Let us make an in-depth study of the uses and preparations of disinfectant or antiseptic lotions.
Phenol Group Antiseptics:
Lysol (liquor cresolis saponatus) and cresol (black and white fluid) are general powerful disinfectants. Lysol, in 3 per cent solution, is generally used for sterilising discarded cultures; Sudol is less toxic substitute for Lysol.
Phenol (0.5 per cent solution) is effective in preserving sera; Chloroxylenol (Dettol) is less active toxic and irritant. Hexachlorophene is incorporated in various antiseptics preparations and reduces the skin flora, if it is used repeatedly as detergent containing 2-3 per cent hexachlorophene.
Metallic Salts:
Mercuric chloride (1:1,000) is an useful disinfectant; merthiolate (1:10,000) can preserve antis- era; silver nitrate (1 per cent) is employed for prophylaxis of gonococcal ophthalmia. Chlorhexidine (Hibitane — modern antiseptic) replaces silver nitrate and is effective against both Gram-positive and Gram-negative bacteria.
Formalin (40 percent solution of formaldehyde in water) is a powerful and rapid disinfectant to decontaminate the surface and disinfect the bacterial cultures.
Borax — formaldehyde solution (Sodium tetra borate – 5 g.; Formaldehyde, 4 percent in water, 1,000 ml) can be useful to sterilize the cleaned metal instruments.
Tincture of iodine or 5 percent phenol solution or stronger solution of chloroxylenol (Dettol) can be used as a single application for preparing the skin of the patient for incision or puncture.
Recently, the addition of 0.5 per cent chlorhexidine in 70 percent ethyl alcohol improves the action of 70 per cent alcohol and is also as effective as 1 percent iodine in alcohol and also to be free from irritation.
Cetrimide (Cetavlon):
This solution has pronounced surface tension lowering properties and, on shaking, it produces a prolific foam. It is incompatible with soap and similar anionic detergent. It has both powerful detergent and bactericidal properties. It is more effective against Gram-positive bacteria and to a lesser degree against Gram-negative bacteria.
Aqueous or alcoholic solution of Cetavlon do not kill spores. It is specially useful to remove tar, oil or grease. For all practical purposes, it is highly active against bacteria in concentration as low as 0.1 percent; one per cent solution can be used for its full detergent power.0.1 percent solution of Cetavlon in 10 per cent alcohol is sufficient to effect a satisfactory degree of sterility within 2 minutes. For a more rapid sterilisation, higher concentration should be used.
A one per cent aqueous solution of Cetavlon has been found to be efficient preparation in the preoperative “Scrub up” of the hands. If soap and water are first used, the hands can be finally rinsed with a 0.1 per cent solution of Cetavlon to give the necessity of persistent bactericidal film. One percent solution of Cetavlon can be used in preliminary cleaning dirty, contaminated wounds. Oils, grease can be removed.
One per cent solution of Cetavlon is very useful to clean dog bite wound, adjunct to routine antirabic vaccination. Basins, bowels, tables can be readily cleaned and disinfected by rinsing with one per cent aqueous solution. Surgical instruments can be effectively cleaned by rinsing with one per cent aqueous solution of Cetavlon in a closed container.
To prevent rusting, sodium nitrate is thoroughly mixed in the proportion of 4 g per liter of solution. Solutions used for storing instruments should be changed at weekly intervals. The instruments should be rinsed and dried when removed from the solution after use.
Preparation of Cetavlon:
Aqueous solution of Cetavlon is rapidly and simply prepared by adding the concentrate to water. When solutions are being prepared for the storage of sterilised instruments, it is preferable to use boiled or distilled water. Cetavlon concentrate 20%. It contains 20% Cetavlon in aqueous solution distinctly coloured with a non-staining yellow dye A 1% solution of Cetavlon is prepared by mixing 35 ml of the concentrate with about 7 litres of water.
Cetavlon Tincture:
An alcoholic solution contains 0.5% Cetavlon coloured by adding a harmless red dye. When applied to the skin, it eliminates bacteria and stains the area so that the site of operation is clearly defined. The dye may be removed by washing and will not harm the dressings.
Cetavlex Cream:
Contains 0.5% Cetavlon in an emolient cream base, it can be used in treatment of wounds and burns during emergency. Savlon concentrate combines the advantages of two outstanding antiseptics of proved value it contains the new antiseptic ‘Hibitane’ (Chlorhexidine gluconate, 1.5% W/V) together with “Cetavlon” (Cetrimide, 15%W/V).Cetrimide possess antiseptic and cleaning properties; it is the most powerful for its detergency.
It is highly active against Gram-positive organisms and Gram-negative organisms such a Pseudomonas pyocynea. The combination of these two antiseptics provides a most powerful antibacterial solution with a wide-spectrum of activity and high speed of killing. A 1 in 200 dilution in water is recommended for disinfection of wards and hospital equipment’s. For preliminary treatment of wounds and bums, in rinsing of hands, a 1 in 100 dilution is used. For preoperative preparation of skin and scrub up of surgeon’s hands a 1 in 30 dilution in water should be recommended.