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Infection prevention and control
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Loveday et al. (2014) reviewed hand-cleaning preparations. They concluded that, generally, washing hands effectively with soap and water removes transient microorganisms and renders hands socially clean, which is sufficient for most care activities. Antimicrobial soap is not required for the majority of healthcare activities but should be used when there is the potential for resident flora to cause infection i.e., surgical procedures. Some antiseptics such as chlorhexidine gluconate have a residual effect, which can be beneficial where it is desirable to have sustained suppression of the growth of microorganisms. Alcohol-based hand sanitisers come in many forms; rub, gel and foam and provide an effective way to rapidly clean the hands, reducing both transient and resident flora, particularly in those locations with limited access to clean water. However, alcohol-based products are rapidly inactivated in the presence of organic matter and so should not be used on visibly soiled hands, nor are they effective against spores, so should not be used when caring for individuals with C. difficile. Alcohol hand rubs have been shown to increase the frequency of hand hygiene and so improve hand hygiene compliance, particularly if located at the point of care (Wilson 2019).
Klippel–Trenaunay syndrome: Pain and psychosocial considerations
Published in Byung-Boong Lee, Peter Gloviczki, Francine Blei, Jovan N. Markovic, Vascular Malformations, 2019
Jamison Harvey, Megha M. Tollefson, Peter Gloviczki, David J. Driscoll
Patients with KTS are prone to cellulitis. Chronic lymphedema is a major cause of cellulitis and lymphangitis, with 13% of patients experiencing infections due to cellulitis.4 These patients are more susceptible to infection because of poor skin integrity associated with impaired venous and lymphatic drainage. Thus, it is imperative for patients to maintain excellent skin hygiene and wash the affected body parts thoroughly with soap and water at least twice daily. For patients with recurrent cellulitis, dilute bleach baths or soaks can be helpful. The preparation includes 0.5 cups of household bleach to a full bathtub (approximately 40 gallons) of lukewarm water. It is important that they wear clean stockings every day and allow their shoes and feet to dry between shoe changes. In addition to the above-mentioned supportive measures, the mainstay of treating pain associated with cellulitis and/or lymphangitis is treatment of underlying infection.
Medical Management of Chemical Warfare Agents
Published in Brian J. Lukey, James A. Romano, Salem Harry, Chemical Warfare Agents, 2019
Patient decontamination requires at least two lanes. The first is an ambulatory decontamination lane, subdivided into two lanes according to gender to address privacy issues. Here, ambulatory patients can be decontaminated with showers supplying low-pressure high-volume warm water and gentle washing (avoid scrubbing, which abrades skin) with a liquid non-particulate non-caustic soap. Soap acts as a surfactant and increases the removal of contaminant from the skin. Avoid bleaching agents that may damage the integrity of skin. (Although military decontamination protocols employ bleaching agents, this is only because many areas in which the military operates lack sufficient quantities of water for decontamination. In World War I, large numbers of decontamination showers were set up in field hospitals.) All of this is to prevent microscopic abrasion of the skin, which would increase the dermal (skin) absorption of chemical agents by the human body. Careful attention should be paid to the use of warm (>65 °F), not cool or cold, water (USASBCCOM, 2002). While conduction, convection, and radiation all contribute to heat loss or gain, evaporative cooling is by far the most efficient method of heat loss known. Evaporation of cool or cold water from the surface of the skin creates huge losses of body heat that can quickly lead to the development of hypothermia. One should also remember that in experimental animals, severe exposure to certain nerve agents resulted in lowering of the basal body temperature (resetting of the body’s thermometer) in the postictal (post-seizure) state.
Antimicrobial lipids in nano-carriers for antibacterial delivery
Published in Journal of Drug Targeting, 2020
Qianyu Zhang, Wen Wu, Jinqiang Zhang, Xuefeng Xia
The antimicrobial activity of certain lipids has been known for over a century [1]. The earliest report on the disinfection using lipids was reported by Robert Koch in 1881 when he found that the diluent of potassium soap could effectively stop the growth of anthrax bacillus in nutrient broth, which is the cause of anthrax [2,3]. This study emphasised on the application of soaps whose major component is alkali salts of fatty acid for its antimicrobial capacity. In the following decades, researchers have demonstrated that fatty acids possessed bactericidal or bacteriostatic effect against a spectrum of pathogens such as the streptococcus, pneumococcus, diphtheria bacillus and typhoid bacillus [4,5]. However, studies on antimicrobial lipids such as fatty acids have been eclipsed mainly due to the advent of antibiotics such as penicillin in the late 1940s. Antibiotics ushered in a new era of antimicrobial treatment and saved countless lives over the years, but its drawbacks became apparent as well. Antibacterial resistance against antibiotics is now an urgent global issue due to the evolution of bacteria under the selective stress of antibiotics.
Treatment of molluscum contagiosum with an East Indian sandalwood oil product
Published in Journal of Dermatological Treatment, 2018
Commonly used treatments such as cryotherapy or curettage may require multiple treatment sessions, are generally painful and have the potential for residual scarring. Other topical treatments such as cantharidin or salicylic acid preparations can be irritating. The absence of pain, scarring, inflammatory response or other side effects make this an attractive potential treatment, especially for the pediatric population. One subject with molluscum lesions on the face and another with lesions in the anogenital area had resolution with no irritation, discomfort or discoloration of the skin. Sandalwood soap has been used for centuries as a cosmetic soap for its moisturizing effects and is well tolerated around the face and eyes, making it an attractive treatment for a wide variety of patients.
Current and future treatment options for community-associated MRSA infection
Published in Expert Opinion on Pharmacotherapy, 2018
A. Khan, B. Wilson, I. M. Gould
Prevention and control of CA-MRSA should be emphasized in certain settings outside of the healthcare environment, such as nursing or residential homes, military barracks, prisons, hostels, swimming pools, and gyms [100]. Farm workers may also be at risk of exposure to LA-MRSA, and standard infection and prevention precautions should be taken in this setting also [100]. As household contacts are at increased risk of acquisition, infection prevention and control in this setting is also important. Importantly, a household approach to decolonization is more effective than measures performed by individuals alone, as asymptomatic carriers act as reservoirs for transmission [104]. In terms of soap usage in preventing transmission, it has been shown that plain soap is as effective as soaps advertised as being ‘antibacterial’ [105]. Indeed, there is a theoretical risk that antibacterial soaps may actually worsen the risk of resistance developing within bacteria that are exposed to these agents [105]. The FDA has very recently banned the use of triclosan in over the counter health products, including soaps.