What are antiseptics in medicine? These are drugs that are used to treat infected wounds, damage to the skin or mucous membranes by microorganisms. Antiseptics are active against protozoa, fungi, bacilli, bacteria, have a wide spectrum of action. The most common antiseptics are represented by halogen-containing iodine preparations, substances from the group of oxidizing agents, for example, hydrogen peroxide, certain acids and alkalis (salicylic), dyes (brilliant green) and so on.
Antiseptic Definition
What is an antiseptic in medicine? Doctors and medical students know the definition by heart. This is a set of therapeutic and preventive measures carried out in order to destroy or significantly reduce the number of pathogenic microorganisms in the wound or the patient’s body as a whole. In the pre-antiseptic period, about 80% of patients died after surgery due to putrefactive, gangrenous and purulent complications. Now (thanks to the use of antiseptic agents and aseptic methods) this can be avoided.
Antiseptics began to develop in the second half of the nineteenth century with the publication of J. Lister, in 1890 a new method was proposed by the German scientist Bergman, some of which are still being used. Now there are many new aseptic and antiseptic methods, as well as safe disinfectants. In the past 25 years, sterilization methods for dressings and medical instruments have begun to be introduced.
Aseptic and Antiseptic
In medicine, the prevention of infection during surgery and minimally invasive methods of therapy and diagnosis is of fundamental importance. Infections can spread internally, that is, through the patient’s body, or externally, through the environment, including medical instruments, household items, and air.
The definition of aseptic and antiseptic in medicine is as follows: a set of measures aimed at preventing infection in the wound, organs and tissues of the patient during surgery and, accordingly, actions aimed at eliminating the infection in the patient's body as a whole or in the wound in particular. Antiseptics, as previously mentioned, can be performed with a preventive or therapeutic purpose. In the first case, the wound is treated to prevent the development of infection, and in the second, if pathogenic microorganisms have already entered the body.
Aseptic and antiseptic measures
The actions aimed at preventing the entry into the wound and the human body as a whole of infection include: carrying out wet cleaning in the wards and other rooms and regular ventilation; sterilization of instruments and devices that are used by orderlies, nurses and doctors, equipping operating rooms with special ventilation systems, as well as the use of sterile material. To eliminate the infection for the purpose of therapy and prevention, bactericidal agents and antibiotics of general or local effect are used, dressings are applied and special solutions are applied, wounds are opened and treated, foreign objects and dead tissue are removed from the wound cavity. Antiseptics and septic tanks in medicine are mutually exclusive (septic tank - decay). To prevent infection, everything related to a traumatic or surgical wound should be sterile.
The main types of antiseptics
Aseptics and antiseptics in medicine are part of surgical science. The concepts are closely interrelated and involve measures aimed at preventing infection from entering the patient's body or therapy already existing. Methods and actions differ only formally. So, the types of antiseptics in medicine are:
- Mechanical Removal of infected or non-viable tissues by mechanical means, i.e. primary surgical treatment of a wound. An opening and treatment of the wound, washing and other manipulations providing cleansing is performed.
- Physical. Treatment and prevention of infection through the use of physical factors that ensure the death of microbes or a significant reduction in their number. Example: the use of hypertonic solutions that draw the contents of a wound into a dressing.
- Chemical. The impact on pathological microorganisms with chemicals that have a bacteriostatic or bactericidal effect. It is better if such substances do not adversely affect healthy human cells and tissues.
- Biological It involves the use of biological products that act directly on microorganisms. These include antibiotics, bacteriophages, antitoxins.
- Mixed. Exposure to several types of antiseptics at the same time.
In addition, local and general antiseptics are distinguished, and local is divided into superficial and deep. Superficial antiseptics involve the use of powders, creams, ointments, applications, while with a deep one, the drug is injected into the inflammatory focus (chipping, penicillin-novocaine blockade). General antiseptic involves saturation of the body with antiseptic substances that are introduced into the lesion with the flow of blood and lymph, positively affecting the microflora.
The origin of antiseptics in surgery
What is an antiseptic in medicine, medieval healers only guessed. Before the advent of modern drugs, only the mechanical method was widely used according to the principle: "You see pus - release it." After the publication of the work of J. Lister in 1867, widespread use of antiseptics in medicine began. An English surgeon and scientist, inspired by L. Pasteur's "microbial theory of decay", convinced of the antiseptic properties of carbolic acid, applied an open fracture dressing. Prior to this, the Parisian pharmacist Lemer began to use acid.
The basics of the antiseptic method
The foundations of the proposed antiseptic method were presented by J. Lister in the article "On a new method of treating fractures ...", published in 1867. So, the surgeon created the first-ever multicomponent method of combating pathogenic microorganisms that penetrate open wounds. Lister went down in the history of surgical science as the founder of antiseptics. The method involved applying a multilayer dressing, treating hands, sterilizing instruments, suture and dressing, as well as the operating room.
