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PubMed1989

Postoperative wound scoring.

Assessing postoperative wound sepsis rates is important from both an economic and an audit point of view. Most definitions of wound sepsis are too narrow and too subjective and wound scoring systems that have been developed to counteract these deficiencies suffer from a lack of objectivity, making valid comparisons between wound sepsis rates in different institutions impossible. The ASEPSIS scoring system is a definite advance in this area and its proven reproducibility makes it invaluable in multicentre trials assessing wound sepsis. However, it has limitations, mainly associated with the underlying assumption regarding the linearity of the ASEPSIS index. It is felt that by closely examining ASEPSIS wound scores from a large number of patients it may be possible to improve this scoring system.

Antisepsis↗
PubMed1979

Office sterilization and asepsis procedures in endodontics.

Available evidence that there has been an epidemic of hepatitis B in the population since the 1960s and of the vulnerability of clinical dental and endodontic personnel has indicated a need to improve general asepsis procedures to guard against the spread of infection, and to improve screening for possible carriers. Specific improvements in personal protection, surface disinfectants and procedures, and control of bacterial populations in dental water units as well as broader use of instrument sterilization can provide safer conditions of treatment for patients and personnel alike. Monitoring of asepsis can increase awareness and guide improvements of skills in aseptic treatment, and improved methods of transporting samples can improve recovery of anaerobic pathogens for determinations of antibiotic susceptibility.

Antisepsis↗
PubMed1975

[The history of wound dressings (author's transl)].

The introduction of antisepsis and asepsis brought about decisive changes in the dressing of wounds. For thousands of years, dressing material had been regarded as protection for wounds, absorbent material, or a base for healing substances, while healing per secundam intentionem by the production of "pus laudabile" was the general rule. With the advent of antisepsis, dressings became a type of medication, healing the wounds per primam intentionem. Different materials have been used over the years, but the most important steps in the development of new dressings were made in the nineteenth century, with the introduction of a degreased cotton and of medicated plasters.

Anti-Infective Agents, Local↗
PubMedDate not supplied

Divided responsibilities for operating room asepsis: The dilemma of technology.

Asepsis and concern for patient safety in the operating room are team responsibilities involving nurses, surgeons, and anesthesiologists. Meaningless rituals now being observed in the OR must be replaced by practices and procedures based on sound principles of aseptic technique. Modern instrumentation and technology, though relieving the surgeon and anesthesiologist of many of the manual tasks which once occupied them, have not solved the problems of infection control in the operating suite. Apathy, carelessness, and indifference may even increase as a by-product of technology, unless curbed by moral, ethical and legal constraints. Asepsis is not a static concept. Operating room policies and procedures need constant review and reexamination. Enforcement of these policies and rules to maintain good aseptic technique requires the cooperation of all who enter the OR suite.

Antisepsis↗
PubMed1980

A pragmatic approach to asepsis in the orthodontic office.

It is incumbent upon each orthodontist to conduct his or her practice in a manner that will not cause harm to anyone. By following the procedures described here the orthodontist can minimize and even prevent the possibility of cross-infection. This is the best protection against the transmission of hepatitis and other diseases and perhaps the filing of a malpractice suit.

Antisepsis↗
PubMed1989

[The asepsis problem at the office of the ENT physician].

Microorganisms were determined in a microbiological study in the near environment of ENT working places. We found especially saprophytic flora as Micrococcus sp., Staphylococcus epidermidis and aerobic spore-forming microorganisms on 54 examination instruments of 2 outpatient and 2 inpatient treatment areas. In 22% of the instrument examinations, microbiological controls were negative. There were no pathogenic microorganisms.

Antisepsis↗
PubMed1964

ASEPSIS IN THE OPERATING THEATRE.

In the investigation of several blood stream infections following open-heart surgery, sutures and other material that had been exposed and handled in the sterile field were examined bacteriologically. One hundred and seventy-five open-heart operations were carried out during the study period and a high percentage of the specimens cultured yielded viable staphylococci and diphtheroids. Glove powder, textile fibres, and skin squames were found in the dust that collected in the room during the operations and staphylococci were frequently recovered from this source, and from the floor. Although the air supply to the theatre appeared to be of good quality, it is suggested that air currents within the room had caused dissemination of this foreign material and had probably contributed to wound infections.

Antisepsis↗
PubMed1982

[Bacterial nosocomial infections in urology: defective wound healing].

