Antiseptic: Difference between revisions

{{Short description|Antimicrobial substance or compound}}

{{Use dmy dates|date=February 2023}}

An '''antiseptic''' ({{lang-el|ἀντί|translit=anti|lit=against}}<ref>{{cite web|url=https://www.perseus.tufts.edu/hopper/text?doc=Perseus%3Atext%3A1999.04.0057%3Aentry%3Da%29nti%2F|title=ἀντί|first1=Henry George|last1=Liddell|first2=Robert|last2=Scott|work=A Greek-English Lexicon|publisher=Perseus perseus.tufts.edu|url-status=live|archive-url=https://web.archive.org/web/20121010011324/http://www.perseus.tufts.edu/hopper/text?doc=Perseus:text:1999.04.0057:entry=a)nti%2F|archive-date=10 October 2012}}</ref> and {{lang-el|σηπτικός|translit=sēptikos|lit=putrefactive|label=none}}<ref>{{cite web|url=https://www.perseus.tufts.edu/hopper/text?doc=Perseus%3Atext%3A1999.04.0057%3Aentry%3Dshptiko%2Fs|title=σηπτικός|first1=Henry George|last1=Liddell|first2=Robert|last2=Scott|work=A Greek-English Lexicon|publisher=Perseus perseus.tufts.edu|url-status=live|archive-url=https://web.archive.org/web/20121010011344/http://www.perseus.tufts.edu/hopper/text?doc=Perseus:text:1999.04.0057:entry=shptiko%2Fs|archive-date=10 October 2012}}</ref>) is an [[antimicrobial]] substance or compound that is applied to living [[biological tissue|tissue]] to reduce the possibility of [[sepsis]], [[infection]] or [[putrefaction]]. Antiseptics are generally distinguished from ''[[antibiotic]]s'' by the latter's ability to safely destroy bacteria within the body, and from ''[[disinfectant]]s'', which destroy microorganisms found on non-living objects.<ref>{{cite journal|title=Antiseptics and Disinfectants: Activity, Action, and Resistance|first1=Gerald|last1=McDonnell|first2=A. Denver|last2=Russell|journal=Clinical Microbiology Reviews|pmc=88911|pmid=9880479|volume=12|issue=1|date=January 1999|pages=147–79|doi=10.1128/CMR.12.1.147}}</ref>

[[Antibacterial]]s include antiseptics that have the proven ability to act against bacteria. [[Microbicide]]s which destroy virus particles are called [[viricide]]s or [[antivirals]]. [[Antifungal]]s, also known as [[antimycotic]]s, are pharmaceutical [[fungicide]]s used to treat and prevent [[mycosis]] (fungal infection).<ref name="Wang2020">{{Cite journal |last=Wang |first=Jing |last2=Zhou |first2=Min |last3=Xu |first3=Jing-Yan |last4=Zhou |first4=Rong-Fu |last5=Chen |first5=Bing |last6=Wan |first6=Yuan |date=8 October 2020 |title=Comparison of Antifungal Prophylaxis Drugs in Patients With Hematological Disease or Undergoing Hematopoietic Stem Cell Transplantation: A Systematic Review and Network Meta-analysis |url=https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2771516 |journal=JAMA Network Open |language=en |volume=3 |issue=10 |pages=e2017652 |doi=10.1001/jamanetworkopen.2020.17652 |issn=2574-3805 |pmc=7545296 |pmid=33030550 |access-date=18 February 2023 |archive-date=18 February 2023 |archive-url=https://web.archive.org/web/20230218192533/https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2771516 |url-status=live }}</ref>

The widespread introduction of antiseptic [[surgery|surgical]] methods was initiated by the publishing of the paper ''[[Antiseptic Principle of the Practice of Surgery]]'' in 1867 by [[Joseph Lister, 1st Baron Lister|Joseph Lister]], which was inspired by [[Louis Pasteur]]'s [[Germ theory of disease|germ theory of putrefaction]].<ref>{{Cite EB1911|wstitle=Antiseptics|volume=2|page=146}}</ref><ref>{{cite journal |last1=Bashford |first1=Henry |title=The Coming of Antisepsis |journal=History Today |date=Apr 1951 |volume=1 |issue=4 |pages=37–41}}</ref> In this paper, Lister advocated the use of carbolic acid ([[phenol]]) as a method of ensuring that any germs present were killed. Some of this work was anticipated by:

* [[Greeks|Ancient Greek]] physicians [[Galen]] ({{circa|130–200}}) and [[Hippocrates]] ({{circa|400 BC}}) as well as [[Sumer]]ian clay tablets dating from 2150 BC that advocate the use of similar techniques.<ref>{{cite journal |vauthors=Eming SA, Krieg T, Davidson JM |title=Inflammation in wound repair: molecular and cellular mechanisms |journal=J. Invest. Dermatol. |volume=127 |issue=3 |pages=514–25 |year=2007 |pmid=17299434 |doi=10.1038/sj.jid.5700701 |doi-access=free }}</ref>

* [[Ignaz Semmelweis]], who published his work ''The Cause, Concept and Prophylaxis of Childbed Fever'' in 1861, summarizing experiments and observations since 1847<ref>{{cite journal |vauthors=Best M, Neuhauser D |title=Ignaz Semmelweis and the birth of infection control |journal=Qual Saf Health Care |volume=13 |issue=3 |pages=233–4 |year=2004 |pmid=15175497 |pmc=1743827 |doi=10.1136/qhc.13.3.233 }}</ref>

* Medieval surgeons [[Hugh of Lucca]], Theoderic of Servia, and his pupil [[Henri de Mondeville]] were opponents of Galen's opinion that [[pus]] was important to healing, which had led ancient and medieval surgeons to let pus remain in wounds. They advocated draining and cleaning the wound edges with wine, dressing the wound after suturing, if necessary and leaving the dressing on for ten days, soaking it in warm wine all the while, before changing it. Their theories were bitterly opposed by Galenist [[Guy de Chauliac]] and others trained in the classical tradition.<ref>{{cite journal | author = Edwards H | year = 1976 | title = Theodoric of Cervia, a medieval antiseptic surgeon | journal = Proceedings of the Royal Society | volume = 69 | issue = 3| pages = 553–5 | pmc=1864551 | pmid=790395}}</ref>

* [[Oliver Wendell Holmes Sr.]], who published ''The Contagiousness of Puerperal Fever'' in 1843

Antiseptics can be subdivided into about eight classes of materials. These classes can be subdivided according to their mechanism of action: small molecules that indiscriminately react with organic compounds and kill microorganisms (peroxides, iodine, phenols) and more complex molecules that disrupt the cell walls of the bacteria.<ref>{{Ullmann|doi=10.1002/14356007.w08_w03|title=Dermatologicals (D), 4. Antiseptics and Disinfectants (D08), Anti‐Acne Preparations (D10), and Other Dermatological Preparations (D11)|year=2020|last1=Kutscher|first1=Bernhard|pages=1–22}}</ref>

* [[Alcohol (chemistry)|Alcohol]]s, including [[ethanol]] and 2-propanol/[[isopropanol]] are sometimes referred to as ''[[surgical spirit]]''. They are used to disinfect the skin before injections, among other uses.

