Antiseptic

Antiseptic is a complex of measures aimed at destroying germs in the wound, reducing their penetration into the wound and developing it. Distinguish antiseptic:

• physical;

• chemical;

• biological;

• mixed.

• Local

Physical antiseptics are methods that create unfavorable conditions in the wound for the development of bacteria and the absorption of toxins and products of tissue decay. Its main task is to ensure the release of the wound detachable into the dressing - it is achieved by the use of hygroscopic gauze, the physical properties and capillarity of which were studied and described as early as 1894 by M.Ya. Preobrazhensky. Tampons made of gauze, drainage from rubber, glass, plastic provide an outflow of wound contents and contribute to the removal of microbes, toxins and decay products of tissues, that is, clean the wound from the infected detachable. Hygroscopic properties of gauze are enhanced when it is moistened with a hypertonic solution. Apply an open method of treating wounds - without applying bandages, which leads to the drying of the wound and thereby creating unfavorable conditions for the development of microbes. Physical antiseptics also include the use of a laser, ultraviolet rays, ultrasound and other physical factors. Ultrasound is the inaudible elastic waves of the human ear, whose frequency exceeds 20 kHz. The bactericidal action of ultrasound is manifested in a liquid medium and is based on a physical and chemical effect. Shock waves act on microorganisms. The chemical effect is based on the release of H and OH ions from the water molecules, which stop the redox reactions in the microbial cell. Laser - an optical quantum generator. In medicine, two types of laser beams are used - high and low energy. The high energy laser beams contribute to the formation of an electric field in the tissues, which leads to the appearance on the surface of the tissue of a sterile coagulation film that prevents the absorption of toxins and the spread of infection. The low energy laser beams change chemical reactions in tissues, have anti-inflammatory and vasodilating effect, improve metabolic processes. Among other physical factors, diadynamic currents( Bernard currents), electrophoresis of various antiseptic agents are widely used.

Mechanical antiseptics. The essence of this method consists in removing from the wound all dead tissue, blood clots, which are a nutrient medium for microorganisms. Achieved by performing primary surgical treatment of the wound, dissection, or even better - excision.

Chemical antiseptic involves the use of various chemicals that have bactericidal or bacteriostatic effects. In addition to affecting the microflora, these substances have a biological effect on tissues in the wound area and on the body as a whole( when absorbed from the wound or in general application).The general and local effects of chemical antiseptics should be sufficiently safe for the macroorganism and its cells and is detrimental to microbes.

Biological antiseptics combines a large group of drugs acting directly on a microbial cell or its toxins and a group of substances acting indirectly through a macroorganism. The first group includes antibiotics, bacteriophages, as well as antitoxins, usually administered in the form of serums( tetanus, antidiphtheria, etc.), to the second group - vaccines, toxins, blood, plasma, immunoglobulins. Their action is based on increasing the immunity and thereby enhancing the protective properties of the body.

Mixed antiseptic. Complex influence of the listed types of antiseptics on the microbial cell and macroorganism. The surgeon in his work tends to get the maximum antiseptic effect and, as a rule, uses several types of antiseptics. A classic example of the practical use of mixed antiseptics is the modern tactics of treating wounds. Primary surgical treatment( physical and mechanical antiseptics) is supplemented by the appointment of antibiotics( biological antiseptics), the appointment of physiotherapy( physical antiseptic).

Depending on the method of application of antiseptic drugs, antiseptic is isolated: superficial and deep.

With a surface antiseptic, the drug is used in the form of ointments, powders, with deep antiseptic - it is injected into tissues in the area of ​​the wound or inflammatory focus( chipping, blockades).

There is also a local antiseptic when the drug acts at the injection site, and the total - injected away from the source of infection the substance is delivered by a current of blood or lymph. As a transition from local antiseptic to general, regional perfusion of antiseptic drugs in the blood vessels that feed the affected organ or limb section should be considered. This creates a high concentration of drugs at the site of infection with a harmless concentration in the body. Applying this or that kind of antiseptic, it is necessary to take into account the side effects of various agents that can cause intoxication( chemical antiseptics), damage to vital anatomical formations( mechanical antiseptics), photodermatitis( physical antiseptics), allergic shock, dysbacteriosis( biological antiseptics).