Editing Antiseptic (section)

==Some common antiseptics==
[[Image:Povidone-iodine.svg|400px|thumb|Structure of povidone-iodine complex, the most common antiseptic in use today]]
Antiseptics can be subdivided into about eight classes of materials.  These classes can be subdivided according to their mechanism of action: small molecules that indiscriminately react with organic compounds and kill microorganisms (peroxides, iodine, phenols) and more complex molecules that disrupt the cell walls of the bacteria.<ref>{{Ullmann|doi=10.1002/14356007.w08_w03|title=Dermatologicals (D), 4. Antiseptics and Disinfectants (D08), Anti‐Acne Preparations (D10), and Other Dermatological Preparations (D11)|year=2020|last1=Kutscher|first1=Bernhard|pages=1–22}}</ref>
* [[Alcohol (chemistry)|Alcohol]]s, including [[ethanol]] and 2-propanol/[[isopropanol]] are sometimes referred to as ''[[surgical spirit]]''. They are used to disinfect the skin before injections, among other uses.
* [[Diguanide]]s including [[chlorhexidine gluconate]], a bacteriocidal antiseptic which (with an alcoholic solvent) is considered a safe and effective antiseptic for reducing the risk of infection after clean surgery,<ref>{{cite journal |last1=Wade |first1=Ryckie G. |last2=Burr |first2=Nicholas E. |last3=McCauley |first3=Gordon |last4=Bourke |first4=Grainne |last5=Efthimiou |first5=Orestis |title=The Comparative Efficacy of Chlorhexidine Gluconate and Povidone-iodine Antiseptics for the Prevention of Infection in Clean Surgery: A Systematic Review and Network Meta-analysis |journal=Annals of Surgery |date=1 September 2020 |volume=Publish Ahead of Print |issue=6 |pages=e481–e488 |doi=10.1097/SLA.0000000000004076|pmid=32773627 |doi-access=free }}</ref> including tourniquet-controlled upper limb surgery.<ref>{{cite journal |last1=Wade |first1=Ryckie G |last2=Bourke |first2=Gráinne |last3=Wormald |first3=Justin C R |last4=Totty |first4=Joshua Philip |last5=Stanley |first5=Guy Henry Morton |last6=Lewandowski |first6=Andrew |last7=Rakhra |first7=Sandeep Singh |last8=Gardiner |first8=Matthew D |last9=Bindra |first9=R |last10=Sher |first10=M |last11=Thomas |first11=M |last12=Morgan |first12=S D J |last13=Hwang |first13=B |last14=Santucci |first14=W |last15=Tran |first15=P |last16=Kopp |first16=L |last17=Kunc |first17=V |last18=Hamdi |first18=A |last19=Grieve |first19=P P |last20=Mukhaizeem |first20=S A |last21=Blake |first21=K |last22=Cuggy |first22=C |last23=Dolan |first23=R |last24=Downes |first24=E |last25=Geary |first25=E |last26=Ghadge |first26=A |last27=Gorman |first27=P |last28=Jonson |first28=M |last29=Jumper |first29=N |last30=Kelly |first30=S |last31=Leddy |first31=L |last32=McMahon |first32=M E |last33=McNamee |first33=C |last34=Miller |first34=P |last35=Murphy |first35=B |last36=O'Halloran |first36=L |last37=O'Shea |first37=K |last38=Skeens |first38=J |last39=Staunton |first39=S |last40=Timon |first40=F |last41=Woods |first41=J |last42=Cortinovis |first42=U |last43=Sala |first43=L |last44=Zingarello |first44=V |last45=Jusoh |first45=M H |last46=Sadagatullah |first46=A N |last47=Georgieva |first47=G |last48=Pejkova |first48=S |last49=Nikolovska |first49=B |last50=Srbov |first50=B |last51=Hamid |first51=H K S |last52=Mustafa |first52=M |last53=Abdelrahman |first53=M |last54=Amin |first54=S M M |last55=Bhatti |first55=D |last56=Rahman |first56=K M A |last57=Jumabhoy |first57=I |last58=Kiely |first58=J |last59=Kieran |first59=I |last60=Lo |first60=A C Q |last61=Wong |first61=K Y |last62=Allan |first62=A Y |last63=Armes |first63=H |last64=Horwitz |first64=M D |last65=Ioannidi |first65=L |last66=Masterton |first66=G |last67=Chu |first67=H |last68=Talawadekar |first68=G D |last69=Tong |first69=K S |last70=Chan |first70=M |last71=Tredgett |first71=M |last72=Hardie |first72=C |last73=Powell-Smith |first73=E |last74=Gilham |first74=N |last75=Prokopenko |first75=M |last76=Ahmad |first76=R |last77=Davies |first77=J |last78=Zhen |first78=S |last79=Dargan |first79=D |last80=Pinder |first80=R M |last81=Koziara |first81=M |last82=Martin |first82=R |last83=Reay |first83=E |last84=Cochrane |first84=E |last85=Elbatawy |first85=A |last86=Green |first86=F |last87=Griffiths |first87=T |last88=Higginbotham |first88=G |last89=Louette |first89=S |last90=McCauley |first90=G |last91=Natalwala |first91=I |last92=Salt |first92=E |last93=Ahmed |first93=R |last94=Goon |first94=P |last95=Manton |first95=R |last96=Segaren |first96=N |last97=Cheung |first97=G |last98=Mahoney |first98=R |last99=Sen |first99=S |last100=Clarkson |first100=D |last101=Collins |first101=M |last102=Bolt |first102=A |last103=Lokanathan |first103=P |last104=Ng |first104=A |last105=Jones |first105=G |last106=Jones |first106=J W M |last107=Kabariti |first107=R |last108=Rhee |first108=S J |last109=Herron |first109=J |last110=Kay |first110=A |last111=Cheung |first111=L K |last112=Thomson |first112=D |last113=Jugdey |first113=R S |last114=Yoon |first114=H |last115=L |first115=Z |last116=Southgate |first116=J |last117=Brennan |first117=C |last118=Kiani |first118=S |last119=Zabaglo |first119=M |last120=Haider |first120=Z A |last121=Poulter |first121=R |last122=Sheik-Ali |first122=A |last123=Watts |first123=A |last124=Jemec |first124=B |last125=Redgrave |first125=N |last126=Dupley |first126=L |last127=Greenhalgh |first127=M |last128=Vella |first128=J |last129=Harris |first129=H |last130=Robinson |first130=A V |last131=Dupre |first131=S |last132=Teelucksingh |first132=S |last133=Gargan |first133=A |last134=Hettiaratchy |first134=S |last135=Jain |first135=A |last136=Kwasnicki |first136=R |last137=Lee |first137=A |last138=Thakkar |first138=M |last139=Berwick |first139=D |last140=Ismail |first140=N |last141=Mahdi |first141=M |last142=Rodrigues |first142=J |last143=Liew |first143=C |last144=Saadya |first144=A |last145=Clarkson |first145=M |last146=Brady |first146=C |last147=Harrison |first147=R |last148=Rayner |first148=A |last149=Nolan |first149=G |last150=Phillips |first150=B |last151=Madhusudan |first151=N |title=Chlorhexidine versus povidone–iodine skin antisepsis before upper limb surgery (CIPHUR): an international multicentre prospective cohort study |journal=BJS Open |date=9 November 2021 |volume=5 |issue=6 |pages=zrab117 |doi=10.1093/bjsopen/zrab117|pmid=34915557 |pmc=8677347 }}</ref> It is also used in mouthwashes to treat inflammation of the gums ([[gingivitis]]).  [[Polyhexanide]] (polyhexamethylene biguanide, PHMB) is an antimicrobial compound suitable for clinical use in critically colonized or infected acute and chronic wounds. The physicochemical action on the bacterial envelope prevents or impedes the development of resistant bacterial strains.<ref name="pmid20829657">{{cite journal |author=Kaehn K |s2cid=684665 |title=Polihexanide: a safe and highly effective biocide |journal=Skin Pharmacol Physiol |volume=23 Suppl |pages=7–16 |year=2010 |pmid=20829657 |doi=10.1159/000318237 |doi-access=free }}</ref><ref name="pmid20829662">{{cite journal |vauthors=Eberlein T, Assadian O |title=Clinical use of polihexanide on acute and chronic wounds for antisepsis and decontamination |journal=Skin Pharmacol Physiol |volume=23 Suppl |pages=45–51 |year=2010 |pmid=20829662 |doi=10.1159/000318267 |doi-access=free }}</ref><ref name="pmid22240928">{{cite journal |vauthors=Eberlein T, Haemmerle G, Signer M |title=Comparison of PHMB-containing dressing and silver dressings in patients with critically colonised or locally infected wounds |journal=J Wound Care |volume=21 |issue=1 |pages=12, 14–6, 18–20 |date=January 2012 |pmid=22240928 |doi=10.12968/jowc.2012.21.1.12 |url=http://www.internurse.com/cgi-bin/go.pl/library/article.cgi?uid=88747;article=JWC_21_1_12_20 |display-authors=etal |url-status=live |archive-url=https://web.archive.org/web/20130618003547/http://www.internurse.com/cgi-bin/go.pl/library/article.cgi?uid=88747;article=JWC_21_1_12_20 |archive-date=18 June 2013  }}</ref>