* [[Diguanide]]s including [[chlorhexidine gluconate]], a bacteriocidal antiseptic which (with an alcoholic solvent) is considered a safe and effective antiseptic for reducing the risk of infection after clean surgery,<ref>{{cite journal |last1=Wade |first1=Ryckie G. |last2=Burr |first2=Nicholas E. |last3=McCauley |first3=Gordon |last4=Bourke |first4=Grainne |last5=Efthimiou |first5=Orestis |title=The Comparative Efficacy of Chlorhexidine Gluconate and Povidone-iodine Antiseptics for the Prevention of Infection in Clean Surgery: A Systematic Review and Network Meta-analysis |journal=Annals of Surgery |date=1 September 2020 |volume=Publish Ahead of Print |issue=6 |pages=e481–e488 |doi=10.1097/SLA.0000000000004076|pmid=32773627 |doi-access=free }}</ref> including tourniquet-controlled upper limb surgery.<ref>{{cite journal |last1=Wade |first1=Ryckie G |last2=Bourke |first2=Gráinne |last3=Wormald |first3=Justin C R |last4=Totty |first4=Joshua Philip |last5=Stanley |first5=Guy Henry Morton |last6=Lewandowski |first6=Andrew |last7=Rakhra |first7=Sandeep Singh |last8=Gardiner |first8=Matthew D |last9=Bindra |first9=R |last10=Sher |first10=M |last11=Thomas |first11=M |last12=Morgan |first12=S D J |last13=Hwang |first13=B |last14=Santucci |first14=W |last15=Tran |first15=P |last16=Kopp |first16=L |last17=Kunc |first17=V |last18=Hamdi |first18=A |last19=Grieve |first19=P P |last20=Mukhaizeem |first20=S A |last21=Blake |first21=K |last22=Cuggy |first22=C |last23=Dolan |first23=R |last24=Downes |first24=E |last25=Geary |first25=E |last26=Ghadge |first26=A |last27=Gorman |first27=P |last28=Jonson |first28=M |last29=Jumper |first29=N |last30=Kelly |first30=S |last31=Leddy |first31=L |last32=McMahon |first32=M E |last33=McNamee |first33=C |last34=Miller |first34=P |last35=Murphy |first35=B |last36=O'Halloran |first36=L |last37=O'Shea |first37=K |last38=Skeens |first38=J |last39=Staunton |first39=S |last40=Timon |first40=F |last41=Woods |first41=J |last42=Cortinovis |first42=U 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|last79=Dargan |first79=D |last80=Pinder |first80=R M |last81=Koziara |first81=M |last82=Martin |first82=R |last83=Reay |first83=E |last84=Cochrane |first84=E |last85=Elbatawy |first85=A |last86=Green |first86=F |last87=Griffiths |first87=T |last88=Higginbotham |first88=G |last89=Louette |first89=S |last90=McCauley |first90=G |last91=Natalwala |first91=I |last92=Salt |first92=E |last93=Ahmed |first93=R |last94=Goon |first94=P |last95=Manton |first95=R |last96=Segaren |first96=N |last97=Cheung |first97=G |last98=Mahoney |first98=R |last99=Sen |first99=S |last100=Clarkson |first100=D |last101=Collins |first101=M |last102=Bolt |first102=A |last103=Lokanathan |first103=P |last104=Ng |first104=A |last105=Jones |first105=G |last106=Jones |first106=J W M |last107=Kabariti |first107=R |last108=Rhee |first108=S J |last109=Herron |first109=J |last110=Kay |first110=A |last111=Cheung |first111=L K |last112=Thomson |first112=D |last113=Jugdey |first113=R S |last114=Yoon |first114=H |last115=L 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|last150=Phillips |first150=B |last151=Madhusudan |first151=N |title=Chlorhexidine versus povidone–iodine skin antisepsis before upper limb surgery (CIPHUR): an international multicentre prospective cohort study |journal=BJS Open |date=9 November 2021 |volume=5 |issue=6 |pages=zrab117 |doi=10.1093/bjsopen/zrab117|pmid=34915557 |pmc=8677347 }}</ref> It is also used in mouthwashes to treat inflammation of the gums ([[gingivitis]]). [[Polyhexanide]] (polyhexamethylene biguanide, PHMB) is an antimicrobial compound suitable for clinical use in critically colonized or infected acute and chronic wounds. The physicochemical action on the bacterial envelope prevents or impedes the development of resistant bacterial strains.<ref name="pmid20829657">{{cite journal |author=Kaehn K |s2cid=684665 |title=Polihexanide: a safe and highly effective biocide |journal=Skin Pharmacol Physiol |volume=23 Suppl |pages=7–16 |year=2010 |pmid=20829657 |doi=10.1159/000318237 |doi-access=free }}</ref><ref name="pmid20829662">{{cite journal |vauthors=Eberlein T, Assadian O |title=Clinical use of polihexanide on acute and chronic wounds for antisepsis and decontamination |journal=Skin Pharmacol Physiol |volume=23 Suppl |pages=45–51 |year=2010 |pmid=20829662 |doi=10.1159/000318267 |doi-access=free }}</ref><ref name="pmid22240928">{{cite journal |vauthors=Eberlein T, Haemmerle G, Signer M |title=Comparison of PHMB-containing dressing and silver dressings in patients with critically colonised or locally infected wounds |journal=J Wound Care |volume=21 |issue=1 |pages=12, 14–6, 18–20 |date=January 2012 |pmid=22240928 |doi=10.12968/jowc.2012.21.1.12 |url=http://www.internurse.com/cgi-bin/go.pl/library/article.cgi?uid=88747;article=JWC_21_1_12_20 |display-authors=etal |url-status=live |archive-url=https://web.archive.org/web/20130618003547/http://www.internurse.com/cgi-bin/go.pl/library/article.cgi?uid=88747;article=JWC_21_1_12_20 |archive-date=18 June 2013 }}</ref>

