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Burns : Journal of the International... May 2023Burns are traumatic wounds that occur when skin is exposed to an amount of energy greater than its maximum dissipation capacity. Alcohol, because it fuels flames and its...
BACKGROUND
Burns are traumatic wounds that occur when skin is exposed to an amount of energy greater than its maximum dissipation capacity. Alcohol, because it fuels flames and its vapor can cause an explosion, is one of the most common causal agents of burns in Brazil. In late 2019, the COVID-19 pandemic caused a sudden and substantial increase in the use of 70% alcohol (w/v) for antisepsis.
OBJECTIVES
To analyze the epidemiological characteristics of alcohol burns during the COVID-19 pandemic in participating Burn Treatment Centers, as well as the severity and treatment of these burns.
METHOD
Descriptive, cross-sectional, quantitative and retrospective study based on data obtained from medical records of patients treated in participating Burn Treatment Centers. Data collection included origin, gender, education level, occupation, circumstance of the accident, wound depth and type of treatment.
RESULTS
Of eight participating centers, theHospital da Restauraç ão Gov. Paulo Guerra Burn Treatment Center experienced the highest number of alcohol burn patients (38.4%) and male gender accounted for 53.6% of all cases. Predominant occupations were those that involve domestic activities (29%) and 48.6% of patients had not completed elementary school. The most common cause was an accident during cooking (35.5%) followed by suicide attempt (18.3%). More than half (58.6%) of the patients had concomitant second and third degree burns and wound treatment of choice was surgical (43.1%).
CONCLUSIONS
The predominant population in this study was male, had a lower level of education, resided in the northeast region and had an occupation carried out in a domestic environment. The latter may reflect the population's longer stay at home due to social constraints caused by the COVID-19 pandemic. There were a large number of second and third degree burns and, as a consequence, a high number of cases in which surgical treatment was required.
Topics: Humans; Male; Burns; Incidence; Retrospective Studies; Cross-Sectional Studies; Pandemics; COVID-19; Length of Stay
PubMed: 35610078
DOI: 10.1016/j.burns.2022.04.005 -
Antibiotics (Basel, Switzerland) Dec 2022Few point prevalence surveys (PPS) have been conducted in Vietnam on Surgical Site Infections (SSI) or antimicrobial use in surgery. The objective of this study was to...
Few point prevalence surveys (PPS) have been conducted in Vietnam on Surgical Site Infections (SSI) or antimicrobial use in surgery. The objective of this study was to evaluate the PPSs of SSI before and after implementation of antibiotic stewardship programs (ASP) and infection control (IC) in a Vietnamese tertiary care hospital. ASP and IC practices were implemented in operating rooms and the orthopedic department, including antibiotic training, skin preparation, hand hygiene, gloves and sterile instruments, and SSIs risk factors. A PPS of SSIs and antimicrobial use was performed in January 2016 according to methods from the Centers for Disease Control and Prevention, before ASP and IC, and in December 2019. Information recorded included surgical data, antibiotic prophylaxis, microorganisms, and SSI risk factors. Skin preparation compliance assessed preoperative washing and antisepsis. SSI prevalence was 7.8% in 2016 versus 5.4% in 2019 ( = 0.7). The use of prophylactic antibiotics decreased from 2016 to 2019. A third-generation cephalosporin was prescribed more than 48 h after surgery for most patients. Skin preparation compliance increased from 54.4% to 70.5% between assessments. The decreased SSI, although non-statistically significant, warrants continuing this program. Vietnamese hospitals must provide comprehensive IC education to healthcare workers to address the prevention of SSI and establish IC policies.
PubMed: 36671224
DOI: 10.3390/antibiotics12010023 -
Journal of the American College of... Nov 2021Whole blood transfusion (WBT) began in 1667 as a treatment for mental illness, with predictably poor results. Its therapeutic utility and widespread use were initially...
Whole blood transfusion (WBT) began in 1667 as a treatment for mental illness, with predictably poor results. Its therapeutic utility and widespread use were initially limited by deficiencies in transfusion science and antisepsis. James Blundell, a British obstetrician, was recognized for the first allotransfusion in 1825. However, WBT did not become safe and therapeutic until the early 20 century, with the advent of reliable equipment, sterilization, and blood typing. The discovery of citrate preservation in World War I allowed a separation of donor from recipient and introduced the practice of blood banking. During World War II, Elliott and Strumia were the first to separate whole blood into blood component therapy (BCT), producing dried plasma as a resuscitative product for "traumatic shock." During the 1970s, infectious disease, blood fractionation, and financial opportunities further drove the change from WBT to BCT, with few supporting data. Following a period of high-volume crystalloid and BCT resuscitation well into the early 2000s, measures to avoid the resulting iatrogenic resuscitation injury were developed under the concept of damage control resuscitation. Modern transfusion strategies for hemorrhagic shock target balanced BCT to reapproximate whole blood. Contemporary research has expanded the role of WBT to therapy for the acute coagulopathy of trauma and the damaged endothelium. Many US trauma centers are now using WBT as a front-line treatment in tandem with BCT for patients suffering hemorrhagic shock. Looking ahead, it is likely that WBT will once again be the resuscitative fluid of choice for patients in hemorrhagic shock.
