Aseptic technique Flashcards
Define antisepsis
prevention of sepsis by the destruction or inhibition of microorganisms using an agent that may be applied safely to living tissue
Define asepsis
absence fo pathogenic microbes in living tissue
Define sepsis
presence of pathogens or their toxic products in the tissues of a patient
Define antiseptic
chemical agent that either kills or inhibits pathogenic microorganisms. applied to the body
Define disinfectant
Germicidal chemical substance that kills microorganisms of inanimate objects
Define disinfection
removal of microorganisms but not necessarily their spores
Define sterilisation
complete elimination of microbial viability, including spores, by chemical / physical means
What are the personnel non - sterile barriers
scrubs suit
head cover
shoe cover
face amsk
What disinfectants can be used to prepare the surgeons skin?
clorhexidine
iodine
alcohol
sterillium
Sterile barriers
gloves
surgical gown
6 physical ways of sterilisation of surgical equipment
heat steam moist heat dry heat irradiation filtration
How is steam sterilisation used and what for?
saturated steam under pressure
instruments, drapes, gowns, swabs, rubber, glass, plastic
How is dry heat sterilisation used?
oxidative destruction of bacteria
glass, cutting instruments, ophthalmic instruments, drill bits, powders, oils
3 main chemical ways of sterilisation
Ethylene oxide
hydrogen peroxide gas plasma
cold sterilisation with disinfectant
How does ethylene oxide sterilisation work?
kills bacteria, spores, fungi and large viruses.
toxic, irritant and flammable
used for fibre - optics, plastic, anaesthetic tubing, optical instruments, high speed drills and burs
How does hydrogen peroxide gas plasma sterilisation work?
uses an electrical field
2 types of sterilisation indicators
chemical - colour change
biological - try to culture spores
How is the patient prepared?
1) hair removal
2) skin preparation
3) draping the patient
How should an operating theatre be designed?
- away from normal traffic
- big enough for surgical team but small enough to clean easily
- air at mild positive pressure
- stainless steel and glass furniture
- windows cant open
- restricted access
- clean surgeries before dirty
- clean between patients, start and end of day and weekly
3 mains determinants of wound infection
1) bacterial factors - number, types, virulence, duration of exposure, growth needs
2) wound factors - want healthy, viable tissue with a good blood supply
3) patient factors - systemic disease, trauma, drug therapy
factors that increase risk of wound infection
- duration of surgery and anaesthesia
- more people in operating theatre
- dirty surgical site
- duration of post - op stay
- wound drainage
- fat patient
- abx prophylaxis
- removing hair a while before surgery
- poor metabolic / nutritional status
- emergency surgery
if abx used incorrectly:
drug resistance increase cost adverse patient effects alters normal flora superinfection hospital acquired infection risk increase
Exceptions for clean surgery abx use
over 90 min
implant used
infection would be catastrophic
immunocompromised patient
ABX prophylaxis recommendations
- give IV
- 30-60 mins before incision
- give every 1- 2 half lives
- 3-6 hours post surgery has no effect
- dont give for more than 12 - 24 hour post op
- dont use oil based of subQ as wont reach incision site
