Not only green. Modern antiseptics in the prevention of infections associated with the provision of medical care Antiseptics and other

Antiseptics (antiseptics)

Antiseptics (from the Greek "against decay") are called antimicrobial agents that retard the development of microorganisms, and disinfectants are substances that kill microbes. Accordingly, a bacteriostatic effect is distinguished, when the development of microorganisms stops, and a bactericidal effect, when microorganisms die completely.

It is easy to see that there is no fundamental difference between antiseptic and disinfecting substances, as well as bacteriostatic and bactericidal action, since any antimicrobial agent, depending on the conditions of its use, in some cases can cause a delay in the development of microorganisms, and in others - its death. A large number of different antiseptics can be systematized in many ways. According to the methods of application, agents for antiseptic effects on the skin, mucous membranes are distinguished. gastrointestinal tract, respiratory, urinary tract etc.

By chemical structure antiseptics are classified according to the classes of chemical compounds to which they belong, which reflects the mechanism of their action. This is a group of halides (antiformin, iodoform, iodinol), oxidizing agents (hydrogen peroxide, potassium permanganate), acids (salicylic, benzoic, boric), alkalis (ammonia), aldehydes (formalin, lysoform), alcohols (ethyl), salts of heavy metals (preparations of mercury, silver, copper, zinc, lead), phenols (carbolic acid, lysol, resorcinol), dyes (methylene blue, brilliant green), soaps (green), tar, resins, petroleum products (ASD, ichthyol, oil naftalan, ozokerite), volatile and other vegetable antibacterial drugs(urzalin, calendula tincture, imanin).

Antiseptics. Halogen group:

Chloramine b. White or slightly yellowish powder with a slight smell of chlorine. Let's dissolve in water, alcohol, contains 25-29% of active chlorine. Has an antiseptic effect. It is used in the treatment of infected wounds (washing, wetting swabs and wipes with 1-2% solutions), disinfection of hands (0.25-0.5%), and disinfection of non-metallic instruments. For disinfection of care items and secretions for typhoid, paratyphoid, cholera and other infections of the intestinal group and for drip infections (scarlet fever, diphtheria, influenza, etc.), 1-2-3% solutions are used, for tuberculosis infection - 5%.

pantocide, release form - tablets, each contains 3 mg of active chlorine. Used as an antiseptic for hand disinfection (1-1.5% solutions), douching and wound treatment (0.10.5%), for water disinfection (1-2 tablets per 0.5-0.75 l of water), which takes place within 15 minutes.

Iodine- obtained from the ashes of seaweed and drilling oil waters.

There are 4 groups of iodine preparations:

inorganic iodides (potassium iodide, sodium iodide);

organic substances that split off elemental iodine (iodoform, iodinol);

Being absorbed, iodine as an antiseptic has an active effect on metabolism, especially on the functions thyroid gland. daily requirement body in iodine is 200-220 mcg. Iodine is excreted from the body mainly by the kidneys, partly by the gastrointestinal tract, sweat and mammary glands.

Inside, iodine preparations are used as an expectorant (increase the secretion of mucus by the glands respiratory tract), with atherosclerosis, tertiary, hypothyroidism, for the prevention and treatment of endemic goiter, with chronic mercury and lead poisoning. With prolonged use of iodine preparations and hypersensitivity to them, iodism phenomena (runny nose, urticaria, salivation, lacrimation, rash) are possible.

Contraindications for taking iodine preparations inside are: pulmonary tuberculosis, nephritis, nephrosis, furunculosis, chronic pyoderma, hemorrhagic diathesis,.

Outwardly, iodine solutions are used as an antimicrobial antiseptic for treating wounds, preparing the surgical field, etc.; exerting an irritating effect, they can cause reflex changes in the activity of the body.

Alcoholic iodine solution- 5% or 10%, used externally as an antiseptic, irritant and distraction for inflammatory and other diseases of the skin and mucous membranes. As a distraction, it is used for myositis, neuralgia.

Lugol solution. Iodine in an aqueous solution of potassium iodide - composition: iodine 1 part, potassium iodide 2 parts, water 17 parts. Lugol's solution with glycerin - composition: iodine 1 part, potassium iodide 2 parts, glycerin 94 parts, water 3 parts. Used to lubricate the mucous membranes of the pharynx, larynx as an antiseptic.

Iodoform. Applied externally as an antiseptic in the form of powders, ointments for the treatment of infected wounds, ulcers.

Iodinol, is a product of the addition of iodine to polyvinyl alcohol, which slows down the release of iodine and lengthens its interaction with body tissues, while simultaneously reducing the irritating effect of iodine on them. Used for chronic tonsillitis, purulent otitis media, chronic periodontitis, purulent surgical diseases, trophic and varicose ulcers, thermal and chemical burns.

In chronic tonsillitis, tonsil lacunae are washed (4-5 washes at intervals of 2-3 days), with purulent otitis media, instillation (5-8 drops) and washing are used. In case of trophic and varicose ulcers, gauze napkins (in 3 layers) moistened with iodinol are applied to the surface of the ulcer (the skin is first washed with warm water and soap and the skin around the ulcer is smeared with zinc ointment). The dressing is performed 1-2 times a day, and the gauze lying on the surface of the ulcer is not removed, but only re-impregnated with iodinol. After 4-7 days, a local bath is prescribed, after which the treatment is continued again. For purulent and infected burns, a loose gauze bandage impregnated with the drug is applied. With fresh thermal and chemical burns of I-II degree, a gauze bandage soaked in iodinol is also applied, the inner layer is irrigated as needed. When using iodinol, phenomena of iodism can be observed.

Iodonate, an aqueous solution of a complex of a surfactant with iodine (3%). Used as an antiseptic for disinfecting the skin of the surgical field, the drug has a high bactericidal activity

Antiseptics. Oxidizers:

Hydrogen peroxide(perhydrol) - two preparations are produced, representing a solution of hydrogen peroxide in water: a solution of hydrogen peroxide 3% and a solution of hydrogen peroxide 27.5-31% (concentrated). Both preparations are clear, colorless liquids with a slight peculiar odor. In contact with organic substances and alkalis, hydrogen peroxide decomposes with the release of gaseous oxygen, which has antiseptic properties and contributes to the mechanical cleaning of tissues. It is used as an antiseptic for rinsing and washing with tonsillitis, stomatitis, otitis media, as well as when treating wounds in solutions at the rate of 1 teaspoon or 1 tablespoon of a 3% solution per glass of water.

Hydroperite- antiseptic tablets containing a complex compound of hydrogen peroxide with urea. The content of hydrogen peroxide is about 35%. Tablets are white, easily soluble in water, the weight of one is 1.5 g. They are used as an antiseptic instead of hydrogen peroxide. To obtain a solution corresponding to approximately 1% hydrogen peroxide solution, dissolve 2 tablets in 100 ml of water. One tablet corresponds to 15 ml (1 tablespoon) of 3% hydrogen peroxide solution. For gargling, dissolve one tablet in a glass of water.

Potassium permanganate(potassium permanganate, "potassium permanganate"), dark or red-violet crystals with a metallic sheen, soluble in water. It is a strong oxidizing agent, on which its antiseptic properties depend. Used in aqueous solutions for rinsing the mouth and throat (0.020.1%), for lubricating burn and ulcer surfaces (2-5%), for washing wounds (0.1-0.5%), for douching in gynecological and urological diseases (0.02-0.1%), in the same concentration for gastric lavage in case of some poisonings as an antiseptic.

Antiseptics. Acids:

salicylic acid, white small needle-shaped crystals, odorless. Slightly soluble in cold water, soluble in hot, easily in alcohol. Applied externally as an antiseptic in powders (2-5%) and 1-10% ointments, pastes, alcohol solutions for lubricating the skin (salicylic alcohol), rubbing - into the area of ​​​​inflamed joints, for rubbing the skin - with itching, seborrhea. It is produced in finished form under the name "Corn liquid" and "Corn plaster" (salicylic acid 20 parts, rosin 27 parts, paraffin 26 parts, petrolatum 27 parts), Galmanin powder containing salicylic acid, zinc oxide (10 parts) talc and starch , Lassar pastes,

Camphocin(salicylic acid, castor oil, turpentine, methyl ether, camphor, capsicum tincture) - for rubbing in rheumatism, arthritis as an antiseptic.

Boric acid, shiny, slightly oily to the touch scales, soluble in cold water and alcohol. It is used in the form of ointments and powders for antiseptic action in case of skin diseases (baby powder "Bolus"), a ready-made paste called "Bornozinc-naftalan" is produced.

