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Results for “ANTISEPSIS AND ANTISEPTICS”

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At least 289 records · Page 16Linked to original sources

PubMed1995

Management of infected penile implants.

Penile prosthesis implantation is associated with a relatively low wound infection rate (3%). Proper adherence to antiseptic principles has kept the incidence low. When an infection does occur, one has the option of removing the device, allowing the infection to clear and possibly returning at a later date for reimplantation, or a salvage procedure, i.e., removing all foreign material, cleansing the wound, and reinserting a new device. The experience with salvage has resulted in approximately 80-90% success in saving the erectile abilities in a number of series.

Anti-Bacterial Agents↗

PubMed1986

The impact of early medical technology on maternal mortality in late 19th century Sweden.

The prevention of fatal complications of childbirth is a priority of health care in the developing countries. This historical study of maternal deaths in Sweden analyses the decline in mortality between 1751-1900 and during this years maternal mortality was reduced by 76% whereas the female mortality dropped only by 33% The decline was especially pronounced during the period 1861-1900, when maternal mortality declined from 567 to 227 per 100,000 live births. The potential impact of medical technology was analysed by epidemiological methods for the period 1861-1900. The introduction of antiseptic technique was estimated to reduce septic maternal mortality 25-fold in lying-in hospitals and 2.7-fold in rural home deliveries, implying that 49% of the septic maternal deaths were thus "prevented". In addition, licensed midwives assisting at home deliveries were estimated to reduce non-septic mortality 5-fold, thus "preventing" 46% of the non-septic maternal deaths. This could be one explanation why Sweden had a lower maternal mortality than the U.S. and the U.K. in the beginning of the 20th century.

Antisepsis↗

PubMedDate not supplied

[The experimental and clinical use of gelatin sponges with kanamycin and gentamycin for the prevention and treatment of suppurative complications in neurosurgery].

Antiseptic gelatin sponges with kanamycin and gentamicin, which were studied in experiments on animals and used in the clinic, are a reliable measure for the prevention of suppuration in craniocerebral surgery in planned operations and in combination with debridement in penetrating injury of the skull and brain. For therapeutic purposes, local application of the agents is effective in focal suppurative processes in the skull and brain after surgical debridement of the purulent focus (abscess of the brain, osteomyelitis of the skull, etc.).

Animals↗

PubMed2005

[Lavasept as an alternative to PVP-iodine as a preoperative antiseptic in ophthalmic surgery. Randomized, controlled, prospective double-blind trial].

BACKGROUND: To reduce the risk of endophthalmitis PVP-iodine is typically used preoperatively. Since iodine is contraindicated in patients with a specific allergic history or severe thyroid disorder we studied the effect of Lavasept, which contains Polyhexanid as an antiseptic alternative. PATIENTS AND METHODS: In a randomized controlled double-blind trial 3 drops of 0.2% Lavasept, 1.25% PVP-iodine or Ringer's solution were applied preoperatively to 67 patients, which have had a minimum of 5 colony forming units (cfu's) in the conjunctival swap. The effectiveness and tolerability were measured. RESULTS: After application of Lavasept or PVP-iodine, the number of cfu was statistically significantly reduced. Lavasept reduced the number of bacterial colonies significantly better than PVP-iodine (p=0.05). All test solutions were equally well tolerated. CONCLUSION: The use af Lavasept is safe, well tolerated and reduces the microbiological contamination of the conjunctival fornix effectively. lt provides a more effective reduction of the cfu's than PVP-iodine 1.25% and this effect tends to be prolonged. Lavasept is a good alternative option in ophthalmology for preoperative antisepsis.

Anti-Infective Agents, Local↗

PubMed2004

A systems approach to preoperative surgical patient skin preparation.

