In 1750, British military surgeon Pringl introduced the concept of antiseptic in medical practice

Types antiseptics
Physical antiseptic Chemical antiseptic Mechanical antiseptic Biological antiseptic Combination antiseptic

Physical antiseptic
Uses physical phenomena that create a wound in adverse conditions for the development of microbial,

Drainage wounds Pho wounds Clear method of treating wounds MSS wounds Processing wounds with ultrasound Irradiation laser wounds

Chemical antiseptic
Use of chemicals (antiseptics) to kill germs or delay their development in the wound. Antiseptics should; Quickly and reliably kill bacteria, Do not harm the tissues and body wounds, Long stay active , Have a good wettability, Do not destroy the material drains, To provide the maximum effect at the minimum concentration,

Methods of application of antiseptics:

Local applications: continuous, one-time, periodically, by a puncture, treatment of skin around the wound. Soaking the tissues around the inflammatory focus ( short block of AV Vishnevsky). Iontophoresis, phonophoresis Parenteral administration (intravenous, vnutriarterialno, intraosseous, endolymphatic)

With halogens
Tincture of iodine in alcohol (2 - 5 - 10%) Yodonat (1% solution) Lugol's solution (10 g iodine, 20 g Iodis addition of potassium and 1000 ml of distilled water or 1000 ml of 96% alcohol)

With oxidants:
A solution of hydrogen peroxide (3% solution for rinsing wounds) , A solution of potassium permanganate (0,01 - 0,1%, 0,1 - 0,5% 2 - 5%), Gidroperit (1% solution for rinsing),

Salts of heavy metals;

Silver nitrate (1-2% and 5-10% solution) Protargol (1 - 5% solution) Collargol (0,2 - 2% solutions

Alcohols:
Ethyl (wine), alcohol (70% and 96%)

Phenols:
Vishnevsky Ointment

Ingredients: 3 parts of tar containing phenol , 3 parts kseroforma, 100 parts of castor oil Acids:
Boric acid (2 - 4% solution) Salicylic acid (part of the paste Lassara) Nadmuravinaya acid(a mixture of formic acid at a concent 2,4% hydrogen peroxide was name Pervomur)

Dyes:
Methylene blue(1 - 3% alcohol solution and an aqueous solution at a concentration of 1:5000) Brilliant green(1 - 2% aqueous or alcoholic solution) Rivanol (freshly prepared solution at a concentration of 1:1000 or 1:2000)

Nitrofurans:
Furatsilinom (a solution of 1:5000 or 1:500) Furagin soluble (0.1% solution w / 300 ml or tablets of 0,3-0,5 g / day) . Furadonin (tablets of 0,1 - 0,15 g of 3 - 4 times per day)

Preparations osmotic action:

Sodium chloride (10% solution) Magnesium sulfate (10 - 25 - 40% solution) Methenamine Glucose (40%)

Detergents:
Novosept (3% aqueous solution)

Rokkal (water 0,1% and 1% solution) Chlorhexidine (aqueous 20% solution is used for washing wounds in developing Denia 1:400 and for flushing the cavities at a dilution of 1:1000)

Derivatives of quinoxaline derivatives:

Hinoksidin(the inside of 0,25 g 3 times per day) Disinfection of the hands of the surgeon Hygienic disinfection Surgical disinfection Rapid disinfection

Preparations for surgical disinfection should:

Quickly kill the pathogenic flora. Reliably kill microbes in glove juice. Having a cumulative effect. Do not irritate the skin of the hands of a surgeon.

Means? biological antiseptic

Antibiotics Vaccines Serum Bacteriophages Immune drugs

Principles of antimicrobial? therapy

Possible to begin treatment early. To address the sensitivity of pathogen-Chairpersons to used drugs. To ensure maximum contact and causative drug. To provide treatment to the destruction of the parasite. To address and prevent the side effects of antimicrobial agents.

With penicillin
Provides: bactericidal effect on strepto-and stafillokokki, spirochete, etc. Apply: with respiratory infections, peritonitis, syphilis, etc. Contra: bronchial asthma, can not enter endolyumbalno patients with epilepsy. Side effects: allergy, the rapid development of resistant strains. The main products of penicillin:? Benzylpenicillin, ampicillin, oxacillin, amoxicillin,? Bitsilliny 1, 2,
3 and others

Tetracyclines
Provides: bacteriostatic effect by inhibiting protein biosynthesis in the microbial cell. Apply: If respiratory infection-tion routes, the digestive tract, urinary tract, etc. Contra: at high sensitivity, impaired renal function, leukopenia, pregnancy, etc. Side effects: diarrhea, allergies, photosensitivity of the skin, damage to tooth enamel, lungs
aspergillosis,and others do not designate, with iron and calcium.