Vaseline boron- contains boric acid 5 parts, vaseline 95 parts. Applied externally as an antiseptic.

Boric alcohol, contains 0.5-5 g of boric acid, ethyl alcohol 70%. Apply this antiseptic in the form of ear drops, 3-4 drops 2-3 times a day.

Pasta Teymurova- contains boric and salicylic acid, zinc oxide, formalin, lead acetate, talc, glycerin, mint oil. It is used as a disinfectant, drying and deodorizing agent for sweating, diaper rash.

Antiseptics. alkalis

sodium borate(borax, sodium borate), colorless crystalline powder. Applied externally as an antiseptic for douching, rinsing, lubrication.

Bicarmint, tablets containing sodium borate 0.4 g, sodium bicarbonate 0.4 g, sodium chloride 0.2 g, menthol 0.004 g. Used as an antiseptic externally as an antiseptic and anti-inflammatory agent for rinsing, washing, inhalation in inflammatory processes of the upper respiratory ways. Dissolve 1-2 tablets in 1/2 glass of water.

Ammonia(ammonia solution), 10% ammonia solution in water. Clear, colorless liquid with a strong ammonia odor. It is used in surgery for washing hands and for inhalation during fainting and intoxication with alcoholic beverages.

Antiseptics. Aldehydes

Formaldehyde

(formalin), a clear, colorless liquid with a peculiar pungent odor. It is used as an antiseptic as a disinfectant and deodorant for washing hands, washing the skin with excessive sweating (0.5-1%), for disinfecting instruments (0.5%), for douching (1:2000 - 1:3000). Included in the lysoform. Formidron is a liquid containing a solution of formaldehyde 10 parts, ethyl alcohol 95% 40 parts, water 50 parts, cologne 0.5 parts. Apply to wipe the skin with excessive sweating.

formaldehyde ointment, white color with a slight smell of formalin and perfume. Apply with increased sweating, rubbed into the armpits once a day, into the interdigital folds.

Lysoform, soapy formaldehyde solution. Ingredients: formalin 40 parts, potassium soap 40 parts, alcohol 20 parts. It has a disinfecting and deodorizing effect. It is used as an antiseptic for douching in gynecological practice, for hand disinfection (1-3% solutions).

Urotropin(hexamethylenetetramine), colorless, odorless crystals, easily soluble in water. Aqueous solutions are alkaline. Used mainly for infectious processes of the urinary tract (cystitis, pyelitis). The action of the antiseptic is based on the ability of the drug to decompose in an acidic environment with the formation of formaldehyde. Prescribe the drug on an empty stomach. Indications for its use are cholecystitis, cholangitis, allergic diseases of the skin, eyes (keratitis, iridocyclitis, etc.). The drug can cause irritation of the kidney parenchyma, with these signs, the drug is stopped.

Urosal, tablets containing 0.3 g of hexamethylenetetramine and phenyl salicylate.

Kalceks- tablets of white color, salty-bitter taste, easily soluble in water. Contain 0.5 g of a complex salt of hexamethylenetetramine and calcium chloride. Apply 1-2 tablets 3-4 times a day for colds as an antiseptic. Cyminal, suppresses (locally) gram-positive and gram-negative bacteria, promotes epithelialization and wound healing. Applied externally in the treatment of wounds, pyoderma, trophic ulcers, burns. Assign in the form of a powder (for dusting) or 1-3% suspension, which is applied to the damaged surface, dressings after 3-4 days. With prolonged use of the drug, dermatitis, burning sensation and itching may occur.

Ethanol(wine alcohol), according to pharmacological properties, they are classified as narcotic substances. Influencing the cerebral cortex, it causes a characteristic alcoholic excitation associated with a weakening of the processes of inhibition. In medical practice, it is mainly used as an external antiseptic and irritant for rubbing, compresses, etc. Intravenously sometimes administered with gangrene and lung abscess in a sterile isotonic solution. Ethyl alcohol is widely used for the manufacture of tinctures, extracts and dosage forms for external use.

Antiseptics. Heavy metal salts

Sublimate (mercury dichloride),

heavy white powder, is a very active antiseptic and highly toxic. Great care must be taken when working with it. Do not allow the drug and its solutions to enter the oral cavity, mucous membranes and skin. Solutions can be absorbed and cause poisoning. Mercury dichloride is used in solutions (1:1000 - 2:1000) for the disinfection of linen, clothing, for washing walls, patient care items, for disinfecting the skin. It is also used in the treatment of skin diseases.

Mercury white ointment used as an antiseptic and anti-inflammatory in skin diseases (pyoderma, etc.).

Calomel (mercury monochloride), used externally in the form of ointments for diseases of the cornea, blennore as an antiseptic. It has a toxic effect on the body, therefore, at present, it has no value as a laxative, diuretic and choleretic, it is used only externally.

Diocide, is a good detergent and antibacterial agent. It has bactericidal activity against various bacteria and bacterial spores, as well as fungistatic activity against fungi and mold. Used as a sterilizing agent for washing the hands of surgeons before surgery, cold sterilization of equipment (cardiopulmonary bypass), surgical instruments. Silver nitrate (lapis) - in small concentrations it has an astringent and anti-inflammatory effect, in stronger solutions it cauterizes tissues, it is bactericidal. Applied externally for erosions, ulcers, excessive granulation, acute conjunctivitis. At chronic gastritis administered orally as a solution or pills. For the prevention of blennorrhea, a 2% solution of silver nitrate is instilled into the eyes of newborns immediately after birth.

Collargol, colloidal silver. Used for washing purulent wounds (0.2-1%), for washing the bladder with cystitis (1-2%), purulent conjunctivitis and blenorrhea for antiseptic action.

copper sulfate(copper sulfate, copper sulphate), blue crystals, easily soluble in water. Used as an antiseptic for conjunctivitis, for washing with urethritis and vaginitis (0.25%). In case of skin burns with phosphorus, the burnt area is abundantly moistened with a 5% solution of copper sulfate. In case of poisoning with white phosphorus taken orally, 0.3-0.5 g of copper sulfate is prescribed for 1/2 cup of warm water and gastric lavage with a 0.1% solution.

Plaster lead simple, contains equal amounts of a mixture of lead oxide, pork fat and sunflower oil with the addition of water until a plastic mass is formed. It is used for purulent-inflammatory processes of the skin, boils, carbuncles as an antiseptic.

zinc oxide, used externally as an astringent and disinfectant for skin diseases as an antiseptic.

Ointment zinc, composition: zinc oxide 1 part, vaseline 9 parts.

Pasta Lassara, contains: salicylic acid 2 parts, zinc oxide and starch 25 parts each, vaseline 48 parts.

Galmanin, contains: salicylic acid 2 parts, zinc oxide 10 parts, talc and starch 44 parts each. Used for sweaty feet as an antiseptic.

Neoanuzole, candles, composition: bismuth nitrate, iodine, tannin, zinc oxide, resorcinol, methylene blue, fatty base. Used for cracks and hemorrhoids of the anus as an antiseptic.

Antiseptics. Phenols

Phenol, carbolic acid. Obtained by distillation of coal tar. Phenol is pure, the solution has a strong bactericidal effect. Used for disinfection of household and hospital items, tools, linen, secretions. To disinfect the premises, a soap-carbolic solution is used. In medical practice, phenol is used for certain skin diseases (sycosis, etc.) and inflammation of the middle ear ( ear drops). Phenol has an irritating and cauterizing effect on the skin and mucous membranes, is easily absorbed through them and in large doses can be toxic (dizziness, weakness, respiratory disorders, collapse).

Lysol, are made from commercially pure cresol and green potassium soap. Used to disinfect the skin as an antiseptic.

Resorcinol, used for skin diseases (eczema, seborrhea, itching, fungal diseases) externally in the form of solutions (water and alcohol) and ointments. Benzonaphthol, an antiseptic for diseases of the gastrointestinal tract. Adults are prescribed as an antiseptic 0.3-0.5 g 3-4 times a day. Children under 1 year old - 0.05 g per dose, up to 2 years old - 0.1 g, 3-4 years old - 0.15 g, 5-6 years old - 0.2 g, 7 years old - 0.25 g, 8 -14 years - 0.3 g.

