1. Mechanical; 2. Physical; 3. Chemical; 4. Biological.

The principle of modern antiseptics - complexity, simultaneous or consecutive use of all 4 of its types.

Slaid 31 The mechanical antisepsis: the hygienic bath, shaving, and extermination of tissues lacking vital capacity. In 1898 Fridrih P. proposed the primary surgical treatment of a wound by means of cutting off its borders, walls and a bottom within healthy tissues.

Slaid 32

A number of receptons is for this purpose used:

a) the wound toilet - is carried out by removal by tools of the foreign matters which are torn away and freely lying in a wound or by washing away their sterile antiseptic r-mi physiological concentration.

Use of the modern equipment and methods of quantitative bacteriology allowed to use large amounts of the sterilizing liquids for washing. In recent years its processing by means of the pulsing stream is made for a toilet of a wound. By means of cavitation BONDS.

B) Primary surgical processing of a wound – the most optimum processing of a wound no later than 12 hours after wound.

C) Secondary surgical processing of a wound is carried out in cases when wound process was complicated by an infectious inflammation. Necrotic fabrics are removed, it becomes clear, whether isn't present in a wound of purulent pockets or zatek. Seams on a wound aren't imposed, operation finish drainage of purulent cavities.

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Physical - the creation of unfavorable conditions for development of microorganisms in a wound and for suction of microbe toxins and products of tissue decay. The drainage provides the outflow of wound contents and promotes the removal of toxins, microbes and products of tissue decay. Irrigation of gauze with hypertonic solutions highly increases its hydroscopic quality but tampons with wound exudation prevent the outflow from the wound, which is why they are not good for drainage.

The open method of treatment can be used (ATU). The wounds are dried; as a result, unfavorable conditions for development of microorganisms are created.

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Chemical antiseptics. It is the method of fight against an infection in a wound based on use of chemicals which have bactericidal and bacteriological effect.

Slaid 35

Classification of anti-septic tanks. To destination and to a method of application. allocate: 1) disinfectants for processing of tools and washing of walls, floors; 2) antiseptic substances of external application for processing of skin of hands of the surgeon, washing of wounds, cavities; 3) chemotherapeutic means - in an organism - chemical antibacterial means for fight against an infection in a wound.

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Chemical substances

1. The group of haloids - the derivatives of chlorine and iodine. Their interaction with hydrogen of a microbe cell causes coagulation of protoplasm proteins. They use chloramin B (0,5 – 2% solution), iodonate (1% water solution), uodopiron, and iodophorm.

2. Oxidants, getting in contact with tissue, release oxygen with possesses a strong oxidizing effect, thus unfavorable conditions for anaerobic and putrefactive microbes are created. They use: the solution of hydrogen peroxide (3% water solution), potassium permanganate (0,1-2% water solution).

3. Acids and alkalis - more often salicylic acid and boric acid, sodium hydrocarbonat are used.

4. Aldehydes are strong bactericidal preparations: formaldehyde, glutaldehyde, and hexamethylentretramine. Severe toxic.

5. Spirits are strong disinfective means. As usual ethyl spirits (70-96% solution) are used. Slaid 37

6. Hypertonic solutions - are weak antiseptics possessing irritating and counter-attracting effects. They use the hypertonic solutions of sodium chloride (10%), glucose (10% and 40% solutions).

7. Salts of heavy metals - are strong and drastic antiseptics clocking sulphohydrical groups and causing the protein coagulation of microorganisms. Many substances of this type are not used now because of their toxic effects. They use the preparations of silver.

8. Phenols are processing products of coat-tar, oil and resins. They denaturate and coagulate proteins of protoplasma in bacteria. There are phenocarbolic acid, birch tar, ihtiol, and naphtalene oil.

9. Dyestuffs – are organic combinations dying tissue and processing bactericidal effect: methylene blue, brilliant green, and acridine lactate (rivanol).

10. Detergents – are drastic surface-active combinations, retailing to the group of ammonium bases. They are widely used ammonium bases. They are widely used in surgerv and an operating field. They are widely used in surgery for treatment. There are cerigel, degmicide, hexidine chloride, roccal etc.