Sanation

Sanation (decontamination/hygiene, Latin: sanatio) is a general medical term denoting a set of treatment and prevention measures aimed at eliminating the focus of infection or pathological process in order to improve the health of an organ or a whole body.

The essence of sanation is to eliminate the root cause of the disease and create conditions for normal functioning and tissue repair. The term is used in various fields of medicine, but its semantic core is active purification and healing of the pathological focus.

Types and medical applications

Depending on the medical specialty and context, sanation may refer to different procedures that share a common goal.

• Surgical sanation:
  • Description: the most common use of the term. It involves surgical treatment of a purulent or necrotic focus.
  • Examples: opening and draining an abscess, excision of non-viable tissue (necrectomy), removal of sequestrations in osteomyelitis, lavage of the abdominal cavity with antiseptics in peritonitis. The principle is “Ubi pus, ibi evacua” (“Where there is pus, there evacuate it”).
• Dental sanation / oral hygiene (in dentistry):
  • Description: a set of measures to eliminate all diseases of the teeth and gums.
  • Examples: treatment of tooth decay and its complications, removal of dental deposits, treatment of periodontal disease, extraction of non-restorable teeth. It is a mandatory step before many routine surgeries.
• Sanation/debridement in otorhinolaryngology:
  • Description: elimination of foci of chronic infection of ENT organs.
  • Examples: lavage of the palatine tonsils lacunae or their removal (tonsillectomy) for chronic tonsillitis; sinus surgery (e.g., maxillotomy) for chronic sinusitis.
• Respiratory sanation:
  • Description: cleansing of the tracheobronchial tree from mucus, pus, blood.
  • Examples: aspiration of contents through an endotracheal tube in ventilated patients or performing bronchoscopy.

Objectives and Principles

The main goal of sanation is to eliminate the source of chronic inflammation, intoxication, and sensitization of the body. Elimination of the focus of infection prevents its further spread, the development of complications (e.g., sepsis, metastatic abscesses) and the occurrence of autoimmune reactions.

Key principles of sanation:

1. It should be curative, aiming at the most complete removal of all pathologically changed tissues and substrates.
2. Proper drainage means enabling unimpeded outflow of wound secretions.
3. Antiseptic treatment is an application of antiseptic solutions to inhibit remaining microflora.

Clinical Significance

Sanation is a fundamental principle in the treatment of purulent inflammatory diseases. Lack of quality sanation of the primary focus will make any — even the most powerful — systemic antibiotic therapy ineffective or only temporary effective, as far as the source of infection and intoxication persists. Successful sanation not only addresses the local problem, but also contributes to the patient’s overall health by eliminating the focus of chronic antigenic stimulation and stress on the immune system.