Antiseptics. Dyes

methylene blue, soluble in water (1:30), difficult in alcohol, the aqueous solution is blue. It is used externally as an antiseptic for burns, pyoderma, folliculitis, etc. With cystitis, urethritis, they are washed with aqueous solutions (0.02%). Solutions of methylene blue are injected into a vein in case of poisoning with cyanide, carbon monoxide, hydrogen sulfide.

brilliant green, Golden-green powder, sparingly soluble in water and alcohol. Applied as an antiseptic externally as an antiseptic in the form of a 0.1-2% alcohol or aqueous solution for pyoderma, blepharitis to lubricate the edges of the eyelids.

Antiseptic liquid Novikov, composition: tannin 1 part, brilliant green 0.2 parts, alcohol 95% 0.2 parts, castor oil 0.5 parts, collodion 20 parts. A colloidal mass that dries quickly and forms an elastic film on the skin. It is used as an antiseptic for the treatment of minor skin lesions. Do not use the liquid for extensive bleeding, infected wounds.

Rivanol(ethacridine lactate), yellow crystalline powder, bitter taste, odorless. Slightly soluble in cold water, alcohol, aqueous solutions are unstable in the light, become brown. Freshly prepared solutions should be used. They have an antimicrobial effect, mainly in infections caused by cocci, especially streptococci. The drug is slightly toxic, does not cause tissue irritation. Used as an external prophylactic and remedy in surgery, gynecology, urology, ophthalmology, otolaryngology. For the treatment of fresh and infected wounds, aqueous solutions of 0.05% are used, for washing the pleural and abdominal cavity with purulent pleurisy and peritonitis, as well as with purulent arthritis and cystitis - 0.5-0.1%. With boils, carbuncles, abscesses, 0.1-0.2% solutions are prescribed in the form of lotions, tampons. For washing the uterus in the postpartum period, use a 0.1% solution, with coccal conjunctivitis - 0.1% in the form of eye drops. In case of inflammation of the mucous membranes of the mouth, pharynx, nose, rinse with a 0.1% solution or lubricate with a 1% solution. In dermatology, ointments, powders, pastes are used as an antiseptic of various concentrations.

Ointment Konkova, composition: ethacridine 0.3 g, fish oil 33.5 g, bee honey 62 g, birch tar 3 g, distilled water 1.2 g.

Antiseptics. Tars, resins, petroleum products, vegetable balms

Birch tar- a product of processing of the outer part of the birch bark. Thick oily liquid, contains phenol, toluene, xylene, resins and other substances. Applied externally in the treatment of skin diseases in the form of 10-30% ointments, liniments. The therapeutic effect as an antiseptic occurs not only as a result of local action (improvement of blood supply to tissues, increased keratinization processes), but also in connection with reactions that occur when skin receptors are irritated. As an integral part, it is included in the ointments of Wilkinson, Vishnevsky, etc. With prolonged use of tar, skin irritation and exacerbation of the eczematous process can be observed.

Balm Vishnevsky- composition: tar 3 parts, xeroform 3 parts, castor oil 94 parts. It is used in the treatment of wounds, ulcers, bedsores, etc. It has antiseptic properties, has a weak irritating effect, and promotes the regeneration process. Wilkinson's ointment - liquid tar 15 parts, calcium carbonate (precipitated chalk) 10 parts, purified sulfur 15 parts, naftalan ointment 30 parts, green soap 30 parts, water 4 parts. Applied as an antiseptic externally as an antiseptic for scabies and fungal skin diseases.

ASD drug are obtained from animal tissue. It is similar in action to tar, but has a less dramatic effect on the skin. Used as an antiseptic in the treatment of eczema, in the first hours it can cause itching and burning.

Forest liquid, a product of heat treatment (dry distillation) of certain tree species (hazel and alder). Used as an antiseptic for eczema, neurodermatitis and other skin diseases.

Ichthyol- ammonium salt of sulfonic acids of shale oil. An almost black syrupy liquid containing 10.5% combined sulfur. It has an anti-inflammatory effect, local anesthetic and some antiseptic. It is used as an antiseptic for skin diseases, neuralgia, arthritis, etc. in the form of an ointment or water-alcohol lotions. In diseases of the pelvic organs (prostatitis, metritis, etc.), ichthyol suppositories or tampons moistened with a 10% glycerin solution of ichthyol are prescribed.

Naphthalene ointment- a complex mixture of hydrocarbons and resins - naftalan oil (70 parts) and paraffin (18 parts) with petrolatum (12 parts). Naftalan oil and its preparations, when exposed to the skin and mucous membranes, have an emollient, absorbable, disinfectant and some analgesic effect. Applied as an antiseptic externally for various skin diseases, inflammation of the joints and muscles (arthritis, myalgia, etc.), neuritis, neuralgia, radiculitis, burns, ulcers, bedsores. Assign alone or in combination with other drugs in the form of ointments, pastes, suppositories. Naftalan emulsion is also used for douching, compresses, tampons, baths.

Paraffin solid(ceresin) - a mixture of solid hydrocarbons obtained during the processing of oil and shale oil. White translucent mass, slightly greasy to the touch. Melting point 50-57bC. Used as a base for ointments. Due to the high heat capacity and low thermal conductivity, paraffin is used for heat treatment for neuralgia, neuritis, etc. Ozokerite is used for the same purpose. Assign as an antiseptic compresses soaked in melted paraffin or paraffin cakes.

Ozokerite- a black waxy mass, a fossil substance of petroleum origin. Contains ceresin, paraffin, mineral oils, resins and other substances. It is used as an antiseptic as a remedy with high heat capacity and low thermal conductivity, for the treatment of heat with neuritis, neuralgia and other diseases. It is prescribed in the form of compresses (gauze pads impregnated with ozokerite, temperature 45-50°C, covered with waxed paper, oilcloth, cotton wool) and cakes (molten ozokerite poured into a cuvette and cooled to a temperature of 45-50°C). A compress or a cake is applied for 40-60 minutes. The course of treatment consists of 15-20 procedures, which are carried out daily or every other day. Ozokerite is heated in a water bath. Sterilized by heating at 100°C for 30-40 minutes.

Balm Shostakovsky(vanillin), polyvinyl butyl alcohol, used for boils, carbuncles, trophic ulcers, purulent wounds, mastitis, burns, frostbite and inflammatory diseases. Promotes cleansing of wounds, tissue regeneration and epithelialization. It is prescribed externally as an antiseptic for wetting wipes and direct application to the wound surface and in the form of 20% solutions in oil, as well as ointments. Inside prescribed for gastric ulcer, gastritis, colitis. It has an enveloping, anti-inflammatory, as well as bacteriostatic effect (gelatin capsules). They are taken 1 time per day 5-6 hours after meals (it is recommended to take them at 11-12 am after light dinner at 6 o'clock in the evening). On the first day, take 3 capsules, then 5 capsules, the course of treatment is 16-18 days.

Cigerol, a clear oily liquid, is used as an antiseptic for the treatment of ulcers, granulating wounds, burns, etc. Moisten a sterile dressing (gauze), which is applied to the wound surface and covered with compress paper. With large wound surfaces and abundant discharge, compress paper is not applied. Bandaging is done after 1-2 days, with burns after 4-5 days.

Ointment autolova- composition: machine or autol oils 85 parts, stearin 12 parts, zinc oxide 3 parts. It is used as an antiseptic in the treatment of ulcers, wounds, burns and as a basis for other ointments.

Sulsen, contains about 55% selenium and 45% sulfur. Used as an antiseptic in the treatment of seborrhea of ​​the scalp. Sulsen soap contains 2.5% sulsen, the same amount of sulsen paste mixed with a special foaming base. Apply sulsen soap or paste after regular shampooing. Then lather wet hair with sulsen soap and rub it thoroughly into the scalp. For washing use 2-3 g of soap (one bar of soap for 8-10 procedures). The foam is left on the hair for 5-10 minutes, after which it is thoroughly washed off with warm water (not higher than 40°C) and the hair is wiped dry. Tube with Sulsen paste is designed for 6-8 procedures, one teaspoon per appointment. Sulsen preparations are used once a week (for oily seborrhea in the first 2 weeks it can be twice a week) for 1-1.5 months. In case of relapse, the course of treatment is repeated. Foam and rinse water should not get into the eyes. After the procedure, wash your hands thoroughly with warm water. Sulsen soap should be stored in tight packaging, protected from light.

Antiseptics. Phytoncidal and other herbal antibacterial drugs

Phytoncides called bactericidal, fungicidal substances contained in plants. Especially a lot of them in the juices and volatile fractions of onions, garlic, radishes, horseradish. Preparations made from them can also act as an antiseptic on the body, enhance the motor, secretory function of the gastrointestinal tract, and stimulate cardiac activity.

