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SAMS > Aseptic Techniques in Surgery > Flashcards

Aseptic Techniques in Surgery Flashcards

1
Q

Why is aseptic technique important?

A
  • surgical disruption of dermal integrity
  • introduction of bacteria into wound
  • -> endogenous: within/on patient
  • -> exogenous: airbone, surgical team
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2
Q

Sterilization

A

Complete elimination of microbial viability

- bacteria, viruses, spores

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3
Q

Disinfection

A

Destruction of MOST pathogenic organisms on inanimate objects

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4
Q

Antisepsis

A

Prevent growth of microorganisms on living tissue by inhibiting activity or killing them (not sterilized)

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5
Q

Living organism too small to be seen with the naked eye

A

Microbe/microorganism

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6
Q

Microbe capable of causing disease

A

Pathogen

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7
Q

Detrimental result of invasion by pathogens

A

Infection

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8
Q

Infection acquired during hospitalization or during attendance at any vet facility

A

Nosocomial

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9
Q

Methods of sterilization

A
  • steam
  • chemical
  • plasma
  • ionizing
  • cold chemical
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10
Q

Steam and pressure

A

Most common

  • destroys bacteria by coagulation and cellular protein denaturation
  • load on edge –> no stacking (increased thickness decreases steam penetration
  • small amount of air between packs
  • gravity displacement: air is heavier than steam
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11
Q

Chemical (gas)

A

Ethylene Oxide

  • flammable, explosive liquid if not mixed with CO2 or freon
  • kills via alkylation
  • lower temp (120-140 F) for cameras, plastics, cables
  • environmental/safety hazards
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12
Q

Plasma

A

Uses reactive ion, electrons, and other atomic particles to sterilize

  • lower temp
  • used with vapor phase H2O2
  • takes only 75 min, immediate use
  • irritant: housed in sealed cassette
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13
Q

Radiation

A

Ionizing radiation (Cobalt 60)

  • used in commercial manufacturing due to expense
  • suture material, gowns, drapes, etc
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14
Q

Cold chemical

A

Glutaraldehyde (2%)

  • noncorrosive
  • good for delicate lensed instruments
  • other: alcohols, chlorhexadine, iodines, phenols, quart, ammonium compounds
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15
Q

Rules for sterilization

A
  • know activity of agent
  • know potential toxicities
  • properly wrap equipment
  • check technique/instruments
  • use indicators
  • know shelf lives
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16
Q

Indicators

A

Monitor effectiveness of sterilization

  • chemical: temp induced change, does not indicate sterility, only optimal conditions
  • biologic: cultured, weekly use recommended
17
Q

Sterile packs should be stored in _______

A

Closed containers

18
Q

Inside of wrappers is considered to be sterile to within _______

A

1 inch of the edges

19
Q

Infection in surgery is indicated in tissue ______

A

With >10^5 cfu/gram of tissue

- antibiotics NOT designed to make up for poor sterile technique

20
Q

Indications of perioperative antibiotics

A
  • OP times 90 min or greater (infection rate doubles)
  • implants
  • severely infected/traumatized
  • respiratory
  • GI
  • urogenital
21
Q

Surgeon’s responsibility

A
  • evaluate overall health of patient
  • preserve vascularity
  • minimize trauma
  • maintain tissue oxygenation
    = enhanced healing and reduced potential for infection
22
Q

Control of enviornment

A
  • disinfection of equipment
  • frequent repetition of cleaning procedure
  • traffic control
23
Q

Patient preparation

A
  • clip/clean area

- scrub: center out, iodine, chlorhexadine (less reaction)

24
Q

Final result of draping

A
  • minimal skin exposure
  • multiple layers
  • waterproof barrier to prevent strike through
25
Q

Personal prep includes:

A
  • pre surgery
  • surgery prep
  • post surgery
26
Q

Pre-surgery

A
  • wash hands
  • keep fingernails short
  • remove jewelry
  • hair coverage: major bacterial contaminant
27
Q

Surgical attire

A
  • clean scrubs
  • booties
  • mask: designed to filter and contain microorganisms from droplets
  • cap/bonnet: hair within cap
28
Q

Surgical gloves

A

Percentage of defects:

  • overall: 23.3% defects
  • more in non-soft tissue procedures
  • 84% of defects in procedures >60 min
29
Q

Scrubbing

A

Contact time is key!

  • 3-5 min with chlorhexidine
  • fingertips to 2 inches above elbow
  • binds to keratin for residual effect
  • check fingernails
  • prewash
30
Q

Brushless/waterless scrub

A
  • alcohol based
  • more effective
  • quicker
  • method of choice by WHO
  • Avagard/Steriliium
31
Q

In the OR

A

From chest to waist is sterile area for body

- from elbow to hand is sterile area for arms

32
Q

Surgery suite etiquette

A
  • inform assistants of position
  • back to back/front to front
  • step up to table
  • maintain sterile field
  • # of people and degree of movement has been correlated to amount of airbone bacteria (same with amount of talking)
33
Q

Instruments/trays

A
  • anything off the table level is contaminated!
  • instruments that fall off to the side are contaminated
  • hands that touch instruments below the table line are contaminated
34
Q

Wet/stained instrument wrappers

A

Strike through

  • when liquids soak through a barrier from sterile to unsterile and vice versa
  • provides a passage for microorganisms
  • contents of pack are contaminated
35
Q

Sterile supplies that fall or the floor, or are stored on the floor should be considered _________

A

Contaminated

36
Q

When opening a sterile pack do not _____

A

Reach across the sterile field

- items opened enveloped style may be handed off to a sterile person

37
Q

After surgery

A
  • keep basic attire on
  • place waste in proper cans
  • wash hands again before next patient
  • lab coat outside of OR
38
Q

Everything done in the operating room is for the purpose of ________

A

Minimizing microbial contamination, to minimize post operative infection and achieve maximal therapeutic benefit

SAMS (13 decks)

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