Chlorhexidine Health Dictionary

Antiseptics prevent the growth of disease-causing micro-organisms without damaging living tissues. Among chemicals used are boric acid, carbolic acid, hydrogen peroxide and products based on coal tar, such as cresol. Chlorhexidines, iodine, formaldehyde, ?avines, alcohol and hexachlorophane are also used. Antiseptics are applied to prevent infection – for example, in preparing the skin before operation. They are also used externally to treat infected wounds.... antiseptics

A solution for rinsing the mouth. Many only leave the mouth feeling fresh and remove loose food debris from the teeth. Some, such as those containing hydrogen peroxide, can help to clean the teeth if the gums are too tender for proper toothbrushing, as in some types of gingivitis. Those containing chlorhexidine are effective against plaque when routine dental hygiene is impossible. Fluoride mouthwashes help to prevent tooth decay (see caries, dental), and a mouthwash of warm salt water can help to ease painful inflammation caused by tooth disorders. Antiseptic mouthwashes intended to combat halitosis are usually ineffective because they do not treat the cause of the problem.... mouthwash

Processes by which vegetative organisms, excluding spores, are killed in order to prevent the items disinfected from passing on infection. Equipment, bedlinen and hard surfaces may all be disinfected – the method chosen will depend on the material and size of the object. One of the most important procedures in preventing the spread of infection is the careful washing of hands before handling equipment and between treating di?erent patients. STERILISATION is di?erent from disinfection in that the methods used kill all living organisms and spores.

Methods of disinfection (1) Skin, wounds, etc. – chlorhexidine (with detergent or spirit); iodine (with detergent or spirit); cetrimide; ethyl alcohol; all must stay in contact with the skin for long enough for bacteria to be killed. (2) Hard surfaces (?oors, walls, etc.) – hypochlorites (i.e. bleaches) with or without detergent; cetrimide; iodine-containing solutions; ethyl alcohol. (3) Equipment – wet or dry heat (e.g. boiling for more than 5 minutes); submersion in liquid disinfectants for the appropriate time (e.g. glutaraldehyde 2·5 per cent), chlorhexidine in spirit 70 per cent, formaldehyde (irritant), chlorhexidine (0·1 per cent aqueous), hypochlorites.... disinfection

A wound is any breach suddenly produced in the tissues of the body by direct violence. An extensive injury of the deeper parts without corresponding injury of the surface is known as a bruise or contusion.

Varieties These are classi?ed according to the immediate e?ect produced: INCISED WOUNDS are usually in?icted with some sharp instrument, and are clean cuts, in which the tissues are simply divided without any damage to surrounding parts. The bleeding from such a wound is apt to be very free, but can be readily controlled. PUNCTURE WOUNDS, or stabs, are in?icted with a pointed instrument. These wounds are dangerous, partly because their depth involves the danger of wounding vital organs; partly because bleeding from a stab is hard to control; and partly because they are di?cult to sterilise. The wound produced by the nickel-nosed bullet is a puncture, much less severe than the ugly lacerated wound caused by an expanding bullet, or by a ricochet, and, if no clothing has been carried in by the bullet, the wound is clean and usually heals at once. LACERATED WOUNDS are those in which tissues are torn, such as injuries caused by machinery.

Little bleeding may occur and a limb can be torn completely away without great loss of blood. Such wounds are, however, especially liable to infection. CONTUSED WOUNDS are those accompanied by much bruising of surrounding parts, as in the case of a blow from a cudgel or poker. There is little bleeding, but healing is slow on account of damage to the edges of the wound. Any of these varieties may become infected.

First-aid treatment The ?rst aim is to check any bleeding. This may be done by pressure upon the edges of the wound with a clean handkerchief, or, if the bleeding is serious, by putting the ?nger in the wound and pressing it upon the spot from which the blood is coming.

If medical attention is available within a few hours, a wound should not be interfered with further than is necessary to stop the bleeding and to cover it with a clean dry handkerchief or bandage. When expert assistance is not soon obtainable, the wound should be cleaned with an antiseptic such as CHLORHEXIDINE or boiled water and the injured part ?xed so that movement is prevented or minimised. A wounded hand or arm is ?xed with a SLING, a wounded leg with a splint (see SPLINTS). If the victim is in SHOCK, he or she must be treated for that. (See also APPENDIX 1: BASIC FIRST AID.)... wounds

n. a chemical that destroys or inhibits the growth of disease-causing bacteria and other microorganisms and is sufficiently nontoxic to be applied to the skin or mucous membranes to cleanse wounds and prevent infections or to be used internally to treat infections of the intestine and bladder. Examples are *cetrimide, *chlorhexidine, and povidone-*iodine.... antiseptic

Burns are injuries caused by dry heat, scalds by moist heat, but the two are similar in symptoms and treatment. Severe burns are also caused by contact with electric wires, and by the action of acids and other chemicals. The burn caused by chemicals di?ers from a burn by ?re only in the fact that the outcome is more favourable, because the chemical destroys the bacteria on the affected part(s) so that less suppuration follows.

Severe and extensive burns are most frequently produced by the clothes – for example, of a child – catching ?re. This applies especially to cotton garments, which blaze up quickly. It should be remembered that such a ?ame can immediately be extinguished by making the individual lie on the ?oor so that the ?ames are uppermost, and wrapping him or her in a rug, mat or blanket. As prevention is always better than cure, particular care should always be exercised with electric ?res and kettles or pots of boiling water in houses where there are young children or old people. Children’s clothes, and especially night-clothes, should be made of non-in?ammable material: pyjamas are also much safer than nightdresses.