Tincture of garlic- is used mainly to suppress the processes of decay and fermentation in the intestines, with intestinal atony and colitis, and is prescribed as an antiseptic also for hypertension and atherosclerosis. Take orally 10-20 drops (adults) 2-3 times a day before meals.

Allylsat- alcohol (40%) extract from garlic bulbs. Assign as an antiseptic for adults 10-20 drops (in milk) 2-3 times a day. Garlic preparations are contraindicated in kidney disease, as they can cause irritation of the renal parenchyma.

Allylchen- alcohol extract from onions. Used as an antiseptic inside, 15-20 drops 3 times a day for several days with intestinal atony and diarrhea.

Urzalin - essential oil obtained from a bear bow. It is used as an antiseptic in the treatment of purulent wounds, ulcers, bedsores, etc. A 0.3% ointment on vaseline is applied to gauze and applied to the damaged surface. The dressing is changed every 2-3 days.

Sodium usninate- sodium salt of usnic acid isolated from lichens. It is an antibacterial agent. Assign as an antiseptic in the form of a 1% water-alcohol or 0.5% oil solution (castor oil), as well as a solution in glycerin, fir balsam. Solutions are abundantly lubricated with gauze bandages, which are applied to the affected surface of the skin. When powdering wounds with powder, 0.1-0.2 g is used per wound about 16 square cm in size.

Imanin- an antibacterial preparation obtained from St. John's wort. It also has the ability to dry the wound surface and stimulate tissue regeneration. Used as an antiseptic in the form of solutions, ointments, powders for the treatment of fresh and infected wounds, burns, ulcers, abscesses, nipple cracks, mastitis, boils, carbuncles. They are also used for acute laryngitis, sinusitis, rhinitis. The solution is irrigated or washed with the affected areas, then a wet bandage is applied, soaked in the same solution, changing daily or every other day. Apply also 5-10% ointment.

Tincture of calendula, alcohol tincture of flowers and marigold flower baskets. Used as an antiseptic for cuts, purulent wounds, burns, for rinsing with sore throat (1 teaspoon per glass of water). Inside, they are also taken as a choleretic agent (10-20 drops per reception).

Sophora japonica tincture- used as an antiseptic for purulent inflammatory processes (wounds, burns, trophic ulcers) in the form of irrigation, washing, for wet dressings.

: use knowledge for health

We present brief description individual chemical classes of antiseptics and disinfectants.

1. Alcohols. Aliphatic alcohols, by denaturing the protein, have an antimicrobial effect to varying degrees.

Ethyl alcohol (wine alcohol) is a fermentation product of sugars. The State Pharmacopoeia provides alcohol of the following concentrations: absolute alcohol contains at least 99.8 vol. %> ethyl alcohol, ethyl alcohol 95% contains 95-96 vol. % ethyl alcohol, ethyl alcohol 90% - 92.7 parts of ethyl alcohol 95% and 7.3 parts of water, ethyl alcohol 70%), respectively, 67.5 and 32.5 parts, ethyl alcohol 40% - 36 and 64 parts.

It is widely used in surgical practice for the treatment of the surgical field, wounds, surgeon's hands (70%), for alcohol compresses (40%), disinfection of instruments, suture material. 70% alcohol has an antiseptic effect, and 96%) also has a tanning effect.

2. Halides. Chloramine - 0.1-5% aqueous solution, contains active chlorine (25-29%), has an antiseptic effect. When interacting with tissues, active chlorine and oxygen are released, which determine the bactericidal properties of the drug. A solution of sodium hypochlorite is used, its 5% solution contains 0.1 g of active chlorine per 1 dm 3 and can be used for irrigation, cleaning and disinfection of contaminated wounds.

Iodine- an effective bactericidal agent. A solution containing iodine in a ratio of 1:20,000 causes the death of bacteria within 1 minute, and spores within 15 minutes, while the toxic effect on tissues is insignificant. Alcohol tincture of iodine contains 2% iodine and 2.4% sodium iodide, is the most effective antiseptic for skin treatment before surgery, venipuncture.

Iodinol- 1% solution. Antiseptic substance for external use. Used for washing wounds, rinsing the throat.

Iodonate and iodopyrone- organic compounds of iodine. Use 1% solution. It is widely used as an antiseptic for the skin, especially in the preoperative preparation of the surgical field.

Lugol's solution- contains iodine and potassium iodide, water and alcohol solutions can be used. Combined drug. As a disinfectant, it is used to sterilize catgut, and as a chemotherapeutic agent, it is used to treat thyroid diseases.

3. Heavy metals. Mercury oxycyanide- disinfectant. At concentrations of 1:10,000, 1:50,000, they are used to sterilize optical instruments. Ammonium mercury ointment contains 5% active insoluble mercury compound, used for skin treatment and wound treatment as a disinfectant.

Silver nitrate- a solution of inorganic silver salts, has a pronounced bactericidal effect. 0.1-2% solution is used for washing the conjunctiva, mucous membranes; 2-5-10% solution - for lotions; 5-20% solutions have a pronounced cauterizing effect and are used to treat excess granulations.

Protargol, collargol (colloidal silver) - have strong bactericidal properties. Protein silver containing 20% ​​silver is used as a local antiseptic for the treatment of mucous membranes. They have astringent and anti-inflammatory action. They are used for lubricating mucous membranes, washing the bladder with cystitis, urethritis, for washing purulent wounds, with sepsis, lymphangitis and erysipelas.

zinc oxide- an antiseptic agent for external use, is part of many powders and pastes. It has an anti-inflammatory effect, prevents the development of maceration.

Copper sulfate - has strong antimicrobial properties.

4. Aldehydes. Formalin- 40% solution of formaldehyde in water. Disinfectant. 0.5-5% solution is used to disinfect gloves, drains, tools; 2-4% solution - for disinfection of patient care items. Formaldehyde in dry form is used for sterilization in gas sterilizers of optical instruments. 1-10% formalin solution causes the death of microorganisms and their spores within 1-6 hours.

Lysol- strong disinfectant. A 2% solution is used to disinfect care items, rooms, soak contaminated tools. Currently, it is practically not used.

5. Phenols. Carbolic acid- has a pronounced disinfecting effect. It is used as part of a triple solution. To obtain an antimicrobial effect, at least a concentration of 1-2% is required, while at a concentration of 5% it already significantly irritates tissues.

Triple solution - contains 20 g of formalin, 10 g of carbolic acid, 30 g of soda and up to 1 liter of water. Strong disinfectant. It is used for processing tools, care items, cold sterilization of cutting tools.

6. Dyes.brilliant green- has a pronounced antimicrobial effect, especially against fungi and gram-positive bacteria (Pseudomonas aeruginosa, staphylococcus aureus), antiseptic for external use. A 1-2% alcohol (or aqueous) solution is used to treat superficial wounds, abrasions, oral mucosa, pustular skin lesions.

Methylene blue - antiseptic against Escherichia coli, pyogenic microbes. 1-3% alcohol (or aqueous) solution is used to treat superficial wounds, abrasions, oral mucosa, skin, 0.02% aqueous solution - for washing wounds.

7. Acids.Boric acid - A 2.5% solution only retards the growth and reproduction of all types of bacteria. 2-4% solution is used for washing wounds, ulcers, rinsing the mouth.

Salicylic acid - antiseptic. Used as a fungicide for skin treatment. Has a keratolytic effect. It is used in the form of crystals (for tissue lysis), is part of powders, ointments.

8. Alkalis.Alcohol ammonia- antiseptic agent for external use. Previously, a 0.5% aqueous solution of ammonia was used to treat the hands of surgeons (the Spasokukotsky-Kochergin method).

9. Oxidizers.Hydrogen peroxide solution - contains 27.5-31% hydrogen peroxide, antimicrobial action due to oxidizing properties. 3% solution - the main preparation for washing purulent wounds during dressings, rinsing, lotions, does not penetrate into the tissues. It is used for bleeding from mucous membranes and decaying cancerous tumors, etc. It is part of Pervomur and is an effective disinfectant ( 6% solution).

Potassium permanganate - belongs to strong oxidizing agents, has a deodorizing and astringent effect. In the presence of organic substances, especially decay and fermentation products, it splits off atomic oxygen with the formation of manganese oxides, which is the reason for the antiseptic effect. It is used in the form of 0.02-0.1-0.5% solutions for washing wounds.