The highest incidence of defective wound healing in all surgical disciplines is observed after urological operations. Wound infections occur in more than 8% of all urological patients. Defective wound healing appears in about 17% of unselected nephrectomy cases, rising to 50% when pyonephrosis is present. Simple adenomectomy is associated with wound infection rates of between 8 and 12% in preoperatively uninfected patients and up to 50% in patients with preoperative bacteriuria. Numerous factors may influence wound healing, e.g. age, obesity, cachexia, chronic infectious and non-infectious diseases, anaemia, thrombopathy, faulty asepsis and antisepsis, preoperative showering and shaving, skin preparation, hand degerming, skin draping, duration of hospitalization, traumatic operative technique, suture material, diathermy, timing and length of operation, duration of hospitalization, and antibiotic regimen. Strict attention has to be paid to these factors if the incidence of postoperative wound infection is to be kept within reasonable limits.

Age Factors↗
PubMed1983

Asepsis and out-patient cystoscopy.

Cystoscopy was performed on a control group of 74 patients under full sterile precautions and on a study group of 83 patients under aseptic conditions, which required fewer materials. The incidence of urinary infections in the two groups was 4 and 6% respectively; this difference is not statistically significant. Rigors were rare in both groups (1%). The financial savings achieved by using an aseptic technique for out-patient cystoscopy are discussed.

Antisepsis↗
PubMedDate not supplied

[Neurosurgery in strict asepsis. First trials in an operation isolator during the placement of 10 ventriculoperitoneal derivations].

Authors report on a series of ten ventricular-cardiac or peritoneal derivations performed under operative field isolation, air-tight and sterile enclosure that makes possible to perform surgery under strict aspsis. The first results compared with those mentioned in the medical literature, let foresee a fall in the occurence of post-operative infections. The technique is adaptable to neurosurgery and does not complicate the operative process.

Antisepsis↗
PubMed1987

[Berolina iubilans: Berlin physicians as Halle doctoral candidates (VI). Curt Schimmelbusch (1860-1895), Halle doctoral candidate of 1886].

The history of asepsis is closely connected with the name of Curt Schimmelbusch. The physician who was awarded the doctor's degree in Halle in 1886 as co-worker of the histologist and pathologist Eberth at first dealt with research in the field of thrombosis. He became famous all over the world by his investigations concerning the development and scientific fundamentation of mechanical sterilisation methods which he performed under Ernst von Bergmann in Berlin. In this field the name of Curt Schimmelbusch is rooted in the special terminology.

Antisepsis↗
PubMed1977

[Hygiene and asepsis in surgery: introduction (author's transl)].

Since the development of asepsis and clinical hygiene by European and American surgeons in the second half of the nineteenth century, the prevention of infection has been one of the most important concerns of surgical practice. However, owing to the rapid expansion of therapeutic methods, medical practice now makes greater demands on clinical hygiene than has hitherto been the case; it has not always been possible for developments in clinical hygiene to keep pace in this respect, and the closing of the resulting gap represents one of the most urgent tasks confronting medicine today.

Age Factors↗
PubMedDate not supplied

The surgeon's responsibility for asepsis.

Eighty percent of postoperative wound infections result from bacteria acquired elsewhere than in the operating room. Concomitant infections--such as dermatitis; periodontitis; infections of the respiratory, gastrointestinal, or urinary tracts--are not identified preoperatively, despite a threat to the patient greater than that of anesthesia and surgery combined. Isolation of overt infection is neglected. The entire hospital becomes a reservoir of bacterial debris that is reflected in the carriage of pathogens by personnel and patients. Infections are often initiated by medical devices that invade the vascular system, respiratory tract, or urinary bladder. Professional leadership at the bedside is the key to detecting and correcting breaches in technique and setting an example of a philosophy of total patient care.

Antisepsis↗
PubMed1975

[Neurosurgery under strict asepsis. Effect of the surgical isolator on the level of infections after valve shunts for hydrocephalus].

The authors report on two groups of 75 shunts for hydrocephalus. Each group includes both cases in which the shunt was implanted for the first time and cases in which the repair of a former shunt was necessary either for mechanical or infectious complications. The operations within the first group were performed with traditional techniques; those of the second group were carried out during the same period of time and by the same team, but with the use of a surgical isolator. The overall rate of early infections was greatly reduced in the second group. Careful analysis of the infections which still occured with the surgical isolator indicated that they were related to the reappearance of a preoperative infection or to secondary contamination through post-operative cutaneous complication. In this second group using the surgical isolator, no contamination occured during the operation itself.

