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分娩時 會陰의 消毒處置와 그價値

Value of the Pudendal-Perineal Asepsis in Delivery Preparation

대한산부인과학회지 1967년 10권 3호 p.25 ~ 26
姜信明/Kang, Shin M.
李順培/朴奇煐/金仁淑/Rhee, Soon Bai/Park, Kee Yong/Kim, In Sook

Abstract


Aseptic technique or reduction of the bacterial flora on the pudendal area in delevery preparation still requires constant re-evaluation.
In this paper a new class of disinfectant, the ampisoteric surface active agent, Hygiene (TEGO 1 03 G) is applied to prepare the perineal area and it´s effects were compared with other varies conventional agents and were evaluated clinically by the incidence of transient episiotomy fever or subclinical infection of clean surgical incision-episiotomy (Showing transient elevation of body temperature orally up to 37?C. or more, lasting less than 4 hours any time in postpartum 3 days period but excluding all other febrile sources) as well as in vitro study. The data to be presented are based on 169 primiparas deliveried in Ewha Womans University Hospital, Seoul, Korea (33 using Hygiene, 15 with Mercurochrome, 13 with Cresol, 30 soap and water, 29 soap and water plus prophylactic systemic antibiotics). From this study following conclusions have been reached.
1. The effect of pudendal..perineal aseptic technic or disinfectant best can sharply be compared and evaluated clinically by the incidence of transient episiotomy fever or subclinical infection of clean incision-episiotomy (Showing transient fever of 37?C. or more orally in any time of postpartum 3 days period, but excluding all other febrile sources) rather than by gross episiotomy wound infection which is often encountering many different criterias or even by in vitro biocides effect alone which is also proven to be incorrect unless using serial basin method or neutralizing, reducing agents.
2. The transient episiotomy fever (Subclinical infection) is strongly correlated with quantitative bacterial innoculation as well as it´s types. It suggested that the most responsible pathogens were Staphylococcus aureus and some Streptococcus. On the other hand E. coli appeared to be relatively .non-causative one in the pudendal perineal area; probably female perneum resistant particularly to the normally inhabiting enteric microorganisms.
3. 1 % Hygiene (TEGO 103G) was superior to a rapid Physol wash, Mercurochrome or Cresol wash in reducing subclinical infection of clean episiotomy (transient fever) mostly acused by Staphylococcus aureus. It seemed also sensitive to Streptococcus.
4. Routine prophylactic antibiotics reduced some transient episiotomy fever, but not all of the incidence of higher temperatures presumably caused by massive bacterial innoculations. Proper aseptic
perineal technic will prevent the clinical infection of episiotomy wound and subclinical transient episiotomy fever as well.
The corection of low hemoglobin level should also be considered in this aspect.

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