Effect of Type of Anode
The electrodes most used as anodes in electrolysis cells for production of hypochlorite are Ti Pt and Ti RuO2, inasmuch as their perfect resistance to Fig. 6. Effect of temperature as a function of the type of the anode. Ti cathode Sa Sc 1.33 cm current density, 10 A dm2 NaCl concentration, 2 m electrolysis time, 1 h. Fig. 6. Effect of temperature as a function of the type of the anode. Ti cathode Sa Sc 1.33 cm current density, 10 A dm2 NaCl concentration, 2 m electrolysis time, 1 h. Fig. 7....
Disinfection by Sodium Hypochlorite Dialysis Applications
32 figures, 7 in color, and 24 tables, 2007 Basel Freiburg Paris London New York Bangalore Bangkok Singapore Tokyo Sydney Founded 1975 by Geoffrey M. Berlyne Department of Nephrology St. Bortolo Hospital I-36100 Vicenza Italy Department of Research and Development Alcavis International, Inc. 8322 Helgerman Court Gaithersburg, MD 20877 USA Library of Congress Cataloging-in-Publication Data Disinfection by sodium hypochlorite dialysis applications volume editors, Claudio Ronco, Gary J. Mishkin....
Contents
Ronco, C. Vicenza Mishkin, G.J. Gaithersburg, Md. Bianchi, P. Buoncristiani, E. Buoncristiani, U. Perugia 7 Sodium Hypochlorite History, Properties, Electrochemical Production 24 Toxicity and Safety of Topical Sodium Hypochlorite 39 Disinfection of Dialysis Monitors Ghezzi, P.M. Montemassi Bonello, M. Anagni Ronco, C. Vicenza Cappelli, G. Ricardi, M. Ravera, F. Ligabue, G. Ballestri, M. Bonucchi, D. Bondi, M. Modena 72 Compatibility of Electrolytically Produced Sodium Hypochlorite Solutions on...
Conclusions 1
During the last 15 years, the worldwide adoption of the CAPD connection systems derived from the original 'Y' system enabling the 'flushing before filling' mainly in the form of 'double-bag' systems, where the 'Y' is in the bag Fig. 8. 'Double Y' CAPD connection system with automatic prevention of accidental intraperitoneal injection of disinfectant. Second injection of disinfectant, at the end of the exchange, to refill the 'Y' on the catheter for the interval phase the slider again in...
Abstract Uhm
Peritoneal catheter exit-site and tunnel infections remain critical problems in patients undergoing peritoneal dialysis. Catheter-related peritonitis occurs in about 20 of patients and exit-site infections are responsible for catheter removal in more than one-fifth of the cases. For the last 2 years in the Department of Nephrology, San Bortolo Hospital, Vicenza, Italy, we have been treating exit-site infections caused by Pseudomonas with sodium hypochlorite packs as well as systemic and local...
Chronic ExitSite Care of Healed ExitSite
Although sterile dressings are recommended until the exit is well-healed, there is no clear consensus as to when patients may begin to shower or change to chronic exit-site care. When the exit-site can be classified as good or equivocal, then showering and chronic care are appropriate 10 . The primary goal of exit-site care is to prevent ESIs and TIs. Exit-site care should include 1 assessment of the exit-site 2 cleansing the exit-site 3 anchoring or immobilizing the catheter and 4 protecting...
The History of Hypochlorite
Some years after the discovery in 1774 of the gas called 'dephlogisticated salt spirit' by the Swedish chemist Carl Wilhelm Scheele, another chemist, the Frenchman Claude-Louis Bertholet obtained in 1787 some bleaching solutions of this gas dissolved in water. In 1810 this gas was renamed 'Chlorine' by the Englishman Davy. A small chemical industry in Paris directed by Leonard Alban, the 'Societe Javel', adopted the Bertholet process for the industrial production of a bleaching solution...
Central Venous Catheters
Tunneled, cuffed catheters were developed in 1987 3 . Since their inception, CVCs have become an access of convenience easily inserted and available for use within minutes. Maturation or healing time is not necessary rather, these devices may be used immediately after radiological verification. They are inserted into deep veins such as the jugular, subclavian, or femoral veins and are advanced into the vena cava. They may be placed percutaneously at the bedside thereby eliminating the need for...
Electrolytic Chloroxidizer
Electrolytic chloroxidizer, otherwise known as Amuchina, is a chlorine-based solution with a 17 sodium chloride component and 0.057 sodium hypochlorite. ExSept is the 5 or 10 dilution of Amuchina. It is said to be effective against all spectrums of pathogens including Gram-positive, Gramnegative bacteria, viruses and spores. Amuchina is similar in molecular size and structure to water, and because it does not present with an electrical charge, the undissociated hypochlorous acid may easily...
Biofilm and Medical Devices
Microorganisms in a sessile phase exhibit a distinct phenotype with respect to gene transcription, growth rate and ability to resist antimicrobial or Table 1. Medical devices associated with biofilm infections Arterial catheters Spinal implants Pulmonary artery catheters Penile implants Umbilical catheters Breast implants Peritoneal dialysis catheters Orthopedic prostheses Urinary catheters Cochlear implants Nasogastric tubes Neurosurgical stimulators Gastrostomy tubes Middle ear implants...