In Russia, antiseptics were introduced by prominent surgeons, among whom are K. Reyer, P. Pelekhin, who authored the first Russian publication on antiseptics, N. Sklifosovsky, S. Kolomin, I. Burtsev (the first surgeon who published his own results on the introduction of antiseptic method), N. Pirogov, L. Levshin, N. Velyaminov, N. Studensky.
Criticism and new methods
The Lehmer method found many supporters, but there were also opponents. What is an antiseptic in medicine when it comes to carbolic acid? This substance has a toxic effect on the tissues and organs of the patient, the surgeon's hands, and respiratory organs (it was supposed to spray the solution in the operating room). This made some surgeons doubt the value of this method.
After a quarter of a century, the aseptic method replaced, the results of which were so impressive that some doctors even began to abandon antiseptics. But over time, it became clear that in surgical practice, you can not do without antiseptics. Soon, several new drugs were proposed, already much less toxic than carbolic acid. Gradually, antiseptics were closely intertwined with asepsis. Surgery is currently unthinkable without the unity of the two disciplines.
Common antiseptics
What is an antiseptic in medicine? This is an antimicrobial drug. The mechanism of action of substances from different groups is not the same, some disrupt the permeability of the plasma membrane of a pathogenic microorganism, others disrupt the structure of the protein molecule or inhibit enzymes that are important for the life of fungi, viruses and bacteria. So that antiseptic agents do not cause harm (after all, at appropriate concentrations they adversely affect most microorganisms), they must be used correctly.
The list of antiseptics in medicine that are used most often is as follows:
- alcohols (the most common are propyl, ethanol, isopropyl, mixtures thereof);
- Quaternary ammonium compounds (used in some disinfectants, antiseptic towels, toilet soap);
- boric acid (against herpes and in the treatment of fungal infections of the vagina);
- brilliant green (dye is still widely used as a solution for treating small wounds and abscesses);
- chlorhexidine gluconate (an antiseptic for the skin and gum inflammation therapy);
- hydrogen peroxide (used to treat wounds and scratches, in everyday life);
- iodine solution (used for pre- and postoperative disinfection, not recommended for treating small wounds);
- octenidine dihydrochloride (the substance has activity against a wide range of microorganisms);
- carbolic acid and other phenol compounds (used as a baby antiseptic powder for the navel, for rinsing the mouth and throat, and for treating the hands of personnel).
Terms of use
Before treating any damage, wash your hands with soap, wash the wound or remove foreign bodies, dirt residues and the like with tweezers. If the wound or burn is extensive, then you can not fill the antiseptic inside. For example, iodine is treated only at the edges of the wound so as not to cause a chemical burn, additional trauma and lead to longer healing. Without consulting a doctor, it is not recommended to use antiseptic drugs for dermatological diseases.
Ethanol is used in medicine as an antiseptic, usually in the form of a solution or as part of other drugs in a small dosage, but is not used in the mucous membranes of the eyes, throat or nose.
For the purpose of intimate prevention, only the external genitalia, vagina and urethra are treated, but this is possible only with the help of suitable antiseptic drugs.
Antiseptics for the prevention and treatment of stomatitis, herpes, colds, pharyngitis, tonsillitis and so on are available in various dosage forms. Rinses, tablets and lozenges for resorption, aerosols for inhalation, and more can be used. Some antiseptics may include local anesthetics, deodorizing agents, or essential oils.
Hand antiseptics
The simplest antiseptic, the use of which is sufficient to comply with hygiene rules, is an ordinary soap. It is enough to wash your hands as needed: after a walk, before eating, before various body care activities, after visiting the toilet. Each time, you should not use an antiseptic - this will only violate the body's natural defense.
Hand antiseptics in medicine and at home are used as a means of hygiene in cases where ordinary soap and water are not available. It is advisable to use antiseptics, which do not contain perfumes and alcohol. The compositions are usually available in the form of a spray or gel. Two milliliters of the drug is applied to dry skin of the hands and rubbed until dry, but at least 15 seconds.
Non-medical use
Antiseptics are used in food production, for example, many preservatives are based on them. Paints and varnishes with the properties of an antiseptic are used to protect wood from saprophytic microflora, protect from rot, insects, blue stain, mold, burning and fire. Disinfectants are part of detergents.
Microbial resistance
With prolonged use of antiseptic agents, microbes can evolve and no longer perceive such substances. Different antiseptics provoke bacteria to develop in different ways. The adaptation of microorganisms may also depend on the dosage: a low dose will not be enough to protect against infections. In addition, resistance to a particular compound can increase resistance to others.