14

Question 1

difference btwn antiseptic and disinfectant

Answer 1

antiseptic chemicals applied to living tissuedisinfectant chemicals applied to inanimate objects

Question 2

types of antiseptics

Answer 2

Alcohol 60-70%IodophorsChlorohexidineTriclosan

Question 3

Characteristics of alcohol antiseptics

Answer 3

rapid bacterialcidal (not spores, variable viruses)60-70%denatures bacT proteins, interfere with metabolism and lysis of cellsefficacy decreased in presence of organic material

Question 4

T/FIsopropyl alcohol has better bactericidal activity but less virucidal activity than ethyl alcohol

Answer 4

TRUEIsopropyl alcohol has better bactericidal activity but less virucidal activity than ethyl alcohol

Question 5

Characteristics of iodophors antiseptics

Answer 5

iodine containingI2 bacteriacidal (NOT I-)disorders protein structure, blocks protein synthesis, alters cell membranesalso kills spores, viruses, fungi(ex. povidone-iodine)

Question 6

concentration of povidone iodine lethal to canine fibroblasts

Answer 6

lethal to canine fibroblasts at 0.5-1.0%

Question 7

adverse skin reaction to povidone iodine

Answer 7

50% (HIGHER THAN CHLOROHEXIDINE GLUCONATE)

Question 8

Difference btwn chlorohexidine gluconate and chlorohexidine acetate

Answer 8

chl gluconate: SCRUB 2-4%chl acetate: SOLUTION < 0.05% (wound treatments)

Question 9

characteristics of chlorohexidine antiseptics

Answer 9

does NOT kill sporesbacterialcidalvariable at viruses and fungireduced activity in presence of organic debris residual activity/cumulative effect

Question 10

activity of chlorohexidine varies with concentration:

Answer 10

low bacteriostatic (interfere with cell membrane;leakage)higher bactericidal (coagulation of cell contents)

Question 11

what systems can chlorohexidine be toxic too

Answer 11

neurotoxicototoxic (middle ear)ocular damage

Question 12

characteristics of triclosan antiseptics

Answer 12

phenol familycauses cell wall disruptionbacteriostatic (less effective than povidone and chlorohex)

Question 13

use of a razor for clipping as opposed to clippers

Answer 13

associated with higher incidences of SSI

Question 14

what % of skin flora remains protected in deeper skin layers/ follicles even after clip and sterile prep

Answer 14

20%

Question 15

contact times for surgical preps

Answer 15

30 s chlorohexidine2 minutes povidone iodine

Question 16

Rochat et al compared one step vs two step povidone iodone/alcohol

Answer 16

= effective

Question 17

scrub suit material and thread count

Answer 17

cotton muslin 140-270 threads per inchor even betterlaundered tightly woven 280 thread count/inch; water resistant (Quarpel) or paper non absorbable gowns

Question 18

when does Quarpel lose its barrier properties

Answer 18

laundered tightly woven 280 thread count/inch; water resistant (Quarpel)75 laundered cycles

Question 19

what area of the hands has the highest bacterial count

Answer 19

FINGERNAILS

Question 20

T/Fseveral studies show that chlorohexidine is more effective than povidone iodine in reducing bacterial counts and maintaining reduction

Answer 20

TRUE

Question 21

incidence of glove perforation 1. single layer2. double layer

Answer 21

1. single layer gloves 12.7-31%2. double gloving 11.5-44% (outter glove) and 3.8-13% (inner glove)

Question 22

T/F Vinyl is more resistant to perforation vs latex

Answer 22

FALSElatex more resistant to perforation than vinyl

Question 23

where are glover perforations most likely to occur

Answer 23

nondominant handorthopedic procedureslonger procedures

Question 24

when gloves are routinely changed, study found that most glove perforations occurred when….

Answer 24

during draping

Question 25

disposable gown contamination based on Moylan et al.

Answer 25

46.6% contamination by 3-3.5 hours of sx76.5% contamination if sx > 4 hr

Question 26

what % of foot bacteria become airborne

Answer 26

15%but little evidence exists to support footwear products

Question 27

what is the #1 method of increasing bacterial load in the environment

Answer 27

TRAFFICminimize traffic

Question 28

laminar flow vs conventional air flow in the OR

Answer 28

prefer laminar flow in HORIZONTAL direction61% decrease in room bacT92% decrease in wound bacT with laminar flow

Question 29

how many air exchanges/ hour is recommended, temperature, and humidity

Answer 29

15 air exchanges/hr30-60% humiditytemp 68-73 Fdoors closed, pressure positive

Question 30

based on compendium July 2011 Zeltzmancompare dry nonwoven vs woven gauze sponges 4 x 4 in terms of material, lint and absorptive capacity

Answer 30

12-ply woven absorbs 5-12.5 ml COTTON 31.2ug lint4-ply nonwoven absorbs 10-18.3 ml 70%rayon/30%polyester; prone to less lint 1.4 ug lint

Question 31

absorptive capacity of moistened 12 x 12 lap sponge

Answer 31

50 ml

Question 32

general estimate of weighing dry 4 x 4 for estimation of blood loss

Answer 32

general1 ml = 1 gm weight

Question 33

ways to prevent retained sponges

Answer 33

1. use defined packs by manufacturers2. count before and after procedure3. throw away once immediately used4. do NOT keep sponges near surgical field5. throw away all sponges and use only laps for cavity procedures6. tag small sponges with hemostats if used7. use sponges with radio opaque markers8. avoid placing free sponges in cavities9.routinely surgery and throw away sponges10, USE CARE

Question 34

term for retained surgical sponge

Answer 34

gossypibomacotton matrix within body1. wall off FB granuloma2. abscess formation

Question 35

Hayes 2014 Vet surgeryrisk factors for glove perforation

Answer 35

1. sx time > 1 hr2. primary surgeon role3. ortho procedures (power instruments, wire)4. polyisoprene material