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Consensus on Wound Antisepsis: Update 2018

Wound antiseptics lost some of their importance for more than a century due to the toxicity of Lister's carbolic wound spray, the toxic side effects of the next generation of antiseptics such as mercury- or arsenic-based compounds, and the initial euphoria after the introduction of the antibiotic penicillin G. Reasons for the renaissance of antiseptics are the development of effective and well-tolerated antiseptic substances, the pandemic spread of multidrug resistant organisms (MDROs), a comparatively high rate of sensitization to locally applied antibiotics, the microbicidal instead of microbiostatic effect of antiseptics, the locally delimited effect with no or - in the case of polyvinylpyrrolidone-iodine…

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 Chlorhexidine (Chloraprep) vs. Povidone-iodine (Betadine) for Preventing Post Procedure & Surgical Wound Infections

It appears from several studies, meta-analysis, and use across several different indications, that topical chlorhexidine-gluconate-70% isopropyl alcohol solution applied to the skin is more effective than povidone-iodine (Betadine) at preventing skin or wound infections when used prior to an invasive or surgical procedure. This beneficial effects of chlorhexidine over povidone-iodine (Betadine) may have to do with chlorhexidine's rapid onset of action and continued efficacy despite the skin being exposed to bodily fluids that could deactivate iodine containing topical antiseptic agents.

 Joseph Lister and the use of antiseptics

Until the acceptance of germ theory in the 1860s, surgeons did not take any precautions to protect open wounds from infection. They did not wash their hands before operating, sterilise their equipment or clean the operating table. This began to change in 1867, when Joseph Lister discovered that carbolic spray was very effective in stopping wounds from getting gangrene. He developed antiseptic surgery by spraying medical instruments, catgut and bandages with a 1-in-20 solution of carbolic acid.

Articles of Interest

What are antiseptic solutions and why they matter to Hospitals

Antiseptic solutions are key to combat hospital infections, one of the main scourges facing healthcare. And it is not just developing economies struggling with this issue- in OEDCE countries, about 4 million people a year fall victim to infections in hospitals. In the EU alone, over 90,000 annual deaths are directly related to this problem, which represents an average of 6% of hospitals’ budgets.

'The Butchering Art': How A 19th Century Physician Made Surgery Safer

A new biography of surgeon Joseph Lister called The Butchering Art is not about food. It tells the story of how the forward-thinking Lister changed medicine forever by getting other surgeons to understand that germs spread disease but that they could something about it.

Antiseptic “Resistance”: Real or Perceived Threat?

Biocides are integral and necessary components of the strategy to prevent dissemination of nosocomial infections in the clinical community, and their antimicrobial efficacy has been documented. However, unlike the mechanisms of action of antibiotics, those of biocides remain poorly characterized, especially at suboptimal concentrations. The published literature has described possible multiple targets of biocides when used in concentrations that have bactericidal effects.

Antiseptics on Wounds: An Area of Controversy (PART ONE)

Antiseptics are agents that destroy or inhibit the growth and development of microorganisms in or on living tissue. Unlike antibiotics that act selectively on a specific target, antiseptics have multiple targets and a broader spectrum of activity, which include bacteria, fungi, viruses, protozoa, and even prions. The most commonly used products in clinical practice today include povidone iodine, chlorhexidine, alcohol, acetate, hydrogen peroxide, boric acid, silver nitrate, silver sulfadiazine, and sodium hypochlorite.

Chlorhexidine-Alcohol versus Povidone-Iodine for Surgical-Site Antisepsis

Preoperative cleansing of the patient's skin with chlorhexidine-alcohol is superior to cleansing with povidone-iodine for preventing surgical-site infection after clean-contaminated surgery.

Civil War Plant Remedies Actually Fought Off Infections, Study Finds

Researchers tested the antimicrobial properties of three plants mentioned in an 1863 treatment book.

Dr. Toshi Is In! "Difference between Antiseptics and Disinfectants"

Antiseptics and disinfectants both kill microorganisms (germs) such as bacteria, fungi, viruses, and tiny parasites like amoeba. An antiseptic is applied to the body, while disinfectants are applied to surfaces

How Humble Moss Healed the Wounds of Thousands in World War I

The same extraordinary properties that make this plant an “ecosystem engineer” also helped save human lives.

Iodine: An Elemental Force Against Infection

The burnt-orange color of the surgical scrub made with polyvinylpyrrolidone-iodine, or povidone-iodine (PVP-I) for short, is easily recognized by the average patient as an antimicrobial precaution. But even this common polymer complex harbors some secrets and intriguing chemical properties, all of which can influence its antiseptic potential.

Natural antiseptics: safe for your skin and the environment

Natural antiseptics are not only better for your skin, but also kinder to the environment as they are biodegradable. ‘After the recklessness of the last century we are only beginning to address the effects of the pollution already introduced to our planet by the pharmaceutical, cosmetic, processed food and household chemical industries.../

Open Access Cell death and barrier disruption by clinically used iodine concentrations

Povidone-iodine (PVP-I) inactivates a broad range of pathogens. Despite its widespread use over decades, the safety of PVP-I remains controversial. Its extended use in the current SARS-CoV-2 virus pandemic urges the need to clarify safety features of PVP-I on a cellular level.

Povidone iodine: useful for more than preoperative antisepsis

While povidone iodine has long been used by surgeons as a preoperative antiseptic, researchers have been looking at the agent for treating viral conjunctivitis as well as other ocular diseases.

Scientists resurrecting use of silver as antiseptic

Silver, one of humankind's first weapons against bacteria, is receiving new respect for its antiseptic powers thanks to the growing ability of researchers to tinker with its molecular structure. Doctors prescribed silver to fight infections at least as far back as the days of ancient Greece and Egypt.

The Pros and Cons of Scrubbing With Betadine, Chlorhexidine

“Should I scrub patients with Betadine or chlorhexidine?” This is probably one of the most frequently asked questions, yet practices seem to be divided between the Betadine clinics and the chlorhex hospitals. Based on a non-representative sample, my impression is that there are far more practices that use chlorhexidine to scrub patients. So what should we do? When quizzed, few people even know why they do what they do.

What Are Examples of Antiseptics?

Researchers tested the antimicrobial properties of three plants mentioned in an 1863 treatment book.

Resources

Skin Antiseptics

Antiseptics are chemical agents applied to the skin to reduce the microbial count and the risk of surgical site infections (SSIs). SSIs are defined as an infection occurring at the surgical site within 30 days of a procedure and represent one of the most common complications of dermatologic surgery. The use of antiseptics dates back to the mid-1800s when Ignaz Semmelweis noted a dramatic decrease in periportal sepsis events with appropriate handwashing techniques, later reaffirmed with Lister’s use of carbolic acid, showing improved infection control and reduction in surgical morbidity.