Antiseptic

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Not to be confused with Antibiotic.

Antiseptic(s) (from Greek ἀντί anti, "against"[1] and σηπτικός sēptikos, "putrefactive"[2]) are antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis, or putrefaction. Antiseptics are generally distinguished from antibiotics by the latter's ability to be transported through the lymphatic system to destroy bacteria within the body, and from disinfectants, which destroy microorganisms found on non-living objects.[3]

Disinfectants do not kill bacterial spores e.g., on surgical instruments; a sterilization process is required for that. Even sterilization may not destroy prions.

Some antibiotics– are true germicides, capable of destroying microbes (bacteriocidal), while others are bacteriostatic and only prevent or inhibit their growth.

Antibacterials are antiseptics that have the proven ability to act against bacteria. Microbicides which destroy virus particles are called viricides or antivirals.

Usage in surgery[edit]

Joseph Lister

The widespread introduction of antiseptic surgical methods followed the publishing of the paper Antiseptic Principle of the Practice of Surgery in 1867 by Joseph Lister, inspired by Louis Pasteur's germ theory of putrefaction. In this paper, Lister advocated the use of carbolic acid (phenol) as a method of ensuring that any germs present were killed. Some of this work was anticipated by:

  • Ancient Greek physicians Galen (circa 130–200) and Hippocrates (circa 400 BC) and Sumerian clay tablets dating from 2150 BC that advocate the use of similar techniques.[4]
  • Medieval surgeons Hugh of Lucca, Theoderic of Servia, and his pupil Henri de Mondeville were opponents of Galen's opinion that pus was important to healing, which had led ancient and medieval surgeons to let pus remain in wounds. They advocated draining and cleaning wound lips with wine, dressing the wound after suturing it if necessary, and leaving the dressing on for ten days, soaking it in warm wine all the while, before changing it. Their theories were bitterly opposed by Galenist Guy de Chauliac and others trained in the classical tradition.[5]
  • Joseph Smith alluded to the use of alcohol as an antiseptic in February 1833, when he wrote what is now section 89 of the Doctrine and Covenants, popularly known as the "Word of Wisdom". Specifically, verse 7 states: "And, again, strong drinks are not for the belly, but for the washing of your bodies."[6]
  • Oliver Wendell Holmes, Sr., who published The Contagiousness of Puerperal Fever in 1843
  • Florence Nightingale, who contributed substantially to the report on the Royal Commission on the Health of the Army (1856–1857), based on her earlier work
  • Ignaz Semmelweis, who published his work The Cause, Concept and Prophylaxis of Childbed Fever in 1861, summarizing experiments and observations since 1847[7]

Some common antiseptics[edit]

A bottle of ethanol (95%) – an antiseptic
  • Hydrogen peroxide is used as a 6% (20 Vols) solution to clean and deodorize wounds and ulcers. More commonly, 3% solutions of hydrogen peroxide have been used in household first aid for scrapes, etc. However, the strong oxidization causes scar formation and increases healing time during fetal development.[8]
  • Iodine is usually used in an alcohol solution (called tincture of iodine) or as Lugol's iodine solution as a pre- and postoperative antiseptic. Some people[who?] do not recommend disinfecting minor wounds with iodine because of concern that it may induce scar tissue formation and increase healing time. However, concentrations of 1% iodine or less have not been shown to increase healing time and are not otherwise distinguishable from treatment with saline.[9] Novel iodine antiseptics containing povidone-iodine (an iodophor, complex of povidone, a water-soluble polymer, with triiodide anions I3, containing about 10% of active iodine) are far better tolerated, do not negatively affect wound healing, and leave a deposit of active iodine, thereby creating the so-called "remnant", or persistent, effect. The great advantage of iodine antiseptics is their wide scope of antimicrobial activity, killing all principal pathogens and, given enough time, even spores, which are considered to be the most difficult form of microorganisms to be inactivated by disinfectants and antiseptics.
  • Polyhexanide (polyhexamethylene biguanide, PHMB) is an antimicrobial compound suitable for clinical use in critically colonized or infected acute and chronic wounds. The physicochemical action on the bacterial envelope prevents or impedes the development of resistant bacterial strains.[10][11][12]
  • Sodium bicarbonate (NaHCO3) has antiseptic and disinfectant properties.[13][14]
  • Balsam of Peru is a mild antiseptic.[15][16][17]

Evolved resistance[edit]

By continued exposure to antibiotics, bacteria may evolve to the point where they are no longer harmed by these compounds.[18]

Bacteria can also develop a resistance to antiseptics, but the effect is generally less pronounced.[19]

The mechanism by which bacteria evolve may vary in response to different antiseptics. Low concentrations of an antiseptic may encourage growth of a bacterial strain that is resistant to the antiseptic, where a higher concentration of the antiseptic would simply kill the bacteria. In addition, use of an excessively high concentration of an antiseptic may cause tissue damage or slow the process of wound healing.[9] Consequently, antiseptics are most effective when used at the correct concentration—a high enough concentration to kill harmful bacteria, fungi or viruses, but a low enough concentration to avoid damage to the tissue.