10. Detergents (surfactants).Chlorhexidine bigluconate- an antiseptic agent that acts on gram-positive microbes and E. coli. A 0.5% alcohol solution is used to treat the surgeon's hands and the operating field. 0.1-0.2% aqueous solution - one of the main preparations for washing wounds and mucous membranes, treating purulent wounds. Included in solutions for the treatment of hands and the surgical field (plivasept, AHD-special). Antiseptic soap with the addition of chlorhexidine is used to treat the hands of the surgeon and the surgical field. The systematic use of chlorhexidine-containing soap leads to the accumulation of this substance on the skin and to the accumulation of antimicrobial action.

Zerigel- antiseptic agent for external use. It is used for processing (film-forming antiseptic) of hands and the surgical field.

Degmin, degmicide - antiseptic agents for external use. Used to treat hands and the surgical field.

11. Nitrofuran derivatives. Furacilin - antimicrobial agent acting on various gram-positive and gram-negative microbes. Aqueous 0.02% solution (1:5000) is used to treat purulent wounds, ulcers, bedsores, burns. An alcohol (1:1500) rinse solution can be used, as well as an ointment containing 0.2% of the active substance. Does not interfere with the wound healing process.

Lifusol- contains furatsilin, linetol, resins, acetone (aerosol). Antiseptic agent for external use. It is applied in the form of a film. Used for protection postoperative wounds and drainage holes from exogenous infection and for the treatment of superficial wounds.

Furadonin, furagin, furazolidone- have a wide antimicrobial spectrum of action. In addition to urinary tract infections, they are used in the treatment of intestinal infections (dysentery, typhoid fever).

12. Derivatives of 8-hydroxyquinoline. Nitroxoline (5-NOC) - chemotherapeutic agent, "uroantiseptic". Used to treat urinary tract infections.

Enteroseptol, intestopan- chemotherapeutic agents used for intestinal infections.

13. Quinoxaline derivatives. Dioxidine- antiseptic agent for external use. A 0.1-1% aqueous solution is used to wash purulent wounds, mucous membranes, especially when antibiotics and other antiseptics are ineffective. With sepsis and severe infections, it can also be administered intravenously.

14. Nitroimidazole derivatives.Metronidazole (Metragil, Flagyl, Trichopolum) - broad-spectrum chemotherapeutic agent. Effective against protozoa, bacteroids and a number of anaerobes.

15. Tar, resin. Birch tar- a product of dry distillation of pine trunks and branches or pure selected birch bark. It is a mixture of aromatic hydrocarbons: benzene, toluene, phenol, creoles, resins and other substances. It is used in the form of 10-30% ointments, pastes, liniments, is part of Vishnevsky's balsamic ointment (tar - 3 parts, xeroform - 3 parts, castor oil - 100 parts), used to treat wounds, ulcers, bedsores, burns, frostbite. At topical application has a disinfecting effect, improves blood circulation and stimulates tissue regeneration.

Currently, preparations based on birch tar are used much less frequently.

16. Quinolones (nalidixic acid, pipemidic acid, oxolinic acid). The mechanism of their action is associated with the ability to inhibit the synthesis of bacterial DNA by inhibiting the activity of microbial cell enzymes.

Fluoroquinolones (ciprofloxacin, ofloxacin, norfloxacin) etc.) - active against gram-positive microbes, highly active against enterobacteria, mycobacterium tuberculosis. They are mainly used for infections of the intestines, abdominal cavity and small pelvis, skin and soft tissues, sepsis.

17. Sulfonamides (sulfadiazine, sulfadimesin, sulfadimethoxine, sulfamonomethoxine, sulfamethoxazole, sulfalene). Disrupt synthesis folic acid microbial cell and act bacteriostatically on gram-positive and gram-negative bacteria, chlamydia, toxoplasma. Widely used in clinical practice combined preparations of sulfonamides with trimethoprim (bactrim, biseptol, septrin, sulfatone) for the treatment of bacterial infections of various localizations.

18. Antifungals. Polyene preparations are distinguished: nystatin, levorin, amphotericin B; imidazole series: clotrimazole, miconazole, bifonazole; triazole series: fluconazole, itraconazole; and others: griseofulvin, flucytosine, nitrofungin, dekamin.

They act on yeast-like fungi of the genus Candida, dermatophytosis. They are used to prevent complications and treat fungal diseases (simultaneously with broad-spectrum antibiotics).

19. Antiseptics of plant origin. Phytoncides, chlorophyllipt, ectericide, baliz, calendula are mainly used as antiseptic agents for external use for washing superficial wounds, mucous membranes, and skin treatment. They have an anti-inflammatory effect.

bacteriophages(bacteria + Greek phagos - devouring, synonym: phage, bacterial virus) - a virus capable of infecting a microbial cell, reproducing in it, forming numerous offspring and causing bacterial cell lysis. Anti-staphylococcal, anti-streptococcal and anti-coli bacteriophages are used mainly for washing and treating purulent wounds and cavities after identification of the pathogen.

Antitoxins- specific antibodies formed in the body of humans and animals under the influence of toxins, microbes, poisons of plants and animals, which have the ability to neutralize toxic properties. Antitoxins play a protective role in toxin infections (tetanus, diphtheria, gas gangrene, some staphylococcal and streptococcal diseases).

Immunoglobulin preparations- y-globulins - a purified y-globulin fraction of human serum proteins, containing in concentrated form antibodies against measles, influenza, poliomyelitis, anti-tetanus y-globulin, as well as increased concentrations of antibodies against certain infectious agents or toxins they secrete.

Antistaphylococcal hyperimmune plasma- has a pronounced specificity due to the high content of antibodies to antigens with which donors were immunized. It is highly effective in the prevention and treatment of purulent-septic diseases caused by staphylococcus aureus. Antipseudomonal hyperimmune plasma is also used.

Proteolytic Enzymes(trypsin, hpmotripsin, chymoxin, terrilitin, iruksol) - when applied topically, they cause lysis of necrotic tissues and fibrin in the wound, liquefy purulent exudate, and have an anti-inflammatory effect.

Biological antiseptics also include ways to increase the nonspecific and specific resistance of the organism.

Nonspecific resistance and nonspecific immunity can be influenced in the following ways:

Ultraviolet and laser blood irradiation (phagocytosis, complement system, oxygen transport are activated);

The use of a suspension of cells and xenoperfusate of the spleen, perfusion through the whole or fragmented spleen (pigs), while relying on the action of lymphocytes and cytokines contained in the spleen tissue;

Transfusion of blood and its components;

The use of a complex of vitamins, antioxidants, biostimulants;

The use of thymalin, T-activin, prodigiosan, levamisole (stimulate phagocytosis, regulate the ratio of T- and B-lymphocytes, enhance the bactericidal activity of blood), interferons, interleukins, roncoleukin, roferon, etc. (have a pronounced activating targeted effect on immunity).

Antibiotics- substances that are products of vital activity of microorganisms (natural antibiotics), which inhibit the growth and development of certain groups of other microorganisms. There are also chemical derivatives natural antibiotics(semi-synthetic antibiotics).

The main groups of antibiotics:

1. B-lactam antibiotics:

1.1. natural penicillins;

Semi-synthetic penicillins:

Penicillins resistant to penicillinase;

Aminopenicillins;

Carboxypenicillins;

Ureidopenicillins;

B-lactamase inhibitors;

1.2. Cephalosporins:

1 generation;

II generation;

III generation;

IV generation.

2. Antibiotics of other groups:

Carbapenems;

Aminoglycosides;

Tetracyclines;

macrolides;

Lincosamides;

Glycopeptides;

Chloramphenicol;

Rifampicin;

Polymyxins.

Penicillins - all drugs in this group act bactericidal, their mechanism of action lies in the ability to penetrate the cell membrane of microbes and bind to "penicillin-binding proteins", as a result, the structure of the cell wall of the microbe is disturbed.

natural penicillins. These include:

Benzylpenicillin (penicillin C);

Procainpenicillin (novocaine salt of penicillin O);

Benzathine penicillin (bicillin);

Phenoxymethylpenicillin (penicillin V).

These antibiotics are active against streptococci of groups A, B, C, pneumococci, gram-negative microorganisms (gonococci, meningococci), as well as some anaerobes (clostridia, fusobacteria) and are inactive against enterococci. Most strains of staphylococci (85-95%) produce B-lactamase and are resistant to natural penicillins.

