Oropharyngeal antisepsis

Oropharyngeal Antisepsis

Oropharyngeal antisepsis (OPA) is a set of practices used to support the prevention of nosocomial infections by reducing the amount of bacteria present in the oropharynx. OPA is usually done before the placement of an endotracheal tube for intubation and other medical procedures such as bronchoscopy, and it is the first line of defence for reducing the risks of post-surgical infections and other risks associated with invasive procedures. OPA is used as a preventative measure to help reduce the risk of nosocomial infections occurring.

Methods of Oropharyngeal Antisepsis

There are a few different methods of oropharyngeal antisepsis. These methods range from mechanical cleaning, such as using swabs and brushes, to chemical methods, such as using antiseptics, chlorhexidine, or povidone-iodine. Each of these methods has their own pros and cons and should be selected based on the procedure to be performed and the risk of infection faced by the patient.

Mechanical Cleansing

Mechanical cleansing involves the use of swabs, brushes, or gauze to remove debris and possibly bacteria from the oropharyngeal area. This method is often used when there is a high risk of infection, or when the patient has difficult-to-access areas of the oropharynx. It is important to note that mechanical cleaning may not be sufficient on its own to reduce the risk of infection, and may need to be accompanied by the use of antiseptics or other treatments.

Antiseptics

Antiseptics are often used in combination with mechanical cleaning for extra protection from infection. Common antiseptics used for oropharyngeal antisepsis include:

• Chlorhexidine, which has been found to be effective in killing many types of bacteria.
• Povidone-iodine, which has broad-spectrum activity against certain bacteria and fungi.
• Dextrose, which is a carbohydrate that can help kill certain bacteria and fungi in the oropharynx.

It is important to note that antiseptics should not be used in patients with a compromised immune system, or in those who are allergic to antiseptics.

Conclusion

Oropharyngeal antisepsis is an important preventative measure for reducing the risk of nosocomial infections and other risks associated with invasive procedures. Mechanical cleansing and the use of antiseptics are the two most common methods of OPA, and the right one should be selected based on the risk of infection faced by the patient. OPA should always be combined with proper hand hygiene and appropriate PPE for the highest level of protection possible.