See also[edit]

Notes[edit]

  1. ^ Liddell, Henry George; Scott, Robert. "ἀντί". A Greek-English Lexicon. Perseus perseus.tufts.edu. 
  2. ^ Liddell, Henry George; Scott, Robert. "σηπτικός". A Greek-English Lexicon. Perseus perseus.tufts.edu. 
  3. ^ McDonnell, Gerald; Russell, A. Denver. "Antiseptics and Disinfectants: Activity, Action, and Resistance". Clinical Microbiology Reviews. National Institutes of Health nih.gov'. 
  4. ^ Eming SA, Krieg T, Davidson JM (2007). "Inflammation in wound repair: molecular and cellular mechanisms". J. Invest. Dermatol. 127 (3): 514–25. doi:10.1038/sj.jid.5700701. PMID 17299434. 
  5. ^ Edwards H (1976). "Theodoric of Cervia, a medieval antiseptic surgeon". Proceedings of the Royal Society. 69 (3): 553–5. PMC 1864551Freely accessible. PMID 790395. 
  6. ^ "Doctrine and Covenants 89:1–9". Lds.org. 2012-02-21. Retrieved 2014-03-04. 
  7. ^ Best M, Neuhauser D (2004). "Ignaz Semmelweis and the birth of infection control". Qual Saf Health Care. 13 (3): 233–4. doi:10.1136/qhc.13.3.233. PMC 1743827Freely accessible. PMID 15175497. 
  8. ^ Wilgus TA, Bergdall VK, Dipietro LA, Oberyszyn TM (2005). "Hydrogen peroxide disrupts scarless fetal wound repair". Wound Repair Regen. 13 (5): 513–9. doi:10.1111/j.1067-1927.2005.00072.x. PMID 16176460. 
  9. ^ a b "Antiseptics on Wounds: An Area of Controversy: Hydrogen Peroxide". Medscape.com. Retrieved 2014-03-04. 
  10. ^ Kaehn K (2010). "Polihexanide: a safe and highly effective biocide". Skin Pharmacol Physiol. 23 Suppl: 7–16. doi:10.1159/000318237. PMID 20829657. 
  11. ^ Eberlein T, Assadian O (2010). "Clinical use of polihexanide on acute and chronic wounds for antisepsis and decontamination". Skin Pharmacol Physiol. 23 Suppl: 45–51. doi:10.1159/000318267. PMID 20829662. 
  12. ^ Eberlein T, Haemmerle G, Signer M, et al. (January 2012). "Comparison of PHMB-containing dressing and silver dressings in patients with critically colonised or locally infected wounds". J Wound Care. 21 (1): 12, 14–6, 18–20. doi:10.12968/jowc.2012.21.1.12. PMID 22240928. 
  13. ^ Malik, Y; Goyal, S (2006). "Virucidal efficacy of sodium bicarbonate on a food contact surface against feline calicivirus, a norovirus surrogate". International Journal of Food Microbiology. 109 (1–2): 160–3. doi:10.1016/j.ijfoodmicro.2005.08.033. PMID 16540196. 
  14. ^ Zamani, M; Sharifi Tehrani, A; Ali Abadi, AA (2007). "Evaluation of antifungal activity of carbonate and bicarbonate salts alone or in combination with biocontrol agents in control of citrus green mold". Communications in agricultural and applied biological sciences. 72 (4): 773–7. PMID 18396809. 
  15. ^ Chemistry: general, medical, and pharmaceutical — Google Books. Books.google.com. p. 460. Retrieved 2016-03-15. 
  16. ^ Leung's Encyclopedia of Common Natural Ingredients: Used in Food, Drugs and ... - Ikhlas A. Khan, Ehab A. Abourashed — Google Books. Books.google.com. 2011-09-21. p. 41. Retrieved 2016-03-15. 
  17. ^ Biocompatibility of Dental Materials — Gottfried Schmalz, Dorthe Arenholt Bindslev — Google Books. Books.google.com. p. 352. Retrieved 2016-03-15. 
  18. ^ "CDC – Antibacterial Household Products: Cause for Concern (Stuart B. Levy)Tufts University School of Medicine, Boston, Massachusetts, USA (Presentation from the 2000 Emerging Infectious Diseases Conference in Atlanta, Georgia)". cdc.gov. 
  19. ^ Albina Mikhaylova; Bernd Liesenfeld; William Toreki; David Moore; Jillian Vella; Roy Carr; Gerald Olderman; Christopher Batich; Gregory Schultz (2009). "Bacterial Resistance Issues in Wound Care and Wound Dressings" (PDF). QuickMedTechnologies. Symposium on Advanced Wound Care and Wound Healing Society Meeting, Poster LB-051. Retrieved 2014-03-04. 

References[edit]

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