Penicillins resistant to penicillinase:

Methicillin;

Oxacillin;

Cloxacillin;

Flucloxacillin;

Dicloxacillin.

The spectrum of antimicrobial action of these drugs is similar to the spectrum of action of natural penicillins, but they are inferior to them in antimicrobial activity. The advantage of these drugs is the stability against B-lactamase of staphylococci, and therefore they are considered the drugs of choice in the treatment of staphylococcal infections.

Aminopenicillins:

Ampicillin;

Amoxicillin;

Bakampicillin;

Pivampicillin.

They have a wide spectrum of antimicrobial activity. Highly active against some gram-negative bacteria, mainly of the intestinal group (E. coli, Proteus, Salmonella, Shigella, Haemophilus influenzae). Bacampicillin and pivampicillin are ampicillin esters, which, after absorption in the intestine, are deesterified and converted to ampicillin, are absorbed better than ampicillin, and create high blood concentrations after taking the same doses.

Antipyretic penicillins:

Carboxypenicillins (carbenicillin, ticarcillin);

Ureidopenicillins (piperacillin, azlocillin, mezlocillin). This group has a wide spectrum of action on gram-positive cocci, gram-negative rods, anaerobes.

Preparations containing penicillins and B-lactamase inhibitors:

Ampicillin and sulbactam - unazine;

Amoxicillin and clavulanic acid - amoxiclav, augmentin;

Ticarcillin and clavulanic acid - timentin;

Piperacillin and tazobactam - tazocin.

These drugs are fixed combinations of broad-spectrum penicillins with B-lactamase inhibitors. They have the ability to irreversibly inactivate a wide range of B-lactamases - enzymes produced by many microorganisms (staphylococci, enterococci, Escherichia coli), bind enzymes and protect the broad spectrum penicillins contained in their composition from the action of B-lactamases. As a result, microorganisms resistant to them become sensitive to the combination of these drugs.

Cephalosporins I, II, III and IV generations. Ranked first among antibacterial agents frequency of use in hospitalized patients. They have a wide spectrum of antimicrobial activity, which covers almost all microorganisms, with the exception of enterococci. They have a bactericidal effect, have a low frequency of resistance, are well tolerated by patients and rarely cause side effects.

Their classification is based on the spectrum of antimicrobial activity. In clinical practice, cephalosporins of the 1st, 2nd, and 3rd generations are most commonly used. In recent years, two drugs have appeared that, on the basis of antimicrobial properties, were classified as fourth-generation cephalosporins.

I generation cephalosporins - cephaloridine, cephalothin, cefapirin, cephradine, cefazolin, cephalexin.

II generation cephalosporins - cefamandol, cefuroxime, cefoxitin, cefmetazole, cefotenan. They have a wider spectrum of action than first-generation drugs.

III generation cephalosporins - cefotaxime, cefodizyme, cefoperazone, ceftibuten, cefixime, latamoxef, etc. Individual drugs active against Pseudomonas aeruginosa.

Cephodizim - the only cephalosporin antibiotic with an immunostimulatory effect.

Widely used to treat nosocomial infections.

IV generation cephalosporins - cefpirom, cefepime - have a wider spectrum of action compared to III generation cephalosporins. Their high clinical efficacy has been established in the treatment of various nosocomial infections.

Carbapenems. Carbapenems (imipenem, meropenem) and combined carbapenem thienam (imipenem + sodium cilastatin) are characterized by the widest spectrum of antibacterial activity. They are used to treat severe infections, mainly hospital infections, especially with an unidentified causative agent of the disease. A wide spectrum and high bactericidal activity allow the use of these drugs as monotherapy, even in the treatment of life-threatening infections.

Aminoglycosides. All of them act only on extracellular microorganisms. Three generations of aminoglycosides are isolated, but only generation II aminoglycosides (gentamicin) and III (sisomycin, amikacin, tobramycin, netilmicin) are used.

Tetracyclines. They inhibit protein synthesis in a microbial cell, have high activity against gram-positive and gram-negative microorganisms (aerobic and anaerobic), chlamydia, rickettsiae, cholera vibrio, spirochetes, actinomycetes. The most active drugs are doxycycline and minocycline.

Doxycycline circulates in the body for a long time and is well absorbed (95%) when taken orally.

Macrolides(erythromycin, clarithromycin, spiramycin, azithromycin, midecamycin). The spectrum of their action is similar to that of natural penicillins. Depending on the type of microorganism and the concentration of the antibiotic, macrolides act bactericidal or bacteriostatically. They are the drugs of choice in the treatment of lobar pneumonia, atypical pneumonia, streptococcal infections (tonsillitis, erysipelas, pharyngitis, scarlet fever).

Lincosamides(lincomycin, clindamycin). The mechanism of action of lincosamides is to suppress the protein synthesis of bacteria. They are active against anaerobes, staphylococci and streptococci. They are the drugs of choice in the treatment of infections caused by anaerobic microorganisms (infection of the abdominal cavity and small pelvis, endometritis, lung abscesses and other localization). As alternative means used for staphylococcal infections.

Glycopeptides(vancomycin, teicoplanin). Violate the synthesis of the bacterial cell wall, have a bactericidal effect. Active against streptococci, pneumococci, enterococci, corynebacteria.

Chloramphenicol. Broad spectrum antibiotic. Active against gram-positive cocci (staphylococci, streptococci, pneumococci, enterococci), some gram-negative bacteria (coli coli, Haemophilus influenzae), anaerobes, rickettsiae.

Rifampicin. The mechanism of action is associated with the suppression of RNA synthesis in the microbial cell. Active against Mycobacterium tuberculosis, gonococci, meningococci.

Polymyxins[polymyxin B, polymyxin E (kalistin)]. The mechanism of action is associated with damage to the cytoplasmic membrane of the microbial cell. They are used only in cases of severe gram-negative infection (Pseudomonas aeruginosa, Klebsiella, Enterobacter) with resistance to all other antibacterial agents.

Detailed instructions on different types of medical antiseptics for treating wounds: what antiseptics are, how they work and how to choose the right drug for different types damage

Summer has come - the time for outdoor activities, cottages and gardens. The time of abrasions and wounds, and hence the high demand for antiseptics. More than 250 trade names of antiseptic agents in the form of ointments, solutions, sprays and powders are registered in Russia. Let's see which drugs are antiseptics in medicine, how they differ from each other and which of them can be recommended for each home first aid kit.

First of all, we note that the pharmacist independently selects a remedy only for external use, and the choice of an antiseptic for the mucous membranes of the nasopharynx, gastrointestinal tract, respiratory and urinary tract, as well as for the genital organs remains with the doctor. Also recall that many antiseptics should not be applied to injured skin. Here are two main points to consider when selling and talking to a client. The mechanism of action of antiseptics may be different, depending on the main active ingredient.

Classification of antiseptics

Halides (halogens and halogen-containing compounds) Compounds of chlorine or iodine (antiformin, iodoform, iodinol, Lugol's solution, chloramine B, chlorhexidine). The bactericidal action is based on the fact that, in contact with organic substrates, these agents emit active halogens - chlorine and iodine, which destroy the proteins of microorganisms. Due to the high bactericidal activity, they are widely used both in medical institutions and at home. Oxidizing agents (hydrogen peroxide, potassium permanganate, hydroperite). In contact with tissues, they release active oxygen, which creates unfavorable conditions for the development of anaerobic and putrefactive microbes. Limited use due to moderate bactericidal activity and short term storage. Acids (salicylic, boric). The shift of pH to the acidic side leads to the denaturation of the protoplasmic protein of the bacterial cell. Salicylic acid has a weak antiseptic effect, and boric acid has a large amount side effects associated with toxicity. Currently, antiseptics for skin treatment are practically not used as antiseptics. Alkalis (ammonia alcohol, sodium tetraborate). Currently, drugs as antiseptics are practically not used due to low antiseptic activity. Aldehydes (formalin, lysoform). Penetrating inside the microbial cell, they enter into contact with the amino groups of proteins, which leads to cell death. The same effect explains the strong irritant effect on the mucous membranes and human skin. Currently, they are used more for disinfection of surfaces in medical facilities. Alcohols (ethyl). They dehydrate tissues and irreversibly coagulate the proteins of microorganisms. They are used quite widely, have a pronounced antiseptic effect. In 2006, WHO declared that alcohol-based hand sanitizers are the gold standard for hand sanitizers. Cationic antiseptics (benzyldimethyl-myristoylamino-propylammonium). The active substance acts on the membranes of microorganisms, leading to their death. It has a very wide spectrum of antimicrobial action, stimulates the immune system, accelerates the healing process of wounds. It is widely used in surgery, obstetrics, gynecology, traumatology, burn therapy, otorhinolaryngology and other fields of medicine. Salts of heavy metals (drugs of mercury, silver, copper, zinc, lead). Antimicrobial action is associated with the blocking of sulfhydryl groups of enzymes of microorganisms. Limited use due to toxicity. Dyes (methylene blue, brilliant green, fukortsin). They are active against Gram-positive bacteria and cocci. Methylene blue has a very weak antiseptic effect and is practically not used. Herbal antibacterial preparations (urzalin, calendula tincture, imanin and others). Weak antiseptic properties. Rarely used.

