ASEPSIS and ANTISEPSIS

DEFINITION OF TERMS
1.

2.

3.

4.

Asepsis the absence of infection or septic material. Antisepsis the prevention of sepsis (putrefaction) by destroying bacteria and infective material. Sterilization- process by which all forms of bacteria are destroyed. Disinfection- process by which only all the infective bacteria are destroyed.

5. Antiseptic a substance that will inhibit the growth of bacteria without necessarily destroying them. 6. Disinfectant is an agent, usually a chemical that kills pathogenic bacteria. 7. Germicide or Bactericide any agent that kill all germs or bacteria.

METHODS OF STERILIZATION

METHODS
1. 2.

3.
4.

Mechanical Thermal Chemical Physical

MECHANICAL METHODS
Thorough scrubbing with soap and water. No absolute sterilization can be attained, however, it is done because a large number of bacteria may be removed. DEBRIDEMENT The removal of devitalized tissue from a wound.

Carries with it the contaminating bacteria and other foreign bodies that may be present.

THERMAL METHODS

DRY
Naked

HEAT

flame this is used in emergency

cases to sterilize needles, other sharp instruments like scalpels, and other materials like kidney basins, etc.
The inside of the basin is sterilized by pouring alcohol into them and igniting it. Special precaution should be taken as this procedure may be a fire hazard.

 Hot

air oven in this form

of sterilization, the materials are subjected to high tempratures (300-320 F for 120 mins) in a hot oven. It is used specially to sterilize vaseline, vaselinized gause, oils, bone wax and talcum powder.

Hot air destroys microorganisms by means of oxidation.

 MOIST

HEAT

Boiling Water one of the commonest method of sterilization used in medical practice. Limited to emergencies and sanitizing certain equipments that are not destroyed by hot water. Disadvantage : dulls cutting instruments like scissors, and may cause deposition of lime on the surface or joints of metallic instruments and utensils. Time of exposure is 20 minutes.

Steam under pressure- this is the best method of sterilizing most, if not all, surgical supplies. The autoclave the apparatus used for this purpose, is so built to withstand increased steam pressure. Exposure is 15-20 mins at 250 F.

ADVANTAGES 1. Rapid Heating power. 2. Destruction of most resistant nonpathogenic and pathogenic spores in short period of exposure. 3. Characteristic and power easily controlled. 4. Automatic controls practically exclude human error in operation. 5. Accurate measures to test efficiency of the method used.

CHEMICAL METHODS

This is done by the use of antiseptic and germicides. The vital parts of the cell are destroyed by coagulation or blocked by combination with the chemical. THE EFFICIENCY IS INFLUENCED BY:
1.

2.

The selection depends on the type of bacteria to be destroyed. The surface of the object must be free of blood, pus, oil, or grease so that the chemical agent can contact the bacterial cell.

3. The time required to destroy the bacteria is influenced by the types of bacteria to be destroyed and the construction and design of the item. 4. The concentration of a solution usually influences the efficiency pf the agent. 5. An increased temperature accelerates the rate of disinfection. 6. The composition and structure of the object or instrument will influence the kind of chemical to be used. 7. The surface tension of a chemical agent promotes contact between the agent and the microorganism.

GROUP OF ANTISEPTICS
1.

2.
3. 4. 5. 6. 7. 8.

Phenol Salts of Heavy Metals Dye Chlorine Oxidizing Miscellaneous group of antiseptics Compound antiseptics New Groups of Antiseptics

PHENOL GROUP - Most commonly used are phenol and lysol. SALTS OF HEAVY METALS In watery solution, the germicidal activity of these salts is great. However, the activity becomes much reduced on coming in contact with soaps, alkalis, proteins, etc.

Example is silver nitrite, which is a powerful antiseptic. However, it easily decomposes when exposed to light,

DYE GROUP- commonly seen in wards and dispensaries. They are just as effective, if not better than the other antiseptics. Examples are gentian violet and merthiolate. CHLORINE GROUP derives its antiseptic capacity from the giving off of chlorine when brought into contact with protein materials of the tissues or bacteria.

Example is Dakins solution which is a hypochlorite solution used in wounds, especially the pungent ones.

OXIDIZING GROUP This group liberates oxygen when bought into contact with the tissues. Examples are hydrogen peroxide and potassium permanganate. MISCELLANEOUS GROUPS OF ANTISEPTICS Alcohol and Zephiran are good examples. Alcohol in 70% solution and Zephiran in 1:1000 aqueous solution are the most common concentrations used.

COMPOUND ANTISEPTICS these are those whose action as an antiseptic is enhanced by combining them with other drugs. Example is the ABC antiseptic douche (Alum, Boric acid, Carbolic acid). New groups of Antiseptics the hexachlorophene and povidone iodine solutions have recently gained popularity, particularly in its use for pre-operative sterilization and disinfection of hydrotherapy equipments.

PHYSICAL METHODS
This method of sterilization involves the use of physical agents like sunlight, ultraviolet and x-rays. Example : UVR therapy ( bactericidal range) for the treatment of bedsores.