BACKGROUND: The merits of a systems approach to preoperative surgical patient skin preparation are presented. A "system" may be defined as the addition of an antiseptic bath(s) or shower(s) within 24 hours before the application of a Food and Drug Administration-compliant patient preoperative skin preparation at the time of surgery. The expected outcome from this added effort is a further reduction in the transient and normal flora that contaminate the skin surrounding the operative site, and contribute to surgical infections. The Centers for Disease Control and Prevention has recommended the addition of this step to the preoperative site preparation regimen. METHODS: A human in vivo study comparing an alcohol-based (ethanol) system to an iodine-based approach, and 2 sets of clinical observations, are presented here. RESULTS: The data confirm the utility of the systems approach. The in vivo study demonstrates that significant reductions (> or =2 log(10)) in normal and transient flora can be achieved quickly and maintained out to 72 hours after the surgery, allowing for wound closure in a prolonged state of skin antisepsis. Clinical observations support the in vivo findings. After initiation of the system, the infection rates for the monitored procedures have decreased. CONCLUSIONS: The data presented here delineate the merits of a systems approach to preoperative surgical patient skin preparation. This approach has a positive impact on infection rates and may reduce the additional costs associated with this preventable event.

Anti-Infective Agents, Local↗

PubMedDate not supplied

Management of wound infection after appendectomy: are parenteral antibiotics useful?

This study investigated the use of antibiotics in the treatment of wound infections after appendectomy. The subjects were 72 patients with post-operative wound infections at a district general hospital in Jordan. All patients received daily antiseptic dressings with povidone-iodine 10% in alcohol. The patients were randomized in a single-blind trial to receive either no antibiotics or parenteral antibiotics metronidazole and cefoxitin. There was no significant effect of antibiotic use in patients with early inflamed or severely inflamed appendicitis. However, for patients with perforated appendicitis the mean length of hospital stay and the mean frequency of change of dressings were significantly reduced. We conclude that antibiotics do not offer any advantage in post-appendectomy wound infections except for cases of perforated appendix.

Administration, Cutaneous↗

PubMedDate not supplied

[Spiritual surgery: an investigation].

BACKGROUND: A very popular modality with the media is psychic surgery which has received little scientific evaluation though. Such phenomena always raise the issues of fakery and deceit. Research has been scarce. METHODS: We report an investigation on one of the most famous psychic surgeons in Brazil, João Teixeira de Farias. 30 surgical interventions with cutting were studied, 6 patients undergoing history-taking, physical examination and analysis of the materials supposedly extracted from them. RESULTS: We were struck by the fact that the surgeon really incisions skin or ocular epithelium in addition to scraping the cornea without identified anaesthetics or antiseptics being used. Just one woman complained of pain as she had her breast incised. Longer follow up of patients failed to notice any infection in the surgical sites. Histopathology found the specimens to be compatible with their site of origin and, apart from a 210g. lipoma, were healthy tissues without discernible pathology. CONCLUSIONS: The surgerical procedures are real but we couldn't evaluate the efficacy. It didn't appear to have any specific effect. Our findings are undoubtedly more of an exploratory kind than conclusive ones. Further studies are clearly necessary to cast light on this unorthodox treatment.

Adult↗

PubMed2000

Antiseptic skin preparation revisited.

Preparing the operation site by painting a solution of something onto the skin is one of the best preserved rituals in surgery. There appears to be something really satisfying about this precursor to the main event, and if the solution used is brightly coloured, or stains the skin, then so much the better--you can actually see where you've been! I hope than no-one is under the illusion that because the whole leg (or arm, or abdomen or anywhere else) is now a sickly shade of brown or alarmingly pink, that no pathogenic organisms can possibly have survived the onslaught. In this comprehensive review of the literature and practice audit, Sally Kent revisits the reasons for skin preparation, and recommends the use of well proven research to determine correct practice.

Antisepsis↗

PubMed1981

Some aspects on prevention and treatment of infection in burns.

Formerly, death due to burns was usually caused by shock in 50% of the cases. Today only 5% of the deaths are caused by shock; 95% of all deaths are due to infection and half of these deaths are due to septicaemia. The treatment of infections depends on two factors: -- Prevention of contamination -- Prevention of bacterial growth. Contamination can be prevented by early skin grafts, a no-touch method when applying dressings, nursing in ventilated rooms and local antiseptics. The history of the use of various antiseptics starting with penicillin V and ending with cerium nitrate is discussed. For the prevention of bacterial growth chemotherapy, active and passive immunisation, and such general methods as the correct treatment of associated diseases and a high calory diet are necessary. Chemotherapy should only be given when there are definite indications. Indiscriminate chemotherapy is dangerous. The most useful immunisation methods are vaccinations against pseudomonas as these vaccinations are also active against other gram-negative bacteria. In children the diagnosis of septicaemia is often difficult. As septicaemia may develop very quickly in children, it is sometimes necessary to start chemotherapy blindly before the results of the blood culture are known.

Antisepsis↗

PubMed1991

Transcutaneous iodine absorption in infants undergoing cardiac operation.

Povidone-iodine is an effective antiseptic, but its topical use has been associated with a number of adverse reactions in burn patients and in neonates as a result of transcutaneous absorption. In particular, high plasma iodine concentrations are known to cause renal failure, metabolic acidosis, and thyroid suppression. Because of the permeable nature of the skin in small infants and the large areas cleaned before cardiac operations, it is possible that significant transcutaneous iodine absorption might occur in this situation. We have studied 17 infants, less than 3 months of age, who were undergoing closed cardiac or thoracic procedures. After povidone-iodine skin preparation in 15 (covering 20% to 30% of body surface area), plasma total iodine concentrations rose fourfold (range, 160% to 1,440%). This increase was significantly different from the preoperative level at 6, 12, 18, and 24 hours. There was no increase in plasma iodine concentration in 2 patients who were not exposed to povidone-iodine or any other iodine-containing compound. We discuss the implications for a topical antisepsis policy in infants.

Body Surface Area↗

PubMed1993

Evaluation of the disinfectant effect of a quick drying rubbing type povidone-iodine alcoholic solution by the glove juice method.

The antiseptic effect of povidone-iodine alcoholic solution (HAD Hand Wash), a newly developed quick drying rubbing type disinfectant, was evaluated in 40 subjects. Samples of hand bacteria were collected by the glove juice method. The bacteria were incubated, and a cell count was performed. Disinfection was carried out by rubbing 3 ml of HAD Hand Wash carefully on to the skin of the subjects' hands. The efficacy of the solution was evaluated by computing the bacterial reduction rates as compared to the pre-disinfection bacterial count after disinfecting once and three times. The bacterial cell count was significantly reduced from the pre-disinfection count for one hour after disinfecting once and for two hours after disinfecting three times. In addition, the bacterial reduction rate after disinfecting three times remained superior to that after disinfecting once over a period of two hours. We concluded that disinfecting once with HAD Hand Wash is sufficient for routine hygienic hand washing, while disinfecting three times is desirable when, as with surgical hand washing, the strictest antisepsis is required. HAD Hand Wash produced no adverse side effects.

Antisepsis↗

PubMed2006

Comparison of two alcohol-based surgical scrub solutions with an iodine-based scrub brush for presurgical antiseptic effectiveness in a community hospital.

The antiseptic effectiveness and acceptability of a commercial alcohol-based waterless (ABWL) and an alcohol-based water-aided (ABWA) scrub solution were compared with a brush-based iodine solution (BBIS) under conditions encountered in community hospital operating rooms. This randomized partially blinded study was based on guidelines from the American Society for Testing and Methods. The three scrub solutions were compared for antimicrobial efficacy, using criteria within the Food and Drug Administration's Tentative Final Monograph for Healthcare Antiseptic Products (FDA-TFM), and for participants' acceptance of the products. Volunteer surgical staff that worked daily in the same operating room for the entire duration of the study were enrolled. In total, 1126 surgical scrub procedures were performed over the duration of the study. Only the ABWL met all of the FDA-TFM criteria. The BBIS performed better than both of the alcohol-based solutions at the end of Day 1 (P=0.03), but the ABWL was more efficacious than the ABWA and the BBIS at the end of Days 2 and 5 (P=0.02 and 0.01, respectively). When colony-count reductions were compared over the entire duration of the study, there was no significant difference between the three solutions (P=0.2). The participants found the ABWL easiest to use (P<0.001), with the fewest adverse effects on skin (P=0.007), and it was their preferred product (P<0.001). Although both of the commercially available alcohol-based solutions may be considered as acceptable alternatives to the BBIS for presurgical antisepsis, the ABWL was found to have significantly higher user acceptability.

