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Fundamentals of Injectable Filler Procedures
Published in Yates Yen-Yu Chao, Sebastian Cotofana, Anand V Chytra, Nicholas Moellhoff, Zeenit Sheikh, Adapting Dermal Fillers in Clinical Practice, 2022
Yates Yen-Yu Chao, Sebastian Cotofana, Nicholas Moellhoff
With adequate cleansing of the skin, the treatment area should be prepared again with disinfectants. Because the injection of fillers is mostly a procedure of the face and is envisaged as a quick minimally invasive procedure, iodophor or polyvidone-iodine is not a good choice because it discolors patients’ faces and its benefit of broad coverage against fungi, viruses, protozoa, cysts, and spores is not necessary for the usual clean facial skin intended for aesthetic injections. Chlorhexidine is a wide-spectrum bactericidal effective against Gram-positive and Gram-negative bacteria but less effective against some species of Pseudomonas and Proteus and relatively inactive against mycobacteria and bacterial spores. An amount of 0.5% solution in alcohol (70%) is indicated for pre-procedure skin preparation. An amount of 70% isopropyl alcohol or ethanol is representative disinfectants, but irritation occurs sometimes.
First Stage Of Labor
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
There is no evidence to support the use of vaginal chlorhexidine by either irrigation or vaginal wipes during labor in order to prevent maternal and neonatal infections. The effect on the incidence of postpartum endometritis is not statistically significant (relative risk [RR] 0.83; 95% confidence interval [CI] 0.61–1.13) [2]. Chlorhexidine solution is safe and inexpensive, and vaginal irrigation is easy to perform, but not beneficial. In summary, vaginal chlorhexidine by either irrigation or vaginal wipes during labor is not recommended.
Management of COVID-19 Rehabilitation Nursing
Published in Wenguang Xia, Xiaolin Huang, Rehabilitation from COVID-19, 2021
Quick-drying hand disinfectant is preferred when sanitizing hands, and other hand sanitizers can be used for allergic people. Chlorhexidine is ineffective in inactivating coronavirus, so it is not recommended. Hand disinfectants containing chlorine, alcohol, hydrogen peroxide, and other ingredients are recommended.
Lichenoid lesions of the upper labial mucosa: a systematic review and a report of a new case with extensive follow-up
Published in Acta Odontologica Scandinavica, 2023
The etiopathogenesis of lichenoid lesions of the upper labial mucosa and the factors provoking them have been subject to speculation from several investigators. Blomgren et al. [11] hypothesized that hypersensitivity to composite restorations, trauma from fillings, lip parafunction, increased lip pressure, or microbial effects (especially Candida-connected) could contribute to the development of these lesions [11]. Backman and Jontell [12], in turn, reported improvement or healing in most cases, wherein chlorhexidine was the only treatment, and they speculated that microbial irritation might initiate such lesions. In addition, they pointed to a possible association between medication- or mouth breathing-associated hyposalivation and development of the lesions [12]. The review we conducted, however, yielded insufficient data on any provoking factors that could consistently explain them in the cases reported. Our patient visited an oral hygienist regularly, maintained good oral hygiene, used chlorhexidine periodically to eliminate irritation from dental plaque and avoided irritating food, all with no significant improvement to the lesions or the symptoms. Oral fungal infection or candidiasis seems to be an uncommon finding in these patients, though it was present in our case, in cases presented by Mainville et al. [17], and in one case from Robinson et al.’s [13] work.
Pediatric impetigo: an expert panel opinion about its main controversies
Published in Journal of Chemotherapy, 2022
Luisa Galli, Andrea Novelli, Giuseppe Ruggiero, Stefania Stefani, Anna Belloni Fortina
Currently, topical disinfectants do not represent a valid treatment for impetigo, although they could be used in addition to the standard therapy for prevention of recurrence [7]. Sodium hypochlorite baths (10 mL of sodium hypochlorite in a liter of water) have been used effectively to decrease bacterial carriage in populations with recurrent infections, such as those that manifest in patients with atopic dermatitis [23]. Dilute bleach baths may help alleviate local skin infections. 0.025% sodium hypochlorite was found to be bactericidal against Gram-positive and Gram-negative bacteria [24] and may help prevent the spread of S. aureus within families. Fisher and Colleagues found that after 5 min in a bath of sodium hypochlorite it was most effective at killing multiple community-acquired MRSA strains [25], being useful for MRSA decolonization. On the contrary, according with the Centers for Disease Control and Prevention (CDC), chlorhexidine is not recommended for patients younger than 18 years because of its risk of skin irritation and hypersensitivity reactions, due to a significant impairment of the epidermic barrier. Allergic contact dermatitis to chlorhexidine has been well known since the first publication by Calnan in 1962 [26]. Being a problem of great concern, the Food and Drug Administration (FDA) has issued an alert concerning hypersensitivity reactions to chlorhexidine-impregnated medical devices. Povidone-iodine is a preferable option (expert for neonates) being less aggressive to the stratum corneum than chlorhexidine [27].
Sublabial Approach to Tip Rhinoplasty: A Cadaver Model
Published in Journal of Investigative Surgery, 2022
Jason E. Cohn, Tyler Pion, Sammy Othman, Timothy M. Greco
As with any surgical technique, there are potential downsides as well. Surgeons could encounter problems with the grafts, including absorption and fracture, which can be resolved with proper pocket dimensions and adequate transfixation. Cohen et al even proposes adding a crescent-shaped graft to provide support to the fixed graft [4]. Potential concern with the sublabial approach in general includes microbial contamination in the oral cavity. Rauso and colleagues recommended prophylactic amoxicillin clavulanate (Augmentin) twice daily for 6 days, initiated 6 hours prior to surgery. Postoperative care plan included delmopinol hydrochloride mouthwash 0.2% and application of a gel with a pool of amino acids and sodium hyaluronate on the wound, 3 times daily for 10 days [11]. Chlorhexidine solution is an acceptable alternative given is common use in the oral cavity [31]. Additionally, patients were instructed to avoid brushing or smoking for a couple days post-surgery, and there was no infection in any of the 14 patients [11].