Topics: ABO Blood-Group System; Blood Banks; Blood Component Transfusion; Blood Preservation; Blood Transfusion; Crystalloid Solutions; History, 17th Century; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Resuscitation; Shock, Hemorrhagic; Shock, Traumatic; Transfusion Reaction; World War I; World War II
PubMed: 34390843
DOI: 10.1016/j.jamcollsurg.2021.08.001 -
Materials (Basel, Switzerland) Sep 2023The actuality of this research is determined by the intensification of new ways of processing woody biomass. This requires revealing the impact of various...
The actuality of this research is determined by the intensification of new ways of processing woody biomass. This requires revealing the impact of various physicochemical factors on the thermal degradation of wood biopolymers. Boron-nitrogen surface modifiers are used for wood antisepsis and we decided to check their effect on flammability. The aim of the research was to evaluate the flame retardant effect of boron-nitrogen surface modifiers of wood in an inert atmosphere (nitrogen was used). The evaluation was carried out by thermal analysis of modified and the control pine wood samples. The thermal analysis included thermogravimetry, differential scanning calorimetry and kinetic parameters of thermal degradation. It was found that the flame retardant effect of boron-nitrogen wood surface modifiers was not significantly pronounced in the nitrogen atmosphere. The mechanism of the flame retardant effect of boron-nitrogen compounds is reduced to "shielding" of the surface and increasing the proportion of carbonized residue. On the basis of correlation-regression analysis of kinetic parameters of wood thermodestruction in a nitrogen atmosphere, mathematical models of activation energy dependence on conversion were obtained and substantiated. The developed models can be further applied to calculate the predicted value of wood activation energy in the nitrogen atmosphere at any conversion value.
PubMed: 37834491
DOI: 10.3390/ma16196353 -
Antimicrobial Resistance and Infection... Jul 2022The approval of ethanol by the Biocidal Products Regulation has been under evaluation since 2007. This follows concern over alcohol uptake from ethanol-based hand rubs... (Review)
Review
Ethanol is indispensable for virucidal hand antisepsis: memorandum from the alcohol-based hand rub (ABHR) Task Force, WHO Collaborating Centre on Patient Safety, and the Commission for Hospital Hygiene and Infection Prevention (KRINKO), Robert Koch Institute, Berlin, Germany.
BACKGROUND
The approval of ethanol by the Biocidal Products Regulation has been under evaluation since 2007. This follows concern over alcohol uptake from ethanol-based hand rubs (EBHR). If ethanol is classified as carcinogenic, mutagenic, or reprotoxic by the European Chemicals Agency (ECHA), then this would affect infection prevention and control practices.
AIM
A review was performed to prove that ethanol is toxicological uncritical and indispensable for hand antisepsis because of its unique activity against non-enveloped viruses and thus the resulting lack of alternatives. Therefore, the following main points are analyzed: The effectiveness of ethanol in hand hygiene, the evidence of ethanol at blood/tissue levels through hand hygiene in healthcare, and the evidence of toxicity of different blood/tissue ethanol levels and the non-comparability with alcoholic consumption and industrial exposure.
RESULTS
EBHR are essential for preventing infections caused by non-enveloped viruses, especially in healthcare, nursing homes, food industry and other areas. Propanols are effective against enveloped viruses as opposed to non-enveloped viruses but there are no other alternatives for virucidal hand antisepsis. Long-term ingestion of ethanol in the form of alcoholic beverages can cause tumours. However, lifetime exposure to ethanol from occupational exposure < 500 ppm does not significantly contribute to the cancer risk. Mutagenic effects were observed only at doses within the toxic range in animal studies. While reprotoxicity is linked with abuse of alcoholic beverages, there is no epidemiological evidence for this from EBHR use in healthcare facilities or from products containing ethanol in non-healthcare settings.
CONCLUSION
The body of evidence shows EBHRs have strong efficacy in killing non-enveloped viruses, whereas 1-propanol and 2-propanol do not kill non-enveloped viruses, that pose significant risk of infection. Ethanol absorbed through the skin during hand hygiene is similar to consumption of beverages with hidden ethanol content (< 0.5% v/v), such as apple juice or kefir. There is no risk of carcinogenicity, mutagenicity or reprotoxicity from repeated use of EBHR. Hence, the WHO Task Force strongly recommend retaining ethanol as an essential constituent in hand rubs for healthcare.
