NCSU Principles of Surgery Flashcards
What are the sources of contamination in an OR? Which one is responsible for most of the surgical wound infections?
- Animal
- Hair, skin, normal flora (oral, nasal, genital, rectal) - Inanimate
- Fomite: any inanimate object capable of carrying infectious organisms - Airborne
* Floor, staff, patient
* May account for 80-90% of surgical wound
infections
Cleaning vs sterilization:
Cleaning: Removes gross soil and bacteria but does not kill or inactivate them.
Done before antisepsis or sterilization because they often fail in the face of gross contamination
Sterilization vs. antisepsis vs. disinfection
Sterilization: Kills everything. For inanimate objects. You cannot sterilize the puppy!
Antisepsis & disinfection: Killing pathogens. Antisepsis is for animals, and disinfection is for inanimate objects.
Why must surgical team members remain within the sterile area?
Movement out of the sterile area may encourage cross-contamination.
Why should talking be kept to a minimum in the operating room?
Talking releases moisture droplets laden with bacteria.
Why is movement in the operating room kept to a minimum, with only necessary personnel allowed?
Movement may encourage turbulent airflow, resulting in cross-contamination.
Why should nonscrubbed personnel avoid reaching over sterile fields?
Dust, lint, or other bacterial contamination may fall on the sterile field.
Why must scrubbed team members face each other and the sterile field at all times?
A team member’s back is not considered sterile, even if wearing a wraparound gown.
Why must equipment used during surgery be sterilized?
Unsterile instruments may be a source of cross-contamination.
Why should scrubbed personnel handle only sterile items, while nonscrubbed personnel handle only nonsterile items?
Nonscrubbed personnel and nonsterile items may be sources of cross-contamination.
What should be done if the sterility of an item is questioned?
It should be considered contaminated, as nonsterile equipment may cause cross-contamination.
Why are sterile tables considered sterile only at table height?
Items hanging over the table edge are out of the surgeon’s vision and are considered nonsterile.
Which areas of surgical gowns are considered sterile?
From mid-chest to waist and from gloved hand to 2 inches above the elbow.
Why should drapes covering instrument tables or the patient be moisture-proof?
Moisture carries bacteria from a nonsterile surface to a sterile surface (strike-through contamination).
What happens if a sterile object touches the sealing edge of the pouch that holds it during opening?
It is considered contaminated, as sealed edges of pouches are not sterile once opened.
Why are sterile items within a damaged or wet wrapper considered contaminated?
contamination can occur from perforated wrappers or strike-through from moisture transport.
Why should hands not be folded into the axillary region but kept clasped in front of the body above the waist?
The axillary region of the gown is not considered sterile.
Why must surgical team members remain seated if they begin the surgery in a seated position?
The surgical field is sterile only from table height to the chest;
movement from sitting to standing during surgery may promote
cross-contamination.
- Describe how to perform the initial clip
Describe how to perform the initial
(“decontamination”) prep - Name 3 scrub solutions and their important
c h a r a c t e r i s t i c s - Describe how to perform the sterile patient prep
- Describe how to quarter drape while maintaining
sterility - Describe how to place the final drape
What are the most common skin flora that contribute to surgical site infections in dogs?
Staphylococcus pseudintermedius***
Enterococcus spp.
Klebsiella spp.
Pasteurella spp.
Sterptococcus spp.
What are the steps in preparing the patient for surgery?
Step 1 - look for infection
Step 2 - managing the hair (clipping)
Step 3 - Initial scrub (decontamination)
Step 4 - position the patient
Step 5 - “sterile” prep
Step 6 - Drape the patient (quarter draping and final draping)
What should you do if a skin infection distant from the surgery site is present?
Elective procedures should be delayed until the infection is resolved.
