Skin disinfection

Last updated

Skin disinfection is a process that involves the application of a disinfectant to reduce levels of microorganisms on the skin. [1] Disinfecting the skin of the patient and the hands of the healthcare providers are an important part of surgery. [1]

Skin disinfection may be accomplished with a number of solutions including providone-iodine, chlorhexidine, alcohol based solutions, and cetrimide. [2] There is strong evidence that chlorhexidine and denatured alcohol use to clean skin prior to surgery is better than any other commercially available antiseptic, such as povidone-iodine with alcohol. [3] [4]

Its importance in health care was determined by Semmelweis in the 1840s. [5]

Related Research Articles

<span class="mw-page-title-main">Mouthwash</span> Liquid rinse for oral hygiene

Mouthwash, mouth rinse, oral rinse, or mouth bath is a liquid which is held in the mouth passively or swirled around the mouth by contraction of the perioral muscles and/or movement of the head, and may be gargled, where the head is tilted back and the liquid bubbled at the back of the mouth.

A bactericide or bacteriocide, sometimes abbreviated Bcidal, is a substance which kills bacteria. Bactericides are disinfectants, antiseptics, or antibiotics. However, material surfaces can also have bactericidal properties based solely on their physical surface structure, as for example biomaterials like insect wings.

<span class="mw-page-title-main">Polyvinylpyrrolidone</span> Water-soluble polymer

Polyvinylpyrrolidone (PVP), also commonly called polyvidone or povidone, is a water-soluble polymer compound made from the monomer N-vinylpyrrolidone. PVP is available in a range of molecular weights and related viscosities, and can be selected according to the desired application properties.

An antiseptic is an antimicrobial substance or compound that is applied to living tissue to reduce the possibility of sepsis, infection or putrefaction. Antiseptics are generally distinguished from antibiotics by the latter's ability to safely destroy bacteria within the body, and from disinfectants, which destroy microorganisms found on non-living objects.

<span class="mw-page-title-main">Tincture of iodine</span> Antiseptic solution rubbed on skin before surgical operations

Tincture of iodine, iodine tincture, or weak iodine solution is an antiseptic. It is usually 2 to 3% elemental iodine, along with potassium iodide or sodium iodide, dissolved in a mixture of ethanol and water. Tincture solutions are characterized by the presence of alcohol. It was used from 1908 in pre-operative skin preparation by Italian surgeon Antonio Grossich.

<span class="mw-page-title-main">Topical medication</span> Medication applied to body surfaces

A topical medication is a medication that is applied to a particular place on or in the body. Most often topical medication means application to body surfaces such as the skin or mucous membranes to treat ailments via a large range of classes including creams, foams, gels, lotions, and ointments. Many topical medications are epicutaneous, meaning that they are applied directly to the skin. Topical medications may also be inhalational, such as asthma medications, or applied to the surface of tissues other than the skin, such as eye drops applied to the conjunctiva, or ear drops placed in the ear, or medications applied to the surface of a tooth. The word topical derives from Greek τοπικόςtopikos, "of a place".

<span class="mw-page-title-main">Chlorhexidine</span> Disinfectant and antiseptic

Chlorhexidine is a disinfectant and antiseptic with the molecular formula C22H30Cl2N10, which is used for skin disinfection before surgery and to sterilize surgical instruments. It is also used for cleaning wounds, preventing dental plaque, treating yeast infections of the mouth, and to keep urinary catheters from blocking. It is used as a liquid or a powder. It is commonly used in salt form, either the gluconate or the acetate.

<span class="mw-page-title-main">Iodinated contrast</span> Substance to enhance X-ray imaging

Iodinated contrast is a form of water-soluble, intravenous radiocontrast agent containing iodine, which enhances the visibility of vascular structures and organs during radiographic procedures. Some pathologies, such as cancer, have particularly improved visibility with iodinated contrast.

Perioperative mortality has been defined as any death, regardless of cause, occurring within 30 days after surgery in or out of the hospital. Globally, 4.2 million people are estimated to die within 30 days of surgery each year. An important consideration in the decision to perform any surgical procedure is to weigh the benefits against the risks. Anesthesiologists and surgeons employ various methods in assessing whether a patient is in optimal condition from a medical standpoint prior to undertaking surgery, and various statistical tools are available. ASA score is the most well known of these.

