Aseptic Technique Flashcards
PREVENT Wound Contamination by Destroying Organisms Before they Enter the Wound
Asepsis
Killing of Bacteria AFTER They have Entered the Wound
Antisepsis
The process of Destroying ALL Microorganisms (Bacteria, Fungi, Spores)
Sterilization
Goal of Aseptic Surgical Technique
Goal is to MINIMIZE Contamination of Surgical Wounds
*Most Surgical Wounds contain Bacteria by the time the Procedure is Completed
Scrub that Removes Gross Dirt and Debris
Primary (“Rough”) Scrub
Germicidal Soap Scrub:
Circular Motion: Site to Periphery
Scrub GENTLY
_____ Minute Minimum Contact Time
Five
Primary Aerial Bacterial Source
YOU (Surgeon)
Lab Coat Protects Scrubs from Hair and Loose Debris and should be Worn Anytime _____ in Sterile Area
NOT
*Remove Lab Coat when Entering Sterile Area
Surgeon Skin Preparation/Washing:
Remove Gross Dirt and Oil
Reduce Surface Bacterial Count
Suppress Bacterial Growth
Hands always Higher than ______\_
Elbows
The _____ Gloving Technique is Preferred because there is much LESS Risk of Breaking Aseptic Technique
Closed
Which of the Following is NOT Sterile once Surgery Starts?
A. Back, Neck, Shoulders, Axillae, Below Waist
B. Anything Below Table Height
C. Wet Gowns or Drapes (unless Waterproof)
D. Any Instrument or Surface you are not sure of
All the Above are NOT Sterile once Surgery Starts
Most Common Method of Sterilization:
Causes Destruction or Denaturation of Cellular Proteins
Steam must Contact Surface to Sterilize
Minimum Standard: 250 Degrees F, 15 psi, 13 Minutes
Steam Sterilization (Autoclaving)
Method of Sterilization Described Below:
Takes Longer than Other Methods: 12-24 Hour Cycles
Aerate Thoroughly: Gas Permeable Items should NOT be used for 24 Hours after Sterilization (Irritant/Carcinogen)
Effectiveness Dependent on Gas Concentration, Temperature, Exposure Time and Humidity
Chemical Sterilization- Ethylene Oxide
Method of Sterilization Described Below:
Two Phases: Peracetic Acid Vapor Phase and Plasma Phase
Ionized or Partially Ionized Gas
Produced by Passing Electromagnetic Energy through a Mixture of Stable Gases
Cheaper/Load and Safer than Ethylene Oxide but Higher initial Cost
Chemical Sterilization- Gas Plasma
Method of Sterilization Described Below:
Used to Wash and Disinfect Surfaces
Dental Instruments and Scopes
Used for Scopes ect. which can’t be Sterilized by other Methods
Chemical Sterilization- “Cold” Disinfectants
*Ex. Chlorhexidine and Glutaraldehyde
When Preparing Packs for Sterilization:
Place Sterilization Indicator in Center of Pack and Indicator Tape on Outside
Identify Date Pack was Sterilized and Who Packed it
Put _______ on Infrequently Used Packs
Expiration Date
Heat Sealed Paper/Transparent Plastic Pouch has a Shelf Life of______
1 Year
_______ Principles of Surgery
Halsted’s
______ Reduces Risk of Infection by Removing Bacteria and Loose Tissue Fragments From Wound
Wound Lavage
*Moist Tissues = Happy Tissues
_____ Dissection is Preferred in Most Instances
Sharp
Tissue Manipulation = ________
Tissue Trauma
*Minimize Trauma by using Most Direct Approach with Ample Length of Incision
Instrument that Divides Tissue with Least Collateral Damage and Precise Control
Scalpel
Hemorrhage that Occurs AFTER 24 Hours Post-Op usually the Result of Ineffective Ligation
Secondary Delayed Hemorrhage
*Ex. Ligatures Slipping Off Larger Vessels
Hemorrhage that Occurs WITHIN 24 Hours of Surgery
Intermediate Delayed Hemorrhage
Hemorrhage that Occurs DURING Surgery
Primary Hemorrhage
Complications of _______ during Surgical Procedure:
Obscured Surgical Field
Increases Rate of Infection
Hematoma Formation- Painful
May be Life Threatening
Uncontrolled Bleeding/Hemorrhage
True/False: Most Bleeding can be Controlled by Applying Pressure while Deciding How to Best Manage the Situation
True
Name Three Techniques used for Temporary Hemostasis
Pressure
Hemostatic Forceps
Topical Hemostatic Agents
Name Four Techniques used for Definitive Hemostasis
Electrocoagulation