Severe scalds are usually produced by escape of steam in boiler explosions. Cigarettes are a common cause of ?res and therefore of burns; people who have fallen asleep in bed or in a chair while smoking may set ?re to the bed or chair. Discarded, unextinguished cigarettes are another cause.

Degrees of burns Burns are referred to as either super?cial (or partial-thickness) burns, when there is su?cient skin tissue left to ensure regrowth of skin over the burned site; and deep (or full-thickness) burns, when the skin is totally destroyed and grafting will be necessary.

Symptoms Whilst many domestic burns are minor and insigni?cant, more severe burns and scalds can prove to be very dangerous to life. The main danger is due to SHOCK, which arises as a result of loss of ?uid from the circulating blood at the site of a serious burn. This loss of ?uid leads to a fall in the volume of the circulating blood. As the maintenance of an adequate blood volume is essential to life, the body attempts to compensate for this loss by withdrawing ?uid from the uninjured areas of the body into the circulation. If carried too far, however, this in turn begins to affect the viability of the body cells. As a sequel, essential body cells, such as those of the liver and kidneys, begin to suffer, and the liver and kidneys cease to function properly. This will show itself by the development of JAUNDICE and the appearance of albumin in the urine (see PROTEINURIA). In addition, the circulation begins to fail with a resultant lack of oxygen (see ANOXIA) in the tissues, and the victim becomes cyanosed (see CYANOSIS), restless and collapsed: in some cases, death ensues. In addition, there is a strong risk of infection occurring. This is the case with severe burns in particular, which leave a large raw surface exposed and very vulnerable to any micro-organisms. The combination of shock and infection can all too often be life-threatening unless expert treatment is immediately available.

The immediate outcome of a burn is largely determined by its extent. This is of more signi?cance than the depth of the burn. To assess the extent of a burn in relation to the surface of the body, what is known as the Rule of Nine has been evolved. The head and each arm cover 9 per cent of the body surface, whilst the front of the body, the back of the body, and each leg each cover 18 per cent, with the perineum (or crutch) accounting for the remaining 1 per cent. The greater the extent of the burn, the more seriously ill will the victim become from loss of ?uid from his or her circulation, and therefore the more prompt should be his or her removal to hospital for expert treatment. The depth of the burn, unless this is very great, is mainly of import when the question arises as to how much surgical treatment, including skin grafting, will be required.

Treatment This depends upon the severity of the burn. In the case of quite minor burns or scalds, all that may be necessary if they are seen immediately is to hold the part under cold running water until the pain is relieved. Cooling is one of the most e?ective ways of relieving the pain of a burn. If the burn involves the distal part of a limb – for example, the hand and forearm – one of the most e?ective ways of relieving pain is to immerse the burned part in lukewarm water and add cold water until the pain disappears. As the water warms and pain returns, more cold water is added. After some three to four hours, pain will not reappear on warming, and the burn may be dressed in the usual way. Thereafter a simple dressing (e.g. a piece of sterile gauze covered by cotton-wool, and on top of this a bandage or adhesive dressing) should be applied. The part should be kept at rest and the dressing kept quite dry until healing takes place. Blisters should be pierced with a sterile needle, but the skin should not be cut away. No ointment or oil should be applied, and an antiseptic is not usually necessary.

In slightly more severe burns or scalds, it is probably advisable to use some antiseptic dressing. These are the cases which should be taken to a doctor – whether a general practitioner, a factory doctor, or to a hospital Accident & Emergency department. There is still no general consensus of expert opinion as to the best ‘antiseptic’ to use. Among those recommended are CHLORHEXIDINE, and antibiotics such as BACITRACIN, NEOMYCIN and polymixin. An alternative is to use a Tulle Gras dressing which has been impregnated with a suitable antibiotic.

In the case of severe burns and scalds, the only sound rule is immediate removal to hospital. Unless there is any need for immediate resuscitation, such as arti?cial respiration, or attention to other injuries there may be, such as fractures or haemorrhage, nothing should be done on the spot to the patient except to make sure that s/he is as comfortable as possible and to keep them warm, and to cover the burn with a sterile (or clean) cloth such as a sheet, pillowcases, or towels wrung out in cold water. If pain is severe, morphine should be given – usually intravenously. Once the victim is in hospital, the primary decision is as to the extent of the burn, and whether or not a transfusion is necessary. If the burn is more than 9 per cent of the body surface in extent, a transfusion is called for. The precise treatment of the burn varies, but the essential is to prevent infection if this has not already occurred, or, if it has, to bring it under control as quickly as possible. The treatment of severe burns has made great advances, with quick transport to specialised burns units, modern resuscitative measures, the use of skin grafting and other arti?cial covering techniques and active rehabilitation programmes, o?ering victims a good chance of returning to normal life.

CHEMICAL BURNS Phenol or lysol can be washed o? promptly before they do much damage. Acid or alkali burns should be neutralised by washing them repeatedly with sodium bicarbonate or 1 per cent acetic acid, respectively. Alternatively, the following bu?er solution may be used for either acid or alkali burns: monobasic potassium phosphate (70 grams), dibasic sodium phosphate (70 grams) in 850 millilitres of water. (See also PHOSPHORUS BURNS.)... burns and scalds

a condition that occurs as a result of reduced salivary flow from a variety of causes, including therapeutic agents, *Sjögren’s syndrome, connective?tissue diseases, diabetes, excision or absence of a major salivary gland, or radiotherapy to the head and neck that destroys the salivary glands. It causes swallowing and speech difficulties, inflamed gums, an increased incidence of dental caries, and loss of denture stability in people who have lost their teeth. Patients with their own teeth should be given strict dietary advice, chlorhexidine or fluoride mouthwashes, and sugar-free nonacidic saliva substitutes; they require special monitoring by their dentist. Medical name: xerostomia.... dry mouth