Major Drugs tetracyclines:? Tetracycline, vibramitsin, minocycline, etc.

Macrolide
Provides: bacteriostatic effect on gonococcus, meningo-cocci, rickettsia and large viruses. Apply: with bronchopulmonary diseases, urinary and biliary tract, meningitis, gonorrhea. Contraindications: the defeat of the parenchyma of the liver. Side effects: nausea, vomiting, allergy. Major Drugs? macrolide: Erythromycin, oleandomitsin, oletetrin, clarithromycin, clindamycin,
oleomorfotsiklin and others.

Aminoglycoside
Provides: bactericidal effect on most Gram-positive and Gram-negative bacteria, including
mycobacterium tuberculosis.

Apply: with broncho-pulmonary infection, urinary tract infections, tuberculosis. Contraindications: hearing impairment, liver disease and kidney disease, pregnancy, children are the
first 2 years of life.

Side effects: ototoksicheskoe, jade-toxic, rarely respiratory depression, allergies. Major Drugs aminoglycoside:
Streptomycin ,Kanamycin ,Monomitsin ,Tobramycin ,Amikacin ,Sizomitsin

With cephalosporins:
Provides: bactericidal effect on virtually the entire micro-coccal flora. Apply: acute and chronic infections of the respiratory, soft tissue infections, peritonitis, sepsis. Contraindications: allergy to teacher-Ratu, the first months of pregnancy. Side effects: Sometimes a violation of renal excretory function, allergies. Major Drugs group? group cephalosporins:
I Generation Cephalosporins: tseporin, cefazolin (kefzol), cephalothin. Cephalosporin II Generation: cefamandole, cefuroxime, tsefmetazol etc. Cephalosporin III Generation: latamoksef, tsefataksim, cefixime, etc. Cephalosporin IV generation: cefepime, tsefpirom, tsefadrin, Cephalexin, Cefaclor, tsefadroksil etc.

Sulfanilamidnye drugs:
Provides: bacteriostatic effect, inhibiting the synthesis of folic acid required for the reproduction of
bacteria.

Apply: infection in the respiratory and urinary tract. Contraindications: pregnancy, renal dysfunction, allergy. Side effects: nephrolithiasis, nausea, vomiting, leukopenia, rarely - Lyell's syndrome. Key sulfanilamidnye drugs:? Sulphathiazole, sulfadimezin (short action);? Sulfazin (average
duration of action);? Sulfapiridozin, sulfadimetoksin (long-acting);? Sulfalen (sverhdlitelnogo action).?

Antifungal? drugs:? Nystatin, levorin,? Nizoral, Orungal etc.?

Preparations, normalization yuschie intestinal microflora nickname:? baktisubtil,

hilak-forte, lineks etc.

Serum - immune preparations derived from the blood of animals, immuno-ized to any antigen, and
containing the appropriate antibodies (tetanus, protivogangrenoznaya serum).

Bacteriophage - a virus of bacteria, capable of reproducing in the bacterial cell and cause its lysis
(antistafilokokkovy, antistreptokokkovy bacteriophages, bacteriophage-Anticoli).

Asepsis - a method which prevents ingress of microbes in the surgical wound, through institutional
arrangements, physical factors and chemicals.

Stages of thermal sterilization

Heating time Time equilibration Time of destruction + time additional security Cooling time Confirmation sterility Direct method - bacteriological. (used occasionally) Indirect methods of control in agri-cation of substances with known melting point (used constantly). Temperature display: benzoic acid (120o), rezorbtsin (119o), amido-Pirin (110o), ascorbic acid (190o), succinic acid (180o), pilocarpine hydrochloride (200o).

Hospital infections (nosocomial infection, hospital infection) infection in patients with existing
hospital microflora.

Forms of hospital infection

Urinary tract infection ... ... ... ... 40% Wound infection ... ... ... ... ... ... ... ... 25% Respiratory infection ... ... .. 16% Septicemia ... ... ... ... ... ... ... ... ... ... ... 3.5%

Isolation of microbes man? (The number of microbial bodies in 1 min.)

In repose ... ... ... ... ... ... ... ... ... ... 10 - 100 thousand When moving ... ... ... ... ... .... 1 million In conversation, cough ... ... up to 7 million