The return of local antiseptics in surgery

Abstract

With regard to bacterial resistance, the topical use of chemical antiseptics is becoming increasingly important as an alternative to antibiotics. In this paper, a topical antiseptic (Lavasept® 1 1 Lavasept concentre = aqueous solution of 20% biguanide + 1% polyethyleneglycol. Solution for use = 0.1 – 0.2% solution Lavasept concentre in Ringer solution (without lactate). Distribution: Fresenius AG, D-61350 Bad Homburg. ) which has been adequately verified by experimental and clinical investigations is presented. Its bactericidal effects are reliable even in the presence of proteins and whole blood; it has high tissue and general tolerance, very low toxicity, does not provoke bacterial resistance, and there is no measureable resorption. The substance is free from iodine, heavy metal salts, PVP, and aldehyde. It is a combination of biguanide (bactericidal component) and polyethyleneglycol which reduces the surface tension of the biguanide and ensures uniform moistening of the wound. This substance has proven to be a promising auxiliary agent to correct surgery in the treatment of various surgical infections of the soft tissue, fresh and chronic infections of the bone, in war surgery (1), and for prophylactic irrigation during operations with a high risk of infection (e.g. change of endoprosthesis, repair of open fractures). The contraindication, as for any topical antiseptic, is the irrigation of aseptic joints.