<span class="mw-page-title-main">Povidone-iodine</span> Antiseptic solution

Povidone-iodine (PVP-I), also known as iodopovidone, is an antiseptic used for skin disinfection before and after surgery. It may be used both to disinfect the hands of healthcare providers and the skin of the person they are caring for. It may also be used for minor wounds. It may be applied to the skin as a liquid or a powder.

An iodophor is a preparation containing iodine complexed with a solubilizing agent, such as a surfactant or water-soluble polymers, for example, povidone. The result is a water-soluble material that releases free iodine when in solution. Iodophors are prepared by mixing iodine with the solubilizing agent; heat can be used to speed up the reaction.

<span class="mw-page-title-main">Brachial plexus injury</span> Medical condition

A brachial plexus injury (BPI), also known as brachial plexus lesion, is an injury to the brachial plexus, the network of nerves that conducts signals from the spinal cord to the shoulder, arm and hand. These nerves originate in the fifth, sixth, seventh and eighth cervical (C5–C8), and first thoracic (T1) spinal nerves, and innervate the muscles and skin of the chest, shoulder, arm and hand.

<span class="mw-page-title-main">Hand sanitizer</span> Alternative to hand washing

Hand sanitizer is a liquid, gel or foam generally used to kill many viruses/bacteria/microorganisms on the hands. It can also come in the form of a cream, spray, or wipe. In most settings, hand washing with soap and water is generally preferred. Hand sanitizer is less effective at killing certain kinds of germs, such as norovirus and Clostridium difficile, and unlike hand washing, it cannot physically remove harmful chemicals. People may incorrectly wipe off hand sanitizer before it has dried, and some are less effective because their alcohol concentrations are too low.

Dakin's solution is a dilute solution of sodium hypochlorite and other stabilizing ingredients, traditionally used as an antiseptic, e.g. to cleanse wounds in order to prevent infection. The preparation was for a time called also Carrel–Dakin solution or Carrel–Dakin fluid.

Cadexomer iodine is an iodophor that is produced by the reaction of dextrin with epichlorhydrin coupled with ion-exchange groups and iodine. It is a water-soluble modified starch polymer containing 0.9% iodine, calculated on a weight-weight basis, within a helical matrix.

A virucide is any physical or chemical agent that deactivates or destroys viruses. The substances are not only virucidal but can be also bactericidal, fungicidal, sporicidal or tuberculocidal.

<span class="mw-page-title-main">Inadine</span>

Inadine is an iodine-containing non-sticky surgical dressing consisting of a knitted viscose fabric with a polyethylene glycol base that contains and slowly releases the antiseptic povidone-iodine (PVP-1). It is applied to superficial wounds.

Octenidine dihydrochloride is a cationic surfactant, with a gemini-surfactant structure, derived from pyridine. It is active against Gram-positive and Gram-negative bacteria. Since 1987, it has been used primarily in Europe as an antiseptic prior to medical procedures, including on neonates.

<span class="mw-page-title-main">Alcohols (medicine)</span> Alcohols used as antiseptics, disinfectants or antidotes

Alcohols, in various forms, are used within medicine as an antiseptic, disinfectant, and antidote. Alcohols applied to the skin are used to disinfect skin before a needle stick and before surgery. They may be used both to disinfect the skin of the person and as hand sanitizer of the healthcare providers. They can also be used to clean other areas and in mouthwashes. Taken by mouth or injected into a vein, ethanol is used to treat methanol or ethylene glycol toxicity when fomepizole is not available.

Decolonization, also bacterial decolonization, is a medical intervention that attempts to rid a patient of an antimicrobial resistant pathogen, such as methicillin-resistant Staphylococcus aureus (MRSA) or antifungal-resistant Candida.