Antisepsis↗
PubMed1982

[Bacterial nosocomial infections in urology: nosocomial urinary tract infections].

The range and extent of infections acquired in hospitals depend firstly on the organisms occurring in the hospital concerned, secondly on the incidence of transmission, depending on the standard of hygiene in the hospital and, finally, on the resistance of the patient. In the past decades changes have taken place in the sphere of all three factors with a resultant unfavourable increase in nosocomial infections. Reasons for this development are found in the widespread, massive and often irrational administration of antibacterial chemotherapeutic agents (leading to selective resistance of hospital bacteria), in neglect of the rules of asepsis and antisepsis and also in an increased disposition of patients towards hospital infections. About 50% of all nosocomial infections affect the urinary tract and 70% of these cases are caused by catheterization of the bladder. Special attention must be paid to correct technique in placing the catheter and in deviating the urine (closed drainage systems). The incidence of nosocomial urinary tract infections and the species of organisms involved have been favourably influenced by a new antibiotic regimen, as well as improved hygienic measures in the Urological Department of the Allgemeine Poliklinik der Stadt Wien (reduction in the mean postoperative infection rate following adenomectomy from 90 to 40%; decrease in typical hospital organisms such as Pseudomonas aeruginosa from over 50 to below 10% and in indole-positive Proteus strains from 25 to below 5%).

Anti-Bacterial Agents↗
PubMed1981

Long-term vascular access in the rat: importance of asepsis.

Chronic indwelling vascular catheters have been used in the rat for many types of experimental studies. Most experiments have been of short duration with little attention to aseptic technique during catheter placement. In this study, rats subjected to a sterile superior vena cava (SVC) catheterization technique, a convential clean but nonsterile SVC catheterization technique, or sham operation were compared. Male Fischer 344 rats (wt 175-200 g) were catheterized or sham operated and then received food and water ad libitum for 25 days. At time of spontaneous death or being killed the SVC was examined grossly and microscopically for infection. Three of six nonsterile conventionally catheterized animals died, and five of these six animals had infected catheters. All sterilely catheterized and sham-operated rats lived 25 days, and none had catheter infection. Sterilely catheterized rats gained weight (1.9 g/day), were in positive nitrogen balance, and had organ weight and blood studies similar to sham-operated noncatheterized controls. Nonsterile catheterization resulted in catheter infection such that normal physiological studies would be uninterpretable.

Animals↗
PubMed1986

[Hospital infections in changing times].

It has already been known in ancient medicine that diseases with similar clinical picture can occur all at once at a certain place and under certain climatic conditions, and the Hippocratics dedicated a special book of their Hippocratic Scriptures to epidemics. The symptom complex of what is nowadays called "hospitalism", however, could only develop when the first hospitals were founded in early Christian cultures, which means social foundations, which were not at all hospitals like today, but social institutions for the old people, for pilgrims and--only in the third place--an asylum for poor, homeless, ill people. As well as in other places where large numbers of people are crowded together under poor hygienic conditions, e.g. in prisons or on overcrowded ships, in those overcrowded hospitals, which were called "Nosokomeion" in the Byzantine world and thus might well have been institutions where nursing of sick people was done, specific epidemic diseases occurred which were rarely found in individuals living in freedom or at their domiciles. Like all other epidemics, they were thought to be attributed to a miasma transported by the air and resulting from bad vapours, and it was for two milleniums that this remained the explanation for infectiosity. As in the hospitals before introduction of anti- and asepsis wound-healing per secundam, i.e. purulence, was regarded as normal and pus was called "Pus bonum and laudabile", which was thought to be the supposition for wound-healing and was the reason for the infernal stench which one could smell. One attributed the occurrence of miasma to this component. It was therefore attempted to combat the hospital infections by all means with desodorizing procedures, thus trying primarily to suppress the stench by frequent whitewashing of the rooms, spraying of vinegar, by burning powder and even using precious incense. On the other hand, various infectious diseases could easily be brought into those overcrowded hospitals, where often three up to six patients had to share one bed, so that still in 1865 no less a person than the famous Theodor Billroth (1829-1894) felt himself obliged to warn of the dangers of a stay in hospital. The danger of "hospitalism" or of "nosocomial infection" let the rich refrain from going into a hospital, until the progress in surgery, which was initiated by the introduction of narcosis, allowed surgical treatment only to be effected in hospitals.(ABSTRACT TRUNCATED AT 400 WORDS)

Antisepsis↗