Antisepsis
With antisepsis ( Greek , "to rot "; σῆψις of "rot."; Cf. " sepsis ") is any measures to reduce the bacterial count of infectious germs from living tissues , and thus to prevent infection , such. B. by disinfection with biocides .
Since the 19th century, the main task of antisepsis has been described in the medical field as "disinfecting the hands of the operating person and all objects that come into contact with the operating field", and thorough washing of the hands is seen as a fundamental measure.
The concept of antisepsis must be differentiated from the later concept of asepsis , which aims at complete sterility and forms a basis for today's hygiene measures . However, this can hardly be achieved on body surfaces, since the skin or mucous membrane cannot be sterilized .
history
The founder of antisepsis was Ignaz Semmelweis (1818–1865), who went down in the history of medicine as the “savior of mothers” , although microscopy had been practiced for a long time in his day and the existence of tiny, only visible with the microscope “ Essence ”was known. Antoni van Leeuwenhoek (1632–1723) had already described "the little Biesterkes". The knowledge of these "beings" had not yet found their way into medicine. The conception of illness at that time was that a poor constitution led to illness, and that infection was not considered the cause.
On August 12, 1865 - one day before Ignaz Semmelweis' death - Joseph Lister performed the first operation with antisepsis on an eleven-year-old boy named James Greenlees in Glasgow, Scotland . The operation was successful, just six weeks later Greenlees was able to leave the hospital completely healthy. In the course of treating a patellar fracture , carbolic acid was used to disinfect tissue by Joseph Lister, 1st Baron Lister and the surgeon Hector Cameron in 1867. One of the first Americans to practice antisepsis according to Lister's method was the Chicago surgeon Edmund Andrews (1824-1904). In a lecture given by the surgeon Richard von Volkmann at the first congress of the German Society for Surgery on April 10, 1872 in Berlin, the antisepsis was treated. Even 33 years later, surgeon Ernst von Bergmann , who specializes in war injuries, is still impressed. He wrote in the magazine Die Woche in January 1905 in his article "On bullet wounds from the modern infantry rifle":
“As early as 1872, at the first congress of German surgeons, von Volkmann, when comparing the fractures of the lower extremities in times of war and times of peace, reported the surprising fact that the former are more favorable than the latter, or, in other words, that the latter are less than to die of these. Although the bullet fractures are usually splinter fractures and the complicated, i. H. Peace fractures associated with a soft tissue wound, even under the disreputable conditions of the Crimean campaign, died less from bullet fractures of the lower leg, namely 25 pct., than died in the model hospitals of Europe during peace, namely 32.5 pct. The reason for this could only be the different nature of the soft tissue wounds complicating the fracture. In the case of peace violations, regardless of whether a machine injures the leg with its teeth and bars or the wheel of a tram goes over it, they are big and wide-gaping, in the case of war injuries small and cramped. The harmful substances causing inflammation - the pus cocci - can penetrate into these much more easily than into these. The new doctrine of wound poisoning explained the striking fact. "
literature
- Christoph Weißer: Antisepsis. In: Werner E. Gerabek u. a. (Ed.): Encyclopedia of medical history. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 72 f.
Individual evidence
- ^ R. Seavey: High-level disinfection, sterilization, and antisepsis: current issues in reprocessing medical and surgical instruments. In: American journal of infection control. Volume 41, Number 5 Suppl, May 2013, pp. S111-S117, ISSN 1527-3296 . doi : 10.1016 / j.ajic.2012.09.030 . PMID 23622741 .
- ↑ J. Tanner, S. Swarbrook, J. Stuart: Surgical hand antisepsis to reduce surgical site infection. In: The Cochrane database of systematic reviews. Number 1, 2008, p. CD004288, ISSN 1469-493X . doi : 10.1002 / 14651858.CD004288.pub2 . PMID 18254046 .
- ^ M. Maiwald, ES Chan: The forgotten role of alcohol: a systematic review and meta-analysis of the clinical efficacy and perceived role of chlorhexidine in skin antisepsis. In: PloS one. Volume 7, number 9, 2012, p. E44277, ISSN 1932-6203 . doi : 10.1371 / journal.pone.0044277 . PMID 22984485 . PMC 3434203 (free full text).
- ↑ Belaieff: On the antiseptic technique. In: Centralblatt für Gynäkologie. Volume 10, No. 19, May 8, 1886, pp. 291 f.
- ^ CR4: Aug 12, 1865: Lister Performs First Surgery with Antiseptic .
- ↑ Steven Lehrer: Explorers of the Body , USA 1979.
- ^ Albert Faulconer, Thomas Edward Keys: Edmund Andrews. In: Foundations of Anesthesiology. Charles C Thomas, Springfield (Illinois) 1965, p. 430.
- ↑ From Die Woche , No. 2, 1905, page 61