Anti-Infective Agents, Local↗

PubMed2001

Bacterial recolonization during foot surgery: a prospective randomized study of toe preparation techniques.

Fifty patients undergoing foot or ankle surgery were randomized into two groups for the purposes of toe preparation. Twenty-four patients underwent a standard preparation which included placing antiseptic between the toes while 26 were additionally cleaned by sliding a gauze swab soaked in topical antiseptic back and forth several times. Povidone iodine followed by chlorhexidine in alcohol was used in both groups. All toes were covered by a sterile glove during surgery unless the toes themselves were to be operated upon. Bacteria were cultured from the toe clefts in 4% of all patients immediately following preoperative disinfection. Significantly fewer patients whose toes had been additionally scrubbed (group 1) showed bacterial recolonization at the end of surgery compared with those undergoing a standard prep (group 2) (7.7% vs 20.8%). We conclude that additional scrubbing of toe clefts prior to surgery reduces the incidence of recolonization of bacteria during the surgical procedure.

Anti-Infective Agents, Local↗

PubMed2001

Comparison of different regimens for surgical hand preparation.

Twenty surgical staff members participated in a clinical trial to compare the microbiology and skin condition of hands when using a traditional surgical scrub (TSS) with a detergent-based antiseptic containing 4% chlorhexidine gluconate (CHG) and a short application without scrub of a waterless hand preparation (HP) containing 61% ethyl alcohol, 1% CHG, and emollients. The HP was associated with less skin damage (P = .002) and lower microbial counts postscrub at days five (P = .002) and 19 (P = .02). The HP protocol had shorter contact time (HP mean [M] = 80.7 seconds; TSS M = 144.9 seconds; P < .0001), and more subjects preferred the HP regimen (P = .001). The HP performed better than the TSS, was less costly, and should be evaluated in larger trials and considered for widespread implementation.

Adult↗

PubMed1999

Surgical gloves: current problems.

One century ago surgical gloves were introduced to practice as part of the new antiseptic technique and originally to protect the hands of the surgeon and his assistants from the harmful dermatologic effects of powerful antiseptics (e.g., carbolic acid) in use at that time. Since then, the wearing of gloves during surgery has been standard practice. Furthermore, the protection value of surgical gloves in preventing cross-infection has stood the test of time. Nevertheless, materials used in glove manufacturing have caused a succession of iatrogenic problems in surgical patients over the years. More recently, emergence of transmissible viruses, such as hepatitis B and C and human immunodeficiency virus, has led surgeons to consider their own safety with the frequent possibility of perforation of surgical gloves by sharp instruments. In this review we discuss the problems associated with surgical glove practice: glove powder-induced peritonitis and adhesions, latex rubber-associated hypersensitivity, and glove perforation.

Anti-Infective Agents, Local↗

PubMed1975

The effect of commonly used antiseptics on wound healing.

Acetic acid, hydrogen peroxide, and povidone-iodine solutions were applied to experimental wounds in rats and to human donor sites to test their effects on wound healing. Control donor sites were treated with saline or dry Owens gauze. The acetic acid and povidone-iodine solutions had no significant gross or microscopic effect on the wounds. The hydrogen peroxide solution seemed to hasten the separation of the scab and to shorten the healing time, though characteristic bullae and ulceration appeared if the hydrogen peroxide treatment was applied after the crust had separated, when new epithelium was visible. We believe that the use of hydrogen peroxide should be avoided after crust separation. When only dry Owens gauze was used to treat split-skin graft donor areas, the result was a 3-day prolongation of the scab separation (compared to the saline controls) and greater subepidermal reactive and inflammatory changes.

Acetates↗

PubMed2002

Antimicrobial effectiveness of povidone-iodine and consequences for new application areas.