All these substances have different degrees of activity, antimicrobial spectrum and toxicity. To understand how to choose the right antiseptic, it is necessary to be guided by all these characteristics in accordance with the goal: primary wound treatment, treatment of festering wounds, or treatment of damaged mucous or intact skin / mucous membranes. When choosing which antiseptic to treat a particular wound, it is imperative to focus on the instructions in order to avoid side effects, as well as determine the dosage required in a particular case. Let us consider in more detail the most popular antiseptics.

Ethanol

At a concentration of 40 to 70%, it shows its disinfecting properties, above 70% - tanning. It is commercially available in the form of alcohol-containing wipes and alcohol solutions. It is not applied to mucous membranes, as it causes a chemical burn. Only the edges of a pre-washed wound are treated with ethyl alcohol. It is not recommended for use in children, since even with external application it can be absorbed into the systemic circulation and inhibit the respiratory center.

Hydrogen peroxide

For the treatment of wounds, only a 3% solution is used (a higher concentration can cause a chemical burn). It is also used as a hemostatic agent. Hydrogen peroxide is an excellent tool for primary wound treatment (washing), as it has a great cleansing ability - with the resulting foam, dirt particles and damaged cells are mechanically removed. It is possible to treat wounds both on the surface of the skin and on the mucous membranes. Hydrogen peroxide is generally not used on healing wounds, as it lengthens the full healing period. Also, it is not used for deep wounds and is not injected into body cavities. When stored in the light, it loses its active properties. Opened packaging is stored for about a month, closed - 2 years.

Iodine/povidone-iodine

It is used in an alcohol solution (the so-called "tincture of iodine") or in Lugol's solution. Only the edges of the wound are treated with iodine so as not to cause soft tissue burns. The great advantage of iodine is its broad spectrum of antimicrobial activity: it kills all major pathogens and, with prolonged exposure, even spores, the most resistant forms of microorganisms. The use of large amounts of iodine is contraindicated in case of hypersensitivity to it, hyperfunction of the thyroid gland, thyroid formations, dermatitis, and kidney diseases. Application to mucous membranes is not desirable, especially in children.

Chlorhexidine bigluconate

Belongs to the group of halides. Typically used at a concentration of 0.5-4.0%. At lower concentrations, the bactericidal activity of chlorhexidine decreases, therefore, as an antiseptic in this case, it is used only in an alcohol solution. Chlorhexidine has bacteriostatic, fungicidal, antiviral properties. However, 1% chlorhexidine against fungi and Mycobacterium tuberculosis has a weaker effect compared to povidone-iodine. The drug can be used for the primary treatment of injured skin areas, as well as to accelerate the healing of purulent wounds and to treat damaged mucous membranes. In most cases, it is well tolerated. There are no age restrictions on the use - a good option for an antiseptic for children. It is not recommended to use together with iodine preparations (often skin irritation).

Benzyldimethyl-myristoylamino-propylammonium

It is used as a solution for washing wounds or as an ointment for application to purulent wounds. It is active against viruses, bacteria, fungi, protozoa, but it has practically no effect on human cell membranes, unlike chlorhexidine. It has an antiseptic, immunostimulating and wound healing effect. The immunostimulatory effect is associated with the ability of the drug to increase the activity of phagocytes and macrophages. The positive effect on wound healing is due to the fact that the active substance absorbs pus and fluid released during wound inflammation. At the same time, the agent does not irritate healthy tissues and does not interfere with the growth of new tissues. The main indication for use is the prevention of suppuration and the treatment of purulent wounds. Application to mucous membranes is possible. It is possible to use for the treatment of wounds in children older than 3 years.

Potassium permanganate (potassium permanganate)

Currently, it is used mainly in a hospital setting. In a pharmacy, an antiseptic is sold in the form of a powder for preparing a solution. Potassium permanganate is used to wash the wounds of the skin and mucous membranes. Suitable for primary treatment and for the treatment of festering wounds (it has cleansing properties due to active oxygen), especially when there is a risk of anaerobic microorganisms entering the wound. Before washing the wound, you need to prepare a fresh solution each time.

Brilliant green solution

Everyone's favorite green. Available in the form of alcohol solutions and pencils. It has a moderate antiseptic effect, effective against gram-positive bacteria. Only the edges of wounds are treated with a solution, without going into damaged tissues. Has a drying effect. It is applied before the period when fresh granulation tissue begins to appear in the wound, since prolonged use prevents adequate tightening of the wound edges. Can be used as a baby antiseptic.

Fukortsin

Coloring antiseptic. A combination of fuchsin, boric acid, phenol, acetone, resorcinol and ethanol. Indications for the use of fucorcin are fungal and pustular skin diseases, abrasions, cracks, etc. It is applied to the edges of wounds. It has a less drying effect than brilliant green and iodine. In the treatment of wounds, it is used much less often. It is undesirable to use in children because of the boric acid and phenol that make up the composition, which have a large number of side effects. When applied to the skin, boric acid easily penetrates into the bloodstream (especially in children) and enters the internal organs and tissues, accumulating there. Therefore, prolonged use can cause intoxication. This property forced to sharply limit the use of boric acid, especially in childhood. Phenol also has the ability to easily penetrate the skin and lead to intoxication of internal organs.

Octenidine (octenidine dihydrochloride)

Cationic surfactant with antimicrobial activity against gram-positive and gram-negative bacteria, viruses, as well as against yeast-like fungi and dermatophytes (fungi that feed on keratin and cause dermatomycosis). It is similar in its action to quaternary ammonium compounds (QAC). The damaged surface is completely processed. Can be used on mucous membranes. No antiseptic age restrictions applied to children. It is currently the drug of choice in Europe as an antiseptic due to its wide spectrum of action and maximum speed achieving an effect.

Table 1.
Comparative characteristics of the main antiseptics

antiseptic	For leather treatment	For the treatment of wounds	For mucous membranes	Applicability for children
Ethanol	+	_	_	-
Hydrogen peroxide	+	+	+	+
Iodine	+	_	- / +	- / +
Chlorhexidine	+	+	+	+
Potassium permanganate	+	_	_	+
brilliant green	+	_	_	+
Fukortsin	+	_	_	_
Benzyldimethyl-myristoylamino-propylammonium	+	+	+	+
Octenidine	+	+	+	+

In every first aid kit

So, what remedies can a pharmacy worker recommend to a buyer for a home first aid kit? First of all, these are benzyldimethyl-myristoylamino-propylammonium and octenidine, as the most versatile and safe means. These drugs are the drugs of choice and should be recommended first. Also quite versatile is chlorhexidine, which is used on intact tissues and for the treatment of wounds, including mucous membranes. As for solutions of brilliant green and iodine, it is necessary to inform the buyer that these antiseptics are only suitable for treating wound edges and should not be used on mucous membranes. Thus, among the entire list of antiseptics on the pharmaceutical market, a fairly small number of drugs have universal application possibilities.

Sources

1. Kharkevich D. A. Pharmacology. M. Geotar Medicine. 2010.
2. Blatun L. A. Miramistin in a comprehensive program to combat hospital infection in a surgical hospital // Miramistin: application in surgery, traumatology and combustiology: collection of works / ed. Yu. S. Krivosheina. M., 2006.
3. Carolin Fromm-Dornieden, Gorovtsov A. V., Nadine Schöfer, Ewa K. Stuermer. Comparison of the rate of growth suppression of E. COLI, STAPHYLOCOCCUSAUREUS and PSEUDOMONASAERUGINOSA by modern antiseptics for the purpose of their use for infected wounds // Fundamental Research. - 2013. - No. 10–2.