Ligature
Vascular Clips
Primary Vascular Repair
Technique used for Definitive Hemostasis Described Below:
Electrical Current Delivered to Tissues
Heat is Produced by Tissue Resistance to the Current: Hemostasis
Advantages:
Decreased Blood Loss and Operative Time
Disadvantages:
Less Hemostatic Security than Ligation
Collateral Tissue Damage
Electrocoagulation
Technique used for Definitive Hemostasis Described Below:
MOST SECURE Occlusion
No Limit to Vessel Size
Ligatures
Technique used for Definitive Hemostasis Described Below:
Rapidly, Easily Applied
Risk of Dislodgement
Vessels up to 5mm
Vascular Clips
Scalpel Handle Used in Small Animals vs. Large Animals
# 3- Small Animals
# 4- Large Animals
Correct Blade Angle used for Cutting with a #10 Blade
30 Degrees
*10s Blades used on # 3 Handles
Scalpel Grip used for:
Finger Movement
Excellent Control
Short Precise Incisions
Pencil Grip
Scalpel Grip used for:
Arm Motion
Long Incision
Fingertip Grip
Review Card: Scalpel Grips
Cutting Technique Described Below:
Pencil Grip or FInger Tip Grip
Pressure Applied at 90 Degrees Angle to Blade Motion
Incision Made with One Continuous Motion Through the Entire Tissue Layer
Slide Cutting
Cutting Technique Described Below:
Fingertip Grip
Sub-Bursting Pressure Applied to Blade while Moving in Perpendicular Motion
Tissue Layer Separation Without Risk of Cutting
Indications: Granulation Tissue Debridement, Elevation of Muscles
Scraping
Describe How to Hold Ringed Instruments
Thumb and Ring Finger Placed in Rings
Index Finger can be Placed Along the Shank for Added Control and Stability
Scissors Described Below:
Identified by Slender Blades
Used for Dissection and Cutting DELICATE Tissues
Metzenbaum Scissors
*Do NOT use to Cut Heavy Fascia
Scissors Described Below:
Thicker Blades
Used for General Dissection and Cutting Tougher Tissue such as Muscle Fascia, Tendon and the LINEA ALBA
Mayo Scissors
Scissors Described Below:
Short Thick Blades with Serrated Edges
Good for Cutting Sutures and Drape Material
Vernon Cartilage and Wire Scissors
Most Commonly used Scissor Grip
Forehand Grip
Scissor Technique Described Below:
Initiate with Small Scissor Cut
When Blades are Nearly Closed, Push Scissors to Cut tissue Layer in one Continuous Motion
Used to Separate Sheets of Tissue- Ex. Reflecting Subcutaneous
Push Cutting
*Just like Cutting Wrapping Paper
Most Common Grip for using Thumb Forceps
Pencil Grip
Very Common General Use Thumb Forceps
Adson-Brown Thumb Forceps
*Grasp as little Tissue with as Little Pressure as Possible
Where should we Grasp Needle with Needle Holders?
1/2 to 2/3 from Tip
Name these Needle Holders
Mayo Hegar Needle Holders
Recommended Grip for Needle Holders that Provides Excellent Control
Thumb-Ring Finger Grip
Grip used for Needle Holders Described below:
Ring Finger Placed in Ring
Thumb placed along Shaft and used to Open/Close Ratchets
Maintains good Control but Increases Speed
Thenar Eminence Grip
Grip used for Needle Holders Described below:
Rapid Suturing but Less Precise Control
Strong Driving Force for Placing Sutures in Tough Tissues
Palm Grip
List the Three Types of Hemostatic Forceps
Temporarily Loosening Hemostat to Facilitate Tightening of Ligature on Vascular Pedicles
Flashing
Hemostatic Forcep Described Below:
Delicate Hemostat used for Ligating Individual Vessels
Transverse Serrations Extend down Entire Length of Jaw
Halstead Mosquito Forceps
Hemostatic Forcep Described Below:
Intermediate Size Hemostat
Transverse Serrations Extend HALF WAY down Jaws
Kelly Hemostatic Forceps
Hemostatic Forcep Described Below:
Used to Occlude Large Vascular Structures such as the Ovarian Pedicle
Rochester-Carmalt Hemostatic Forceps
Instrument used to Secure the Drapes to the Skin
Backhaus Towel Clamps
Instrument Described Below:
Used to Grasp Tissue Facilitating Retraction
DO NOT place on Skin
Allis Tissue Forceps
Instrument used to Aid Exteriorization of Uterine Horn during Ovariohysterectomy
Snook Ovariohysterectomy Hook