* [[Iodine]], especially in the form of [[povidone-iodine]], is widely used because it is well tolerated; does not negatively affect wound healing; leaves a deposit of active iodine, thereby creating the so-called "remnant", or persistent effect; and has wide scope of antimicrobial activity. The traditional iodine antiseptic is an [[ethanol|alcohol]] solution (called [[tincture of iodine]]) or as [[Lugol's iodine]] solution. Some studies<ref name="VermeulenWesterbos2010">{{cite journal|last1=Vermeulen|first1=H.|last2=Westerbos|first2=S.J.|last3=Ubbink|first3=D.T.|title=Benefit and harm of iodine in wound care: a systematic review|journal=Journal of Hospital Infection|volume=76|issue=3|year=2010|pages=191–199|issn=0195-6701|doi=10.1016/j.jhin.2010.04.026|pmid=20619933}}</ref> do not recommend disinfecting minor wounds with iodine because of concern that it may induce scar tissue formation and increase healing time. However, concentrations of 1% iodine or less have not been shown to increase healing time and are not otherwise distinguishable from treatment with saline.<ref name="medscape.com">{{cite web |url=http://www.medscape.com/viewarticle/456300_3 |title=Antiseptics on Wounds: An Area of Controversy: Hydrogen Peroxide |publisher=Medscape.com |access-date=4 March 2014 |url-status=live |archive-url=https://web.archive.org/web/20130719075630/http://www.medscape.com/viewarticle/456300_3 |archive-date=19 July 2013  }}</ref> Iodine will kill all principal pathogens and, given enough time, even [[Endospore|spores]], which are considered to be the most difficult form of microorganisms to be inactivated by disinfectants and antiseptics.
* [[Octenidine dihydrochloride]], currently increasingly used in continental Europe, often as a chlorhexidine substitute.
* [[Peroxide]]s, such as [[hydrogen peroxide]] and [[benzoyl peroxide]]. Commonly, 3% solutions of hydrogen peroxide have been used in household first aid for scrapes, etc.  However, the strong oxidization causes scar formation and increases healing time during fetal development.<ref>{{cite journal |vauthors=Wilgus TA, Bergdall VK, Dipietro LA, Oberyszyn TM |title=Hydrogen peroxide disrupts scarless fetal wound repair |journal=Wound Repair Regen |volume=13 |issue=5 |pages=513–9 |year=2005 |pmid=16176460 |doi=10.1111/j.1067-1927.2005.00072.x |s2cid=1028923 }}</ref>
* [[Phenols]] such as phenol itself (as introduced by Lister) and [[triclosan]], [[hexachlorophene]], [[chlorocresol]], and [[chloroxylenol]]. The fact that the more substituted and more [[Lipophilicity|lipophylic]] phenols are less toxic, less irritant and more powerful was gradually discovered in late 19th century.<ref>{{Cite thesis |last=de Solis |first=Nilka M. G. |title=Effect of plasmids that confer preservative-resistance on the performance of bacteria in preservative efficacy tests |date=1993 |degree=Doctoral |publisher=University College London |url=https://discovery.ucl.ac.uk/id/eprint/10109659 |page=31}}</ref> Nowadays comparatively more water-soluble phenols such as chlorocresol are commonly used as preservatives in personal care products while less soluble such as chloroxylenol – as topical antiseptics. Both can be encountered in household disinfectants.
* [[Quat salt]]s such as [[benzalkonium chloride/lidocaine]] (trade name Bactine among others), [[cetylpyridinium chloride]], or [[cetrimide]]. These surfactants disrupt cell walls.
* [[Quinoline]]s such as hydroxyquinolone, dequalium chloride, or [[chlorquinaldol]].
* [[4-Hexylresorcinol]], or S.T.37