Good theatre practice Flashcards
define sepsis
the presence of pathogens
define asepsis
free from infection
define antisepsis
prevention of sepsis
what is strerilisation
elimination of all mircoorganisms including spores
define disinfection
removal of microorganisms (does not always include spores)
what is a disenfectant?
agent that will distroy mircoorganisms
what needs to be done regarding the instuments used for surgery?
- cleaned,
- checked for damamge and that they are working effectivly,
- sterilised to maintian asepsis
Give an example of a weekly theatre cleaning routine:
- Morning Damp dusting – First thing.
- Between cases – Immediate action required
- At the end of day – disinfectant solutions
- Once a week – Deep cleaning, All areas remember the hard to reach places
how do you check a theatre has been cleaned corrrectly?
take regular swabs for culture growth (remember had to reach areas), skins, taps, operating table
Preoperative preparation of the patient
what needs to happen to the patient the 12ish hours before surgery?
starvation
Preoperative preparation of the patient
is bathing needed before a surgery?
depends of the breed and the type of surgery occuring, might be needed a few days before
when can clipping of the area be done?
- before surgical day (can irritate the skin and cause microorganism overgrowth)
- prior to induction (if patient is cooperative)
- once induction has been done
Preoperative preparation of the patient
what special preperation is sometimes needed for lower GI surgery?
enema
Preoperative preparation of the patient
what special preperation is sometimes needed for urinary tract and abdominal surgery?
urinaty catherterisation (reduces size of the bladder provides more room in abdomen)
Preoperative preparation of the patient
what special preperation is sometimes needed for oral surgery?
flushign of the mouth with dilute hibiscrub
Preoperative preparation of the patient
what special preperation is sometimes needed for foot surgery?
apply bags with hibiscrub, allowing feet to soak , to remove all dirt
what are the key questions to ask before surgery?
- patient history has been confirmed
- not sensitive to chosen dienfectants
what are the 3 main steps of preoperative pateint preperation?
- cannula
- catheter
- cleaning
what is used for/needed for the preoperative scrub/clean of animal?
- sterile bowl
- sterile lint-free material (10x10 gause swab)
- sterile/non-sterile gloves can be worn but hands must bee clean
what solution is used for the surgical scrub solution
what two preoperative procedures require a sterile scrub to be performed before they are carried out?
IV cannulas and urinary catheters
what areas of the body require preoperative sterile flushign prior to exploratory or repair surgery?
wounds, eyes, ears, mouth and feet
why is surgical scrubbing of the patient vital?
animal carries commensal bacteria of skin that can be opportunistic and pathogenic if allowed to enter the body
what technique is used for the surgical scrub of the animal skin?
circular motion moving outwards way from the incision site
what is the nomal solution used for cleaning preperation of the patients skin? how long does this need to be in contact?
chlorohexidine 2%, minimum of 5 minutes
what skin cleaning solution is used for patients that have chrohexidine sensitivites? how long does this need to be in contact?
povidone iodine 7.5%, for 3 minutes
what are the issues with using povodine iodine fro a surgical skin scrub?
does not achive good bacteriocidal effects inthe presence of gross contamination (mud, blood)
what solution is usded to clean ocular areas?
Povidone Iodine 0.2%-2% or 1:50 dilution.
(chlorohexidine is an irritant to the mucus membrane)
what cleaning solution is used for the ear?
- flushed frist with saline
- then dilute 0.2% chlorohexidine
what cleaning solution can be used for feet?
wrapped in a bag containing 2% chlorohexidine left for 5 mins to remove gross contamination, then clipped and scrubbed for another 5 mins
what can be used to clean open wounds prior to surgey?
0.9% saline
what should not be used in open wounds prior to surgery and why?
chlorohexidine as it has been found to be toxic to cells and could cause delayed wound healing and problems post op
what is used to clean the mouth prior to surgery?
0.1% chlorohexidine (dogs) (premade rinse)
what are the isses of using chlorohexide for oral cleaning in cats?
research has shown that can lead to oral ulceration of mucus membrane - need to use proper oral scrub for cats
what are the issues with other wetting during the srugical scrub of the patient?
can lead to strike through of the surgical drapes, and cooling of the patient leading to hypothermia
why do we drape the patient?
- to maintian asepsis
- prevent contamination of surgical site
what should drapes cover?
where practical - the entire patient only leaving the surgical site visible
(not needed for cat castrate or large animal)
what are the advantages of disposable drapes?
- more cost effective
- better at repetting liquids (prevent strike through)
what is strike through in a surgical sense?
then the blood and fluid or liquid from above the drape soak into the drape and can hurbour bacterial growth
what are the uses for a fenestrated drape?
for small procedures with small animals
what draping technique is used for a large surgery
4 corner draping
what is an adhesive barrier drape? when are they used?
sticky on one side and can be fixed to patient, act like a second skin, helpful for limb surgery where surgeon wants to move the limb
what can adhesive barrier drapes be inpregnated with and what does this do?
inpregnated with iodine to provide an extra barrier for asepsis