Topics: 2-Propanol; Animals; Anti-Infective Agents, Local; Antisepsis; Berlin; Ethanol; Germany; Hand Disinfection; Hand Hygiene; Hospitals; Patient Safety; World Health Organization
PubMed: 35794648
DOI: 10.1186/s13756-022-01134-7 -
Scientific Reports Jan 2023Surgical site infection (SSI) is the most common complication of surgery, increasing healthcare costs and hospital stay. Chlorhexidine (CHX) and povidone-iodine (PVI)... (Meta-Analysis)
Meta-Analysis
Surgical site infection (SSI) is the most common complication of surgery, increasing healthcare costs and hospital stay. Chlorhexidine (CHX) and povidone-iodine (PVI) are used for skin antisepsis, minimising SSIs. There is concern that resistance to topical biocides may be emergeing, although the potential clinical implications remain unclear. The objective of this systematic review was to determine whether the minimum bactericidal concentration (MBC) of topical preparations of CHX or PVI have changed over time, in microbes relevant to SSI. We included studies reporting the MBC of laboratory and clinical isolates of common microbes to CHX and PVI. We excluded studies using non-human samples and antimicrobial solvents or mixtures with other active substances. MBC was pooled in random effects meta-analyses and the change in MBC over time was explored using meta-regression. Seventy-nine studies were included, analysing 6218 microbes over 45 years. Most studies investigated CHX (93%), with insufficient data for meta-analysis of PVI. There was no change in the MBC of CHX to Staphylococci or Streptococci over time. Overall, we find no evidence of reduced susceptibility of common SSI-causing microbes to CHX over time. This provides reassurance and confidence in the worldwide guidance that CHX should remain the first-choice agent for surgical skin antisepsis.
Topics: Humans; Anti-Infective Agents, Local; Povidone-Iodine; Chlorhexidine; Preoperative Care; Surgical Wound Infection
PubMed: 36611032
DOI: 10.1038/s41598-022-26658-1 -
Journal of Vitreoretinal Diseases 2022An alternative ocular antiseptic is needed for patients who do not tolerate povidone-iodine (PI). The purpose of this study is to compare the antimicrobial effect of...
PURPOSE
An alternative ocular antiseptic is needed for patients who do not tolerate povidone-iodine (PI). The purpose of this study is to compare the antimicrobial effect of hypochlorous acid (HA) 0.01% with PI 5% applied topically to the ocular surface.
METHODS
Swabs of the inferior conjunctiva and posterior lower eyelid margin of 40 patients were taken from both eyes and plated onto blood agar plates. One eye was treated with HA and the other with PI, and swabs were taken after 1-minute exposure. The eye treated with PI was rinsed with sterile saline and another swab was taken. Colony-forming units (CFUs) were recorded after 2 days. Patients rated the level of irritation after treatment in each eye.
RESULTS
HA and PI both gave significant reduction in CFUs from baseline ( < .001 for HA and = .002 for PI). The mean reduction in logCFU ± 95% CI was 0.850 ± 0.387 or greater for HA and 0.749 ± 0.385 or greater for PI; this was equivalent to a mean reduction of 7.1-fold or greater or 86% or greater (95% CI, 66%-94%) for HA and 5.6-fold or greater or 82% or greater (95% CI, 57%-93%) for PI. CFUs increased in 17 eyes after saline rinse. PI caused substantial irritation in 31 of the 40 participants, whereas no individuals had any irritation from topical HA.
CONCLUSIONS
Both HA and PI were effective in reducing ocular bacterial load. Unlike PI, HA was not irritating to the eye. Saline rinse after topical PI may increase bacterial counts in some individuals.
PubMed: 37008664
DOI: 10.1177/24741264211013622 -
Frontiers in Chemistry 2022The plight of antimicrobial resistance continues to limit the availability of antibiotic treatment effective in combating resistant bacterial infections. Despite efforts...
The plight of antimicrobial resistance continues to limit the availability of antibiotic treatment effective in combating resistant bacterial infections. Despite efforts made to rectify this issue and minimise its effects on both patients and the wider community, progress in this area remains minimal. Here, we designed a peptide named KDEON WK-11, building on previous work establishing effective residues and structures active in distinguished antimicrobial peptides such as lactoferrin. We assessed its antimicrobial activity against an array of bacterial strains and identified its most potent effect, against with an MIC value of 3.12 μM, lower than its counterparts developed with similar residues and chain lengths. We then determined its anti-biofilm properties, potential mechanism of action and cytotoxicity. We identified that KDEON WK-11 had a broad range of antimicrobial activity and specific capabilities to fight with low cytotoxicity and promising potential to express anti-lipopolysaccharide qualities, which could be exploited to expand its properties into an anti-sepsis agent.
PubMed: 36465859
DOI: 10.3389/fchem.2022.1000765