References

  1. 1 2 Krettek, Christian; Aschemann, Dirk (2006). Positioning Techniques in Surgical Applications: Thorax and Heart Surgery - Vascular Surgery - Visceral and Transplantation Surgery - Urology - Surgery to the Spinal Cord and Extremities - Arthroscopy - Pediatric Surgery - Navigation/ISO-C 3D. Springer Science & Business Media. p. 10. ISBN   9783540309529.
  2. British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 839. ISBN   9780857111562.
  3. Wade, Ryckie G; Bourke, Gráinne; Wormald, Justin C R; Totty, Joshua Philip; Stanley, Guy Henry Morton; Lewandowski, Andrew; Rakhra, Sandeep Singh; Gardiner, Matthew D; Bindra, R; Sher, M; Thomas, M; Morgan, S D J; Hwang, B; Santucci, W; Tran, P; Kopp, L; Kunc, V; Hamdi, A; Grieve, P P; Mukhaizeem, S A; Blake, K; Cuggy, C; Dolan, R; Downes, E; Geary, E; Ghadge, A; Gorman, P; Jonson, M; Jumper, N; Kelly, S; Leddy, L; McMahon, M E; McNamee, C; Miller, P; Murphy, B; O'Halloran, L; O’Shea, K; Skeens, J; Staunton, S; Timon, F; Woods, J; Cortinovis, U; Sala, L; Zingarello, V; Jusoh, M H; Sadagatullah, A N; Georgieva, G; Pejkova, S; Nikolovska, B; Srbov, B; Hamid, H K S; Mustafa, M; Abdelrahman, M; Amin, S M M; Bhatti, D; Rahman, K M A; Jumabhoy, I; Kiely, J; Kieran, I; Lo, A C Q; Wong, K Y; Allan, A Y; Armes, H; Horwitz, M D; Ioannidi, L; Masterton, G; Chu, H; Talawadekar, G D; Tong, K S; Chan, M; Tredgett, M; Hardie, C; Powell-Smith, E; Gilham, N; Prokopenko, M; Ahmad, R; Davies, J; Zhen, S; Dargan, D; Pinder, R M; Koziara, M; Martin, R; Reay, E; Cochrane, E; Elbatawy, A; Green, F; Griffiths, T; Higginbotham, G; Louette, S; McCauley, G; Natalwala, I; Salt, E; Ahmed, R; Goon, P; Manton, R; Segaren, N; Cheung, G; Mahoney, R; Sen, S; Clarkson, D; Collins, M; Bolt, A; Lokanathan, P; Ng, A; Jones, G; Jones, J W M; Kabariti, R; Rhee, S J; Herron, J; Kay, A; Cheung, L K; Thomson, D; Jugdey, R S; Yoon, H; L, Z; Southgate, J; Brennan, C; Kiani, S; Zabaglo, M; Haider, Z A; Poulter, R; Sheik-Ali, A; Watts, A; Jemec, B; Redgrave, N; Dupley, L; Greenhalgh, M; Vella, J; Harris, H; Robinson, A V; Dupre, S; Teelucksingh, S; Gargan, A; Hettiaratchy, S; Jain, A; Kwasnicki, R; Lee, A; Thakkar, M; Berwick, D; Ismail, N; Mahdi, M; Rodrigues, J; Liew, C; Saadya, A; Clarkson, M; Brady, C; Harrison, R; Rayner, A; Nolan, G; Phillips, B; Madhusudan, N (9 November 2021). "Chlorhexidine versus povidone–iodine skin antisepsis before upper limb surgery (CIPHUR): an international multicentre prospective cohort study". BJS Open. 5 (6): zrab117. doi: 10.1093/bjsopen/zrab117 .
  4. Wade, Ryckie G.; Burr, Nicholas E.; McCauley, Gordon; Bourke, Grainne; Efthimiou, Orestis (December 2021). "The Comparative Efficacy of Chlorhexidine Gluconate and Povidone-iodine Antiseptics for the Prevention of Infection in Clean Surgery: A Systematic Review and Network Meta-analysis". Annals of Surgery. 274 (6): e481–e488. doi: 10.1097/SLA.0000000000004076 .
  5. Maibach, H. I.; Aly, Raza (2012). Skin Microbiology: Relevance to Clinical Infection. Springer Science & Business Media. p. Part two. ISBN   9781461258681.