Mucous membrane disinfection for infection prevention

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• Structure and function of mucous membranes
• Mucous membrane disinfection and its relevance
• octenisept^® - wound and mucous membrane antiseptic
  

Mucous membranes (mucosa) are layers of tissue which coat the inside of hollow organs and the nasal and oral cavities and form the conjunctiva in the eye. They act as a protective barrier and regulate absorptive and secretory processes.¹
Mucous membranes secrete a filmy fluid on their surface which in most cases also contains mucins (mucous substances) and IgA antibodies.¹ This moist antibody-containing surface layer reduces the likelihood of foreign bodies entering the body.²
Well-functioning mucous membranes are thus of crucial importance for the immune defences The immune system would be severely compromised without an intact mucous membrane: It would be left having to constantly combat bacteria, viruses and harmful substances from the environment. This could result in allergies, neurodermatitis and, for example, increased vulnerability to infections.²
The structure of the mucous membrane differs from one area of the body to another depending on how the relevant organ functions. In principle it consists of the outer epithelium, under which there is the lamina propia (a layer of connective tissue) and finally a muscle layer. The lamina propia may consist of one or several layers depending on the area of the body.

Unlike the outer skin, mucous membranes are more sensitive and do not have hair or a stratum corneum.^3,4

Various aerobic and anaerobic microorganisms (microbes) colonise the mucous membrane. The extent of colonisation depends on a number of factors such as age, sex, hormonal effects or pathological factors.

Depending on its position in the body, the mucous membrane has other functions as well as acting as a protective layer:⁴

• In the oesophagus, it ensures that nutrients are transported smoothly.
• In the stomach, it protects the abdominal wall from gastric acid.
• In the gut, nutrients are absorbed via the mucous membrane.
• In the uterus, it is shed during menstruation and restored in the course of the menstrual cycle to prepare for a fertilised egg cell to become embedded in it.

Mucous membranes are highly sensitive to external influences.³ Exposure to physical and chemical effects such as harmful substances sometimes results in acute disorders which can in the worst become chronic.³ Special protection is therefore required during medical procedures affecting the mucous membranes to prevent microbial penetration.

Mucous membrane antiseptics such as octenisept^® are highly suitable for reducing the microbial load in these cases.

Disinfection of mucous membranes takes place prior to diagnostic and surgical procedures, for example in the ano-genital area of the vulva, vagina or glans penis. These include:

• urological and proctological interventions, including in pregnant and lactating women
• diagnostic interventions in the uro-genital area; vaginal, transvaginal or andrological examinations
• Fitting an IUD (coil)
  
• procedures for artificial fertilisation (in-vitro fertilisation) in men and women
• fitting transurethral single-use and permanent catheters into the bladder

Mucous membranes and wounds respond sensitively to external effects.3 The use of alcohol-based skin antiseptics on these areas can sometimes be painful or irritating for patients or even cause tissue damage. For this reason a suitable wound and mucous membrane disinfectant should be

• water-based
• well tolerated,
• painless to use

A broad antimicrobial spectrum of activity is also important, with the level of effective ingredients kept as low as possible but high enough to achieve the efficacy required. A good antiseptic will also have long-lasting effects.

An IUD (intra-uterine device), or coil, is the third most commonly used method of contraception in Germany.⁵ IUDs are small, flexible plastic items that act as contraceptive devices when placed in the uterus by

• killing sperm or reducing sperm motility,
• preventing sperm from fertilising an egg and/or
• causing an inflammatory reaction within the uterus that damages the sperm.

Fitting a coil is a sensitive procedure and must only be performed by a qualified physician. Preparation and disinfection of the mucous membrane plays a major role here in reducing the risk of complications.

A coil is then conventionally inserted in accordance with the following procedure:

1. Disinfection of vaginal area: This reduces the risk of infections during fitting. A good product to choose here is the wound and mucous membrane antiseptic octenisept^®.
2. Inserting the coil into the uterus through the vagina: If this is too painful the medical personnel can administer medication beforehand to open the cervix.
3. Fastening a plastic thread to the coil: This is used to ensure that the coil is positioned correctly and helps to remove it later.

octenisept^® is an effective wound and mucous membrane disinfectant: It disinfects traumatic, acute, chronic wounds as well as postoperative and burn wounds. It can be used as a mucous membrane antiseptic prior to diagnostic or surgical procedures in the ano-genital and vaginal areas as well as the oral area. It can also be applied before fitting transurethral single-use and permanent catheters and supports pre-operative skin antisepsis in the mucous membrane environment.

octenisept^® scores highly here as its is well tolerated, rapid-acting and safe to use in pregnancy (from the fourth month onwards).⁶ It is painless to use, colourless and suitable for infants and babies.*

All about octenisept^®

* Please see package insert

Important user information

octenisept^®  Active substances: octenidine dihydrochloride, phenoxyethanol (Ph.Eur.). Composition: 100 g solution contain: 0.1 g octenidine dihydrochloride, 2.0 g phenoxyethanol (Ph.Eur.). Other ingredients: cocamidopropylbetaine, sodium D gluconate, glycerol 85%, sodium chloride, sodium hydroxide, purified water. Indications: For repeated, short-term antiseptic treatment of mucous membranes and adjacent tissues prior to diagnostic and surgical procedures - in the ano-genital region including the vagina, vulva and glans penis as well as prior to bladder catheterization - in the oral cavity. For short-term supporting therapy of interdigital mycotic infections and adjuvant antiseptic wound treatment. Contraindications: octenisept^® may not be used in cases of hypersensitivity to any of the components of the preparation. octenisept^® should not be used for rinsing the abdominal cavity (e.g. intra-operatively) or the bladder, nor the tympanic membrane. Undesirable effects: rare: burning, redness, itching and warmth at the application site, very rare: allergic contact reaction, e.g. temporary redness at the application site; frequency unknown: after lavage of deep wounds with a syringe, persistent edema, erythema and also tissue necrosis have been reported, in some cases requiring surgical revision. Rinsing of the oral cavity may cause a transitory bitter sensation. Revision 11/22

To prevent possible tissue injury, the product must not be injected into the deep tissue using a syringe. The product is intended for superficial use only (application by swab or spray pump).

Schülke & Mayr GmbH, 22840 Norderstedt, Germany, Tel. +49 40 52100-666, info@schuelke.com