14 Flashcards
difference btwn antiseptic and disinfectant
antiseptic chemicals applied to living tissuedisinfectant chemicals applied to inanimate objects
types of antiseptics
Alcohol 60-70%IodophorsChlorohexidineTriclosan
Characteristics of alcohol antiseptics
rapid bacterialcidal (not spores, variable viruses)60-70%denatures bacT proteins, interfere with metabolism and lysis of cellsefficacy decreased in presence of organic material
T/FIsopropyl alcohol has better bactericidal activity but less virucidal activity than ethyl alcohol
TRUEIsopropyl alcohol has better bactericidal activity but less virucidal activity than ethyl alcohol
Characteristics of iodophors antiseptics
iodine containingI2 bacteriacidal (NOT I-)disorders protein structure, blocks protein synthesis, alters cell membranesalso kills spores, viruses, fungi(ex. povidone-iodine)
concentration of povidone iodine lethal to canine fibroblasts
lethal to canine fibroblasts at 0.5-1.0%
adverse skin reaction to povidone iodine
50% (HIGHER THAN CHLOROHEXIDINE GLUCONATE)
Difference btwn chlorohexidine gluconate and chlorohexidine acetate
chl gluconate: SCRUB 2-4%chl acetate: SOLUTION < 0.05% (wound treatments)
characteristics of chlorohexidine antiseptics
does NOT kill sporesbacterialcidalvariable at viruses and fungireduced activity in presence of organic debris residual activity/cumulative effect
activity of chlorohexidine varies with concentration:
low bacteriostatic (interfere with cell membrane;leakage)higher bactericidal (coagulation of cell contents)
what systems can chlorohexidine be toxic too
neurotoxicototoxic (middle ear)ocular damage
characteristics of triclosan antiseptics
phenol familycauses cell wall disruptionbacteriostatic (less effective than povidone and chlorohex)
use of a razor for clipping as opposed to clippers
associated with higher incidences of SSI
what % of skin flora remains protected in deeper skin layers/ follicles even after clip and sterile prep
20%
contact times for surgical preps
30 s chlorohexidine2 minutes povidone iodine
Rochat et al compared one step vs two step povidone iodone/alcohol
= effective
scrub suit material and thread count
cotton muslin 140-270 threads per inchor even betterlaundered tightly woven 280 thread count/inch; water resistant (Quarpel) or paper non absorbable gowns
when does Quarpel lose its barrier properties
laundered tightly woven 280 thread count/inch; water resistant (Quarpel)75 laundered cycles
what area of the hands has the highest bacterial count
FINGERNAILS
T/Fseveral studies show that chlorohexidine is more effective than povidone iodine in reducing bacterial counts and maintaining reduction
TRUE
incidence of glove perforation 1. single layer2. double layer
- single layer gloves 12.7-31%2. double gloving 11.5-44% (outter glove) and 3.8-13% (inner glove)
T/F Vinyl is more resistant to perforation vs latex
FALSElatex more resistant to perforation than vinyl
where are glover perforations most likely to occur
nondominant handorthopedic procedureslonger procedures
when gloves are routinely changed, study found that most glove perforations occurred when….
during draping
disposable gown contamination based on Moylan et al.
46.6% contamination by 3-3.5 hours of sx76.5% contamination if sx > 4 hr
what % of foot bacteria become airborne
15%but little evidence exists to support footwear products
what is the #1 method of increasing bacterial load in the environment
TRAFFICminimize traffic
laminar flow vs conventional air flow in the OR
prefer laminar flow in HORIZONTAL direction61% decrease in room bacT92% decrease in wound bacT with laminar flow
how many air exchanges/ hour is recommended, temperature, and humidity
15 air exchanges/hr30-60% humiditytemp 68-73 Fdoors closed, pressure positive
based on compendium July 2011 Zeltzmancompare dry nonwoven vs woven gauze sponges 4 x 4 in terms of material, lint and absorptive capacity
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
absorptive capacity of moistened 12 x 12 lap sponge
50 ml
general estimate of weighing dry 4 x 4 for estimation of blood loss
general1 ml = 1 gm weight
ways to prevent retained sponges
- 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
term for retained surgical sponge
gossypibomacotton matrix within body1. wall off FB granuloma2. abscess formation
Hayes 2014 Vet surgeryrisk factors for glove perforation
- sx time > 1 hr2. primary surgeon role3. ortho procedures (power instruments, wire)4. polyisoprene material
