RU2134124C1 - Method of surgeon hand treatment at urgent operations - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method is carried out by treatment of surgeon hand skin with egg shell solution in hydrochloric acid at ratio 1:2 and pH 7.5 for one minute. Preliminary surgeon hands are treated with concentrated solution of sodium hydrocarbonate for one minute. Method provides sterility for 2 min and does not cause irritation and skin intolerance. EFFECT: enhanced effectiveness of method. 1 cl

Description

 The invention relates to medicine, namely to methods for disinfecting the skin of the hands of a surgeon. The relevance of this topic is due to the fact that during urgent (urgent vital indications) surgical interventions there is no time to thoroughly treat the surgeon's hands, and for this, as a rule, there are no conditions, since such operations are unexpected, and therefore, the need for them may arise any, even in the field, so much for their conduct remains unprepared. Nevertheless, the necessary conditions for the antiseptics of the surgeon's hands, as you know, must be observed in any operation, regardless of the situation and the conditions in which the surgeon and the patient are.

 However, the current methods of treating the hands of a surgeon, as a rule, do not meet these requirements, since even in the conditions of the clinic and planned operations, it takes 5 minutes or more for the preoperative treatment of the hands of the surgeon, which is unacceptable when the patient’s life depends on each minute lost. For example, the “Spasokukotsky-Kochergin” method: after thoroughly washing hands with warm water and soap for a minute, hands are washed in basins with a 0.5% freshly prepared solution of ammonia with a sterile towel - 3 minutes in one and then 3 minutes in another basin. After that "hands are drained with a sterile towel and treated with alcohol for 5 minutes. Some surgeons additionally treat their fingers with 10% iodine tincture. The simplicity and high efficiency of this method have won its widespread acceptance and widespread" but for urgent surgery it turned out to be of little use because of the duration of its implementation - 12 or more minutes (Yu. A. Nesterenko. Surgical diseases, 1978). However, some individuals are intolerant of ammonia, which also destroys the skin of the hands.

 “Zabludovsky’s method: hands are washed with 5% tannin for 2-5 minutes without first washing with water. Tannin treatment leads to coarsening of the skin and the appearance of cracks in the skin of the hands, which acquire a yellow-brown color." (Yu.A. Nesterenko). The most suitable for urgent surgery, in our opinion, is a method of treating hands with a 20% chlorhexidine solution mixed with 70% ethyl alcohol in a ratio of 1:40. Thus obtained 0.5% aqueous-alcoholic solution of chlorhexidine bigluconate is used to treat the surgeon's hands for 2-3 minutes twice. But this drug can also cause itching of the skin and dermatitis (M. D. Mashkovsky. Medicines, 1977, volume II, p. 450-451). All these methods require a long time, cause irritation to the skin of the hands of the surgeon and have a short effect within two hours or less, which requires repeated processing of the hands. Thus, all these methods are unsuitable for urgent surgery, which prompts the search for more advanced methods of processing the surgeon's hands.

 In connection with the foregoing, the aim of the present invention is to develop a new, faster way to sterilize the hands of the surgeon and more gentle for the skin of the hands, as well as with a longer effect of the effect of sterilization of the skin so that it is not required to re-treat the hands during surgery.

 To achieve this goal, we have developed a new method for treating the hands of a surgeon, which allows sterilization of the skin of the hands in two minutes with a long-lasting effect - up to ten hours and without signs of irritation of the skin of the hands.

 As a prototype, we took the most modern chlorine-containing drug chlorhexidine, which is used in practice to sterilize the surgeon's hands, but which has a number of disadvantages described above. To develop our new method of sterilizing the hands of a surgeon, we used the well-known drug P.N. Ulyanova - (Sterilization of infected wounds. Bulletin of the USSR Academy of Sciences, 1940, pp. 35-37).

 This preparation was obtained by dissolving the eggshell in hydrochloric acid to a pH of 7.5. Moreover, in cases of treatment of purulent wounds that already have an acidic environment, the wound was pre-treated with a solution of drinking soda, which allowed more successful use of the sterilizing effect of the drug.

 The method was implemented as follows.

 First of all, the preparation was prepared by dissolving the eggshell in concentrated hydrochloric acid, taken in a ratio of 1: 2. It took 12 hours to undergo a complete neutralization-dissolution reaction. The end of the reaction was determined by the precipitation breakdown: the resulting solution was mixed with a concentrated solution of baking soda. Flakes fall out during the reaction, but there should be no gas bubbles. The resulting neutral solution of eggshell in hydrochloric acid was purified by filtration through gauze with cotton wool.

The chemical composition of the feedstock:
Ca ₃ (PO ₄ ) ₂ - 55%
CaCO ₃ - 9%
CaCl ₂ - 2%
After treatment with hydrochloric acid, Ca ₃ (PO ₄ ) ₂ passes into CaH ₂ PO ₄ , and CaCO ₃ into CaCl ₂ , and other components of the composition undergo a similar rearrangement. The resulting solution is diluted with distilled water 100 times, after which the drug is considered ready for use, while its pH corresponds to 7.5.

 Hands that were clean in the domestic sense did not require pre-treatment, however, if they were dirty, it was enough to wash off the dirt with water and rinse clean hands with water to moisturize. After that, the hands were covered with baking soda powder, which, partially dissolved, adhered to the hands, and the hands became dry. After one minute, the baking soda was washed off the surface of the hands with a solution of eggshell in hydrochloric acid for one minute, after which the skin of the hands became sterile, and even when working in rubber gloves after ten hours, when the gloves were filled with “glove juice”, the last one like the skin of the hands, they remained sterile, which was controlled by sowing scrapings from the skin of the hands of the surgeon and “glove juice” taken after ten hours of rubber gloves on the hands of the surgeon. Crops were made on meat and peptone broth and sugar agar in Petri dishes, both before and after hand treatment.

 Here is an extract from the protocol of the experience of hand sterilization with a two-minute treatment. Experience N 10. Drug P.

 When sowing scrapings from the skin of the hands before sterilization, an increase in the microbial flora was revealed.

 Hand skin treatment was carried out according to the described procedure with a two-minute treatment.

 Sweating in sterile rubber gloves lasted 10 hours.

 Crops of multiple scrapings of the epidermis and “glove juice” were sown. Over 10 days there was no growth of crops.

 Conclusion Hands after treatment remained sterile for 10 hours.

 A total of 50 experiments were carried out and the results were stable.

 With repeated use by one surgeon, no irritation of the skin of the hands was observed, which allows us to recommend this method of two-minute treatment of the skin of the hands of the surgeon for implementation in public health practice, especially during emergency operations: ambulance, in the field, etc.

Claims (1)

 A method of treating a surgeon’s hands during urgent operations with a chlorine-containing solution, characterized in that the surgeon’s hands are treated for one minute with a solution including eggshell and concentrated hydrochloric acid in a ratio of 1: 2 at pH 7.5, while the surgeon’s hands are pre-treated with a concentrated solution baking soda one minute.