References 1
1 Geo CW Handbook of Chlorination and Alternative Disinfectants, ed 4. A Wiley-Interscience Publication, 1999, p 1569. 2 Rachitsky GI, Chuev VP, Kamalov RH, Smetanyak SM, Kolchenko LA Sodium hypochlorite a wide potential in dentistry. Dentistry 2001 6. 3 Bakhir VM Water treatment disinfection problems and solutions. Drinking Water 2003 1 13-20. 4 Khelifa A, Moulay S, Hannane F, Benslimene S, Hecini M Application of an experimental design method to study the performance of electrochlorination...
Production of Sodium Hypochlorite
NaOCl is essentially produced by two methods chemical and electrochemical. Cl2 is made to react with a solution of NaOH. In this way, NaOCl, NaCl and water are produced according to the reaction This method produces solutions of high concentrations, but their purity and stability do not satisfy the quality characteristics that are necessary for their use in the food and medical sectors. We start with a solution obtained by dissolving NaCl, until obtaining concentrated brine. The solution is...
Blood Levels
The 1978 Tentative Final Monograph for OTC Topical Antimicrobial Products stated that where appropriate, safety information should include studies to show expected blood levels after the use of an OTC product 28 . Sodium hypochlorite breaks down almost instantaneously on contact with blood and blood components, and therefore would not be expected to be found as sodium hypochlorite in the blood stream. Therefore, information on blood levels of sodium hypochlorite is not technically feasible....
Historical Use of Sodium Hypochlorite
The history of the use of hypochlorite as a disinfectant and antiseptic goes back hundreds of years. It was used for the treatment of wounds and burns even before the revolutionary work of Lister and Koch. Among early uses, the Marquis de la Motte used a hypochlorite solution for the treatment of gangrene in 1732 1 and Paris surgeons used it for the treatment of burns, operative wounds, and ulcers 1 . As noted in the background section, Semmelweis used hypochlorite as an antiseptic hand wash to...
Topical Safety
Ultimately, the real life topical use of sodium hypochlorite solution to reduce microbial flora involves a risk benefit balance. The potential for adverse effects must be drawn from the studies discussed and weighed against effectiveness. The topical safety is most important since this is the normal route of administration. It is a generalization, but a reaction often observed is that potential users may associate the odor of chlorine, its bleaching action and environmental use to conclude that...
Results
A total of 44 catheter lumens were evaluated only two Hemosplit with povidone iodine were evaluated . The average maximum displacement for each catheter type in each solution is presented in table 3. Significance in displacement was reached for Alcavis 50 on the Cannon Cath II catheter, however this is not significant since the catheter exposed to Alcavis 50 ESH had reached maximum displacement as limited by the ATS 900 system. Fig. 1. ATS 900 meter with computer. Fig. 1. ATS 900 meter with...
Human Sensitization and Irritation Tests
The fact that sodium hypochlorite is not a sensitizer is a significant advantage that sodium hypochlorite solutions have over some other topical antiseptics. To clarify sensitization potential, Hazelton Laboratories examined 1.1 sodium hypochlorite solution using a standard test for predicting sensitization or allergic reactions, the Guinea Pig Maximization Test 46 . This test consisted of dermal and intradermal application of various concentrations of test solutions of sodium hypochlorite as...
Biofilm and Disinfection in Dialysis
Disinfection enters the quality assurance program in dialysis and represents part of the various anti-inflammatory treatment strategies adopted to improve outcome in these patients. Several liquid chemical germicides or physical disinfectant techniques are commercially available and choice is based not only on effectiveness but also Fig. 1. Subsequent phases of biofilm formation with bacterial deposition a , attachment b , growing c up to a mature biofilm d onto a silicone tube from a dialysis...
Stability of Sodium Hypochlorite Solutions
The stability of NaOCl solutions depends on some factors 4. Concentration of impurities that catalyze decomposition and or production of chlorates. Decomposition of hypochlorite procedures according to two main mechanisms Let's analyze, point by point, the factors influencing the stability of NaOCl solutions. The more concentrated the solution, the faster the decomposition. Therefore, the weaker the solution, the more stable it is. Decomposition due to age and temperature follows by 90 reaction...
Effect of Current Density
The effect of the variation in active chlorine production as a function of the density of applied current for the anodes is illustrated in figure 8. For the Ti Pt and Ti RuO2 anodes, the AC increases almost linearly with increase of current density. A somewhat different tendency is observed for graphite anodes. In fact, AC increases up to a maximum of about 12 g l at 20 A dm2 beyond this value, it diminishes abruptly. The fact that the graphite anode could not tolerate a high current density...
Sodium Hypochlorite
Sodium hypochlorite has long been recognized for its effectiveness as an antiseptic and disinfectant. In his historic pioneering work, in which he proved in a convincing clinical trial the importance of hand disinfection, Semmelweis used sodium hypochlorite as a hand wash and disinfectant to reduce mortality from childbed fever 1 . In another historic discovery, Carrel and Dakin introduced 0.45-0.5 buffered sodium hypochlorite for the treatment of trauma wounds during the First World War 2, 3 ....
Dedication
Amuchina's history has been part of my family for over 50 years. My grandfather Pietro bought Amuchina Company from Eridania, a large Italian sugar company, in 1948. My grandfather Pietro and my father Giorgio spent all their work and energy to improve and promote the use of Amuchina as an antiseptic and a disinfectant. Since then our mission has been the prevention of infections. After so many years of activity, we can surely say their goals were achieved. They were always convinced of the...