The microbicidal action spectrum of povidone-iodine (PVP-I) is broad - even after short onset times. Unlike local antibiotics and other antiseptic substances, no resistance develops. The high degree of bactericidal efficiency in respect of highly resistant gram-positive pathogenic micro-organisms, such as methicillin-resistant Staphylococcus aureus (MRSA) and enterococcus strains, is particularly significant for hospital hygiene. An in vitro study with 10 genotypically different MRSA isolates showed an optimum bactericidal effect (logarithmic reduction factor value >5) without protein load after just 30 s exposure and even in a dilution of Betaisodona solution (Mundipharma GmbH) of 1%. With protein load (0.2% albumin), the optimum in microbicidal effectiveness shifts to concentrations > or = 10% Betaisodona solution referring to an exposure time of 30 s. Since recent results are now also available on the toxicological safety of PVP-I preparations for the ciliated epithelium of the nasal mucosa and the good tolerability on skin and other mucous membranes is a known factor, a controlled clinical study is currently being carried out to eliminate colonizations of MRSA. Evidence has also recently been produced of the antiviral activity of PVP-I against herpes simplex, adeno- and enteroviruses, as well as its high degree of efficiency against Chlamydia. Hence alongside the classical fields of application, such as the disinfection of the skin and hands, mucosa antisepsis and wound treatment, there are also useful indications for the substance, i.e. rinsing of body cavities and joints and application to the eye.

Adenoviridae Infections↗

PubMed2006

Prevention of infection in arterial reconstruction.

BACKGROUND: Arterial reconstructions with prosthetic graft materials or vein are susceptible to infection with a resultant high patient mortality and risk of limb loss. To reduce the risk of infection effective perioperative measures are essential. OBJECTIVES: To determine the effectiveness of perioperative strategies to prevent infection in patients undergoing peripheral arterial reconstruction. SEARCH STRATEGY: We searched the Cochrane Peripheral Vascular Diseases Group trials register (last searched May 2006) and the Cochrane Central Register of Controlled Trials (CENTRAL) (last searched Issue 2, 2006), and reference lists of relevant articles. SELECTION CRITERIA: All randomised controlled trials (RCTs) evaluating measures intended to reduce or prevent infection in arterial surgery. DATA COLLECTION AND ANALYSIS: AS and PSE independently selected and assessed the quality of included trials. Relative risk was used as a measure of effect for each dichotomous outcome. MAIN RESULTS: Thirty-five RCTs were included. Of these, 23 were trials of prophylactic systemic antibiotics, three of rifampicin-bonded grafts, three of preoperative skin antisepsis, two of suction wound drainage, two of minimally invasive in situ bypass techniques, and individual trials of intraoperative glove change and wound closure techniques. Wound infection or early graft infection outcomes were recorded in all trials. Only two trials, both of rifampicin bonding, followed up graft infection outcomes to two years. Trials of antibiotics versus placebo were of highest quality with six double-blind studies of the ten included. Prophylactic systemic antibiotics reduced the risk of wound infection (Relative Risk (RR) 0.25, 95% Confidence Interval (CI) 0.17 to 0.38) and early graft infection in a fixed-effect model (RR 0.31, 95% CI 0.11 to 0.85, P = 0.02). Antibiotic prophylaxis for greater than 24 hours appears to be of no added benefit (RR 1.28, 95% CI 0.82 to 1.98). There was no evidence that prophylactic rifampicin bonding to dacron grafts reduced graft infection at either one month (RR 0.63, 95% CI 0.27 to 1.49) or two years (RR 1.05, 95% CI 0.46 to 2.40). There was no evidence of a beneficial or detrimental effect on rates of wound infection with suction groin-wound drainage (RR 0.96 95% CI 0.50 to 1.86) or of any benefit from a preoperative bathing or shower regimen with antiseptic agents over unmedicated bathing (RR 0.97, 95% CI 0.70 to 1.36). AUTHORS' CONCLUSIONS: There is clear evidence of the benefits of prophylactic broad spectrum antibiotics. Many other interventions intended to reduce the risk of infection in arterial reconstruction lack evidence of effectiveness.

Antibiotic Prophylaxis↗