L03: Preparation for Aseptic Surgery (Kim) Flashcards
sources of infection during a surgery
instruments local skin flora hair/dirt/debris surgeon skin flora surgeon attire operating table air-borne from room
Halsted’s Principles for good surgical outcomes
asepsis gentle tissue handling hemostasis preserve blood supply reduce dead space avoid tension anatomic dissection
If all are followed, should achieve <5% infection rate for clean procedures
sterilization vs. disinfection/antisepsis
sterilization: destruction of ALL living organisms w/ no toxic residue and no instrument damage
disinfection/antisepsis: decreases number of organisms, but does not get rid of all of them
methods of PHYSICAL sterilization
dry or wet heat
radiation
filtration
methods of CHEMICAL sterilization
ethylene oxide (most common)
H2O2 plasma
gluteraldehyde (“cold sterilization”)
Dry vs. Wet Heat sterilization
Dry Heat: no humidity, slow, death by oxidation, can burn objects and temper metal, rarely used
Wet Heat: 100% humidity, rapid, water catalyst for coagulation and protein denaturation, reliable, inexpensive, non-toxic
how does steam sterilization (autoclave) work?
- attains appropriate temperature and duration
- pressurization used to achieve higher temperature (but doesn’t in itself kill the bacteria)
- the higher the temp used, the less time required to sterilize
FLASH method
270 degrees for 3 minutes; often used when instrument dropped
- not protocol or gold standard
- used on emergency basis
shelf life of single wrap muslin
2 days
shelf life of double wrap muslin
3 weeks
shelf life of crepe paper and single layer muslin
10 wks
shelf life of polypropylene peel pouches
12 mo. (probably indefinitely)
what not to autoclave
many plastics
suture material
electronics
powders, glassware, liquids
danger of ethylene oxide
- colorless, odorless, toxic gas
- can create ocular irritation: must aerate objects for hours to days to prevent this
adv. of ethylene oxide
can manipulate concentration, humidity, and temp. to alter sterilization times