Antiseptics for the treatment of wounds are in every home first aid kit. But do people always choose the right way to treat a wound? After all, it is not without reason that there are several different solutions, each of which should be used to treat certain wounds and sores. Today we will find out why we need an antiseptic? Consider the 9 most popular and inexpensive funds and take a look at their differences.

What is an antiseptic?

Let us immediately turn to the Greek translation of the term: anti - against, septikos - putrid. And an antiseptic is really called any remedy that is able to fight bacteria caused by decomposition processes, and also serves as a prevention of their reproduction.

Antiseptics have been known since ancient times. The embalming of corpses was carried out with means that prevented the processes of decay, otherwise some of the finds would not have survived to their contemporaries. But antiseptics began to be popularized only from the middle of the 19th century, when the first trials of surgical operations using carbolic acid began.

By the way! Antiseptics are not used for wound healing, but for their disinfection, i.e. to kill infection and prevent inflammation.

Antiseptics are now used not only in medicine, but also in other areas. For example, in the woodworking industry for impregnation of wood in order to avoid the development of putrefactive processes. Logs for a bath, which will constantly be in a humid environment, will definitely need pre-treatment with antiseptic impregnations. So, what are antiseptics?

9 best antiseptics

Carbolic acid, which was first used as a body antiseptic, is not used today because of its danger. In fact, it is a harmful phenol, which in large quantities can cause poisoning. But over 150 years, many different antiseptics have been invented that meet all the necessary requirements, namely:

All these requirements are met to varying degrees by at least 9 antiseptics, which are considered the most effective and affordable.

The antiseptic effect of ethyl alcohol does not last long. As soon as the alcohol evaporates (30-40 seconds), the action stops. But usually it is enough to destroy the most active microbes. Ethanol is primarily treated for small, fresh wounds and cuts, but should not be used continuously. Alcohol dries out the skin and, if used frequently, can cause microtrauma. The cost of one bottle of ethanol (100 ml) is small: about 30 rubles.

Aqueous solution of Furacilin

Furacilin belongs to antimicrobials wide spectrum. It is used more often in the form of an aqueous solution, although it is possible to prepare it with alcohol. An aqueous solution of Furacilin is good to use for the treatment of wounds and sores on the mucous membrane: in the oral cavity, nose, vagina. But it also works great as a skin antiseptic (ulcers, burns).

Furacilin is sold in the form of ready-made solutions (60-70 rubles per 100 ml), tablets that need to be ground into powder before dissolving (80-90 rubles for 10 pcs.), As well as effervescent self-dissolving tablets (110-120 rubles for 10 pcs. ).

It is a so-called antiseptic-antioxidant, which, upon contact with the skin, releases oxygen. This is indicated by the bubbles that appear when peroxide is applied to the wound. The more bubbles, the more pollution. Treatment of the wound with hydrogen peroxide is very effective on postoperative sutures, as the resulting foam automatically washes away dirt without requiring wiping the wound.

Despite the apparent aggressiveness of hydrogen peroxide, it is a fairly mild antiseptic that can also be used for mucous membranes. For example, they can moisten a cotton swab and insert it into the nostril to stop bleeding and treat the damaged vessel. At the same time, it is an excellent drying agent. The cost of a bottle of peroxide (10 ml) is approximately 40 rubles.

Potassium permanganate solution

It has an antimicrobial and disinfectant effect due to the oxidizing ability of manganese. Potassium permanganate is used to treat wounds, sores, burns. But it is important to prepare weak solution, because highly concentrated can cause a chemical burn to the skin.

At home, it is not recommended to use potassium permanganate precisely because of ignorance of the exact concentration for certain wounds and non-compliance with the technique of its preparation. But pink water is suitable, for example, for wetting a dried bandage. In a pharmacy, potassium permanganate is sold in the form of burgundy crystals and is called Potassium permanganate. The cost of a five-gram vial is 60-70 rubles.

Good old antiseptic, which is in almost every home. For the treatment of wounds, a 5% solution is used, although in some cases it is necessary to dilute it to a less concentrated one. Iodine is good for treating fresh cuts and shallow wounds.

It is not recommended to use iodine solution for the treatment of wounds received more than 5 days ago, as well as acne, bedsores and thermal burns. Also, iodine should be used with caution in people suffering from endocrine diseases. 10 ml of iodine costs only 10-15 rubles.

Or simply brilliant green, which is so disliked in the USA, believing that it is toxic. But in Russia, this antiseptic is the most popular. Perhaps there is no person who would never come across a brilliant green. It has an excellent antimicrobial effect, but it does not damage tissues and does not cause burns, such as iodine. The content of ethyl alcohol in brilliant green makes the antiseptic even more effective in use for both fresh and old wounds.

A solution of brilliant green is able to fight not only gram-positive and gram-negative bacteria, but also dangerous Staphylococcus aureus and diphtheria bacillus. Another plus of brilliant green: the ability to stimulate tissue regeneration. And this is the cheapest antiseptic: the cost of a bottle (10 ml) is 10 rubles. Against the background of all the pluses, only one minus is distinguished: a rich green color that is washed off for a very long time. And in order not to stain yourself and everything around with brilliant green, you can use not a standard bottle, but a special pencil. It costs 50-60 rubles.

Otherwise, it is called "red brilliant green", although its properties are somewhat different from those of a solution of brilliant green. Fukortsin also contains ethyl alcohol, as well as boric acid and phenol. Therefore, it must be used with caution.

Fukortsin is used to disinfect wounds, prevent their suppuration and stop the process that has already begun. Suitable for the treatment of purulent and fungal skin diseases. It is used for abrasions, erosive wounds, acne on the face. The cost of a bottle of Fukortsin (25 ml) is approximately 40 rubles.

Chlorhexidine bigluconate

An antiseptic that is rarely found in a home first aid kit because it is not universal. Chlorhexidine bigluconate (or as it is called more simply - Chlorhexidine) is prescribed by a doctor, and in a certain concentration.

For example, 0.05% is used to rinse the throat and wash the nose, and a more concentrated solution is needed to treat wounds on the skin: from 0.1 to 0.5%. Chlorhexidine is good for festering wounds and burns. It is suitable for the prevention of sexually transmitted diseases (genital organs can be treated with a 0.1% solution).

Important! For open wounds and mucous membranes, an aqueous solution of Chlorhexidine is used. Alcohol is also used by surgeons for rubbing hands before operations, processing tools and instruments.

Depending on the concentration of Chlorhexidine, it is able to fight certain types of bacteria and infections. The cost of a bottle of an aqueous solution of 0.05% costs less than 10 rubles per 100 ml. Alcohol will cost 10-15 rubles more.

A universal antiseptic that appeared relatively recently and immediately became popular. Its basis is a complex monohydrate. Those who have tried Miramistin once rarely return to other means. It has a very wide spectrum of action, it perfectly fights infections of the throat, nose, and genital tract, and is suitable for suture treatment. Another plus is that it is absolutely tasteless and does not sting, even if you treat severe and deep wounds.

The minus of Miramistin is its price. This is the most expensive antiseptic presented earlier. A bottle of 150 ml costs 340-350 rubles. But it is economically used, thanks to the spray nozzle.

There are also antiseptic ointments that also work effectively ( Ichthyol ointment, Vishnevsky ointment, Tetracycline, Erythromycin, Levomekol, etc.) and antibacterial powders for wounds (Gentaksan, Baneocin, Streptocid, Xeroform, Galagran).

How to properly treat an open wound

Antiseptic treatment requires any, even a minor wound. The cat scratched, the burr came off, they were damaged during shaving - it is necessary to treat the wound in order to avoid its infection and the development of gangrene. There are cases when a negligent attitude towards oneself led to serious consequences, and, for example, an infection got into the body due to a squeezed and untreated pimple.

Having received a wound (any damage to the skin that provoked bleeding), you must immediately exclude any contact with it. Then take an antiseptic and apply it to the wound with a piece of cotton wool or a bandage, or simply by spraying it. Then, if the damage is serious, you should consult a doctor. If it’s not serious, you can stick a patch on top or bandage it.

Attention! Before treating a deep wound with an antiseptic, you need to stop heavy bleeding. This is done with a pressure bandage or pulling the vessel with a tourniquet according to all the rules of first aid.

It turns out that out of the nine antiseptics listed, it is optimal to use Miramistin, brilliant green or hydrogen peroxide. These are the three most versatile tools that meet the maximum number of requirements. They perfectly disinfect wounds, do not cause pain in the victim, do not cause irritation and toxic poisoning of the body.