Trauma and Poisoning
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
Estimation of the area of a burn is often performed using the "rule of nines," which divides the body into areas each corresponding to a multiple of 9% of the body surface area (BSA). Treatment of all burns involves strict asepsis (freedom from infection; a = without, sepsis = infection) and care of the wound, relief of pain, control of infection, correction of attendant anemia, maintenance of nutrition, and prevention or relief of shock. Treatment of shock always takes precedence since the fluid and protein loss through burned surfaces can be enormous. Local treatment of the wound may be open (exposed to the air) or closed (covered), depending on the type of wound and area burned.
The art and science of surgery
Lois N. Magner, Oliver J. Kim in A History of Medicine, 2017
By the end of the nineteenth century, many surgeons had joined microbiologists in using improved methods of sterilization and were full participants in the debates concerning the relative merits of heat versus chemical sterilization and antiseptic versus aseptic methods. The goal of antisepsis is to kill the germs in and around a wound by means of germicidal agents. The goal of asepsis is to prevent the introduction of germs into the surgical site. Because almost all wounds contain some microbial contaminants, the concept of aseptic wounds is essentially a microbiological myth. On the other hand, antiseptics alone cannot guarantee uncomplicated healing; the immunological status of the patient and the pathogenic burden are important factors. Lister generally preferred his own antiseptic methods and, despite his admiration for Louis Pasteur, insisted on keeping his instruments in carbolic acid even after Pasteur and Charles Chamberland demonstrated that heat sterilization was superior to chemical disinfection of surgical instruments. Chamberland's autoclave, a device for sterilization by moist heat under pressure, was in general use in bacteriology laboratories in the 1880s.
Operation Theatre: Design and Sterilization
Pradeep Venkatesh in Handbook of Vitreoretinal Surgery, 2023
Strict asepsis is a hallmark of all modern-day surgeries. Asepsis and sterile surgical technique remain the pillars for protecting the patient and for rendering the most satisfactory result from surgical intervention. Aseptic technique is constituted by the series of practices employed to prepare the environment, the personnel, and the patient, since it is near impossible to sterilize these. Practices employed to prepare the instruments, supplies, and other inanimate objects used during surgery are designated as sterile technique. The former decreases or abolishes the pathogenic load, while the latter clears all living organisms in both the vegetative and spore state. Previously, sterilization was considered an absolute process by which all micro-organisms were destroyed. This is, however, impossible because micro-organisms die logarithmically. A practical definition implies reduction of micro-organism load to a level below that required to cause infection.
Subcutaneous injections: A cross-sectional study of knowledge and practice preferences of nurses
Published in Contemporary Nurse, 2023
Özlem Fidan, Arife Şanlialp Zeyrek, Sümeyye Arslan
Ensuring asepsis and antisepsis of the sites of administration sites for prevention of infection is critical (WHO, 2010). While more than half of the nurses indicated that they provided antisepsis on the site before subcutaneous injection, the others stated that they cleaned it either sometimes or not at all. A study from India reported that 72.42% of the individuals giving themselves insulin injections did not clean the site before the injection (Gawand et al., 2016). Turaç and Ünsal (2018) stated in their study that although 84.9% of the nurses stated that the use of disinfection of the injection site is always necessary, 69.7% of the nurses do not disinfect the injection site. Erek Kazan and Görgülü (2009) states that the nurses wipe the area with alcohol but do not wait for the alcohol to dry. According to a review examining the clinical efficacy of skin preparation before the injections, it is unclear whether skin cleansing is necessary or not (Dulong et al., 2020). According to Theofanidis (2017), nurses disinfect the skin before insulin injections as a longstanding medical ritual, despite the lack of evidence on the need for disinfection. At this point, the differences in the literature may have affected the practices of nurses.
Prospective study evaluating post-operative central nervous system infections following cranial surgery
Published in British Journal of Neurosurgery, 2019
Yi-Fang Ma, Liang Wen, Yu Zhu
Prior to the introduction of asepsis and prophylactic antibiotics, the incidence of surgical site infections was high.5–7 Even now, some studies have reported an incidence of PCNSI exceeding 5%, which suggests that it remains a significant threat to patients undergoing cranial surgery.8–11 A retrospective study performed by our research group reported an incidence of 7.4%, which was higher than the rates reported in most other studies. Because a high incidence of PCNSI represents a risk to the lives of patients, our institution implemented a series of methods aimed at decreasing the rate of infections. The primary purpose of the present study was to evaluate the efficacy of these methods; the total PCNSI incidence of 1.8% observed in the present study was much lower than that in our previous study.
Potential clinical value of catheters impregnated with antimicrobials for the prevention of infections associated with peritoneal dialysis
Published in Expert Review of Medical Devices, 2023
Hari Dukka, Maarten W. Taal, Roger Bayston
PD fluid is commercially supplied in bags, which come connected to a Y-shaped giving set. The patient manually connects the short arm of the Y connector to the PD catheter. The other arm of the Y-shaped giving set is attached to an empty dialyzate bag (Figure 2). A small volume of dialysis fluid is drained directly from the new bag into the empty bag and in principle this flushes away any bacteria at the end of the catheter. This has been named the ‘flush before fill’ technique. After this, the dialysate in the peritoneal cavity from the previous exchange is drained out into the empty bag. Once this process is finished, fresh dialysis fluid is infused into the peritoneal cavity via the PD catheter after clamping the long arm of the Y connector, which leads to the bag that now contains drained dialysate. The ‘flush before fill’ technique has been shown to reduce peritonitis rates [11]. Patients are trained to follow strict hand hygiene and to follow an aseptic technique while performing exchanges to reduce the risk of infections.
Related Knowledge Centers
- Antiseptic
- Fermentation
- Parasitism
- Pathogenic Fungus
- Sterilization
- Surgery
- Virus
- Pathogen
- Pathogenic Bacteria
- Putrefaction