatal skin cleansing in rural Nepal.

OBJECTIVE: A high proportion of deaths during the neonatal period are attributed to infections. Neonatal skin plays an important role in protecting the newborn from invasive pathogens. In preparation for a study of newborn skin cleansing with chlorhexidine in Nepal, we evaluated the feasibility, acceptability, and safety of the newborn cleansing procedure. STUDY DESIGN/SETTING: Observational pilot study of full-body cleansing of newborns in rural Nepal. METHODS: Thirty two newborn infants were wiped with commercially available non-antiseptic baby wipes. Pre and post-procedure axillary temperatures were recorded to estimate the impact of cleansing on body temperature. Skin aggravation, residual moisture, removal of vernix, and maternal satisfaction were assessed qualitatively. RESULTS: Body temperature of newborns decreased an average of 0.40 C (95% CI: 0.31 to 0.49 C, p < 0.0001) during the procedure. There was no evidence of skin aggravation, injury or removal of vernix, and mothers expressed satisfaction with the procedure. The procedure was simple and project workers were easily trained. CONCLUSION: Care must be taken to promptly wrap infants after skin cleansing procedures as slight temperature decrease was noted after the procedure. These pilot data indicate, however, that gentle cleansing of newborn skin poses minimal risk to infants. This procedure is safe and appropriate precautions can be taken to deliver safe skin antisepsis with chlorhexidine to infants in the community.

Body Temperature↗