* [[Iodine]], especially in the form of [[povidone-iodine]], is widely used because it is well tolerated; does not negatively affect wound healing; leaves a deposit of active iodine, thereby creating the so-called "remnant", or persistent effect; and has wide scope of antimicrobial activity. The traditional iodine antiseptic is an [[ethanol|alcohol]] solution (called [[tincture of iodine]]) or as [[Lugol's iodine]] solution. Some studies<ref name="VermeulenWesterbos2010">{{cite journal|last1=Vermeulen|first1=H.|last2=Westerbos|first2=S.J.|last3=Ubbink|first3=D.T.|title=Benefit and harm of iodine in wound care: a systematic review|journal=Journal of Hospital Infection|volume=76|issue=3|year=2010|pages=191–199|issn=0195-6701|doi=10.1016/j.jhin.2010.04.026|pmid=20619933}}</ref> do not recommend disinfecting minor wounds with iodine because of concern that it may induce scar tissue formation and increase healing time. However, concentrations of 1% iodine or less have not been shown to increase healing time and are not otherwise distinguishable from treatment with saline.<ref name="medscape.com">{{cite web |url=http://www.medscape.com/viewarticle/456300_3 |title=Antiseptics on Wounds: An Area of Controversy: Hydrogen Peroxide |publisher=Medscape.com |access-date=4 March 2014 |url-status=live |archive-url=https://web.archive.org/web/20130719075630/http://www.medscape.com/viewarticle/456300_3 |archive-date=19 July 2013 }}</ref> Iodine will kill all principal pathogens and, given enough time, even [[Endospore|spores]], which are considered to be the most difficult form of microorganisms to be inactivated by disinfectants and antiseptics.

* [[Octenidine dihydrochloride]], currently increasingly used in continental Europe, often as a chlorhexidine substitute.

* [[Peroxide]]s, such as [[hydrogen peroxide]] and [[benzoyl peroxide]]. Commonly, 3% solutions of hydrogen peroxide have been used in household first aid for scrapes, etc. However, the strong oxidization causes scar formation and increases healing time during fetal development.<ref>{{cite journal |vauthors=Wilgus TA, Bergdall VK, Dipietro LA, Oberyszyn TM |title=Hydrogen peroxide disrupts scarless fetal wound repair |journal=Wound Repair Regen |volume=13 |issue=5 |pages=513–9 |year=2005 |pmid=16176460 |doi=10.1111/j.1067-1927.2005.00072.x |s2cid=1028923 }}</ref>

* [[Quat salt]]s such as [[benzalkonium chloride]]/[[Lidocaine]] (trade name Bactine among others), [[cetylpyridinium chloride]], or [[cetrimide]]. These surfactants disrupt cell walls.

* [[4-Hexylresorcinol]], or S.T.37

* [[Actinonin]]

{{reflist}}

* {{Cite NIE|wstitle=Antiseptic|year=1905 |short=x}}

{{Concepts in infectious disease}}

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