50 The use of a carrier serves to cause a slow continuous release of free iodine, while limiting undesirable properties such as staining and local toxicity. 51, 150 The mechanism of action is incompletely understood but involves disordering protein structure, blocking protein synthesis, and altering the cell membrane. 93 Iodide (I −) has no antimicrobial value. 22, 179 Iodine is found in various forms in aqueous solutions, but its antimicrobial efficacy is largely due to molecular iodine (I 2) and hypoiodic acid. Iodophors are iodine-containing compounds in which the iodine is complexed to a high-molecular-weight carrier such as polyvinyl pyrrolidone (a polymer similar to dextran). The subject of antiseptics and disinfectants has been exhaustively reviewed previously a brief review of commonly used antiseptics follows, but readers seeking greater detail are directed to the appropriate references. 22 The term disinfectant is applied to similar agents used on inanimate objects such as instruments or surfaces. The term antiseptic generally is used to refer to chemicals applied to living tissue to achieve a microbial function. This chapter reviews agents commonly used in surgical preparation, as well as associated clothing and facility guidelines.Īsepsis is the condition in which living pathogenic organisms are absent 153 aseptic protocol therefore consists of the mannerisms, thoughts, and associated agents or devices used to achieve that condition. The authors assume that readers will have good familiarity with aseptic procedures as the term pertains to the mechanics of behavior in the surgical suite and preparation of the patient. Pursuit of this goal involves adhering to basic aseptic protocols of behavior in the operating theater, as well as applying knowledge of proper patient selection and preparation, operating personnel preparation, and design/maintenance of surgical facilities. A low incidence of surgical site infection is one of the primary goals of aseptic surgery.