Aspesis Flashcards
What is the difference between asepsis and antisepsis?
Asepsis— prevent/minimize wound contamination by destroying organisms before they enter the wound
Antisepsis - killing of bacteria father they have entered the wound
Difference between disinfection and sterilization?
Disinfection — use of germicidal substances to kill most microorganisms
Sterilization — process of destroying all microorganisms (bacterial, fungal, and spores)
How do you prepare a patient for surgery?
+/- bath 24hours pre-op
Clip hair
Vacuum loose hair
Primary (rough) scrub to remove dirt and debris
How do you sterile prep the surgical site ?
Scrub technique must prevent contamination of prep material
Germicidal soap scrub Circular motion from the site to periphery Scrub GENTLY 5 minute contact time Final prep solution
What is the primary source of bacteria during surgery?
YOU
More people + more activity = more bacteria
4% chlorhexidine and 15% povidone iodine both proved 70-80% bacterial reduction. In with which solution does regrowth occur more rapidly?
Povidone iodine
How much contact time do you require when you scrub?
3-5mins
T/F: open gloving is preferred to closed gloving because there is much less risk of breaking aseptic technique
False
Closed gloving is preferred
Anyone scrubbed should keep their hands between the level of _________________________ to maintain sterile technquie
Waist and axillae
When placing quarter drapes, ideally the surgeon should stay a minimum of _____ “ form the edges of the operating table
12
T/F: the top drape should cover the entire instrument table
True
This this a break is aseptic technique or a beak in asepsis?
Raising your ands above shoulders
Break in aseptic technique
This this a break is aseptic technique or a beak in asepsis?
Raising your hand and touching your mask
Break in asepsis
What are the physical sterilization methods?
Thermal energy
Filtration - liquids (eg millipore filter)
Radiation
-gamma radiation
What are the chemical sterilization methods?
Plasma
Ethylene oxide
Disinfectants
What is the most common method of sterilization?
Steam (autoclaving)
-saturated steam heat under pressure
Destruction/desaturation of cellular proteins
What are disadvantages of steam sterilization?
Cannot be used for some materials
Dulls sharp instruments
Cycling time
Pack size limitations
How does a gas plasma sterilization work?
Peracetic acid vapor phase
Plasma phase
- ionized or partially ionized gas
-produced by passing electromagnetic energy through a mixture of stable gases
Fast turn around
Why must you aerate materials sterilized by ethylene oxide?
Irritant
Carcinogen/teratogen
Should be aerated for 8-12hours
What is the use of “cold” disinfectants ? What are the products used?
Wash and disinfect surfaces, not suitable for surgical instruments
Chlorhexidine, iodophors
Glutaraldehyde (scopes)
When preparing a pack for sterilization, the pack should not be more than ____” thick
12
What is the shelf life of a heat sealed paper/transparent plastic pouch pack?
1 year
What is the shelf life of 2layer pack with nonwoven polypropylene fabric?
8 weeks
What is the shelf life of a 2 layer cloth pack?
4 weeks
T/F: wound lavage reduces risk of infection by removing bacteria and lose tissue fragments from the wound
True
T/F: you should try to make your incision as small as possible to prevent bacterial contamination of the site
False
Give ample length to the incision to prevent tissue trauma
What is intermediate delayed hemorrhage?
Within 24hrs of surgery
What is secondary delayed hemorrhage ?
More than 24hours after surgery — usually result of ineffective ligation
What are the consequences of hemorrhage ?
Obscures surgical field (technical errors)
Increase rate of infection
Hematoma formation — painful and interferes with normal wound healing
May be life threatening
How should you deal with hemorrhage during surgery?
Stay calm
More bleeding can be controlled by applying pressure while deciding how to manage
- hemostatic forceps (crush vessel and stimulate clot formation
- topical hemosatic agents — scaffold to promote clot formation
Gelfoam/surgical/hemablock
Ligature/electrocoagulation/vascular clips/primary vascular repair
