Prep for aseptic sx (Kim)

Question 1

contamination from

Answer 1

1. instruments
2. local skin flora
3. local hair/dirt/debris
4. surgeon skin flora
5. surgeon attire
6. operating table
7. air borne from room

Question 2

Sterilization

Answer 2

• destruction of ALL living organisms
• no toxic residue
• no instrument damage

Question 3

Physical methods of sterilization

Answer 3

• heat (dry and wet)
• radiation
• filtration

Question 4

chemical methods of sterilization

Answer 4

• ethylene oxide
• H2O2
• Gluteraldehyde

Question 5

Dry heat

Answer 5

• no humidity
• slow
• death by oxidation
• can burn objects and temper metal

*not used

Question 6

wet heat

Answer 6

• 100% humidity
• rapid
• water is catalyst for coagulation and protein denaturation
• reliable, inexpensive, non-toxic

Question 7

Steam sterilization

Answer 7

• autoclave
  
  • need to attain appropriate temp and duration
  • pressurization used to achieve higher temp

Question 8

FLash sterilization

Answer 8

• quicker for a crucial instrument that becomes unsterile
• only 3 minutes
  
  • not gold standard

Question 9

Arranging packs

Answer 9

• density of packing can decrease penetration and sterilization

Question 10

single wrap muslin

Answer 10

2 day shelf life

Question 11

double wrap muslin

Answer 11

3 week shelf life

Question 12

crepe paper + single layer muslin

Answer 12

10 week shelf life

Question 13

propylene peel pouches

Answer 13

12 month shelf life

Question 14

Don’t autoclave

Answer 14

• many plastics
• suture materials
• electronics
• powders
• glassware
• liquids

Question 15

Ethylene Oxide

Answer 15

• colorless, odorless, toxic gas
  
  • must aerate objects for hours to days
• temp range: 84-150
• can manipulate concentration, humidity, temps to alter sterilization times

Question 16

Cold sterilization

Answer 16

• gluteraldehyde
• not really cold….?

Question 17

Radiation

Answer 17

• lethal ionization
• gamma radiation most popular
• commercially sterile products

Question 18

Indicators

Answer 18

• physical: machine puts out info that says parameters met
• chemical: color changing tab
  
  • most common
  • not foolproof
• biological: bacterial spores in vial
  
  • most fool proof way
  • results take days
  • rarely used in vet med

Question 19

Antisepsis

Answer 19

• reducing bacterial burden on patient and surgeon
• all can be toxic
  
  • use at appropriate dilutions

Question 20

Chlorhexidine

Answer 20

• Pros
  
  • non-irritating
  • good residual activity
  • not affected by organic matter
  • effective against a wide array of microbes
• Cons
  
  • allergies from chronic exposure
  • ototoxicity
  • corneal toxicity

Question 21

Iodophors

Answer 21

• Pros
  
  • cheap
  • effective against a wide array of microbes
• Cons
  
  • can cause dermal irritation
  • decreased activity in organic matter
  • unreliable residual activity
  • stains

Question 22

Alcohols

Answer 22

• Pros
  
  • very rapidly acting
  • acts on evaporization
  • cheap
• con
  
  • dec activity on organic matter
  • poor residual activity
  • drying effects on the skin
  • rapid heat dissipation

Question 23

Surgical site prep

Answer 23

• cannot sterilize skin
  
  • `~20% residual bacteria
• wide clip
  
  • no razors
  • clip day of
• antiseptic scrub
  
  • should last 3 minutes

Question 24

Summary

Answer 24

• sterilization can be performed in multiple ways
  
  • know methods understand why one might not be suitable
• Difference between sterilization, disinfection, antisepsis
• Be familiar with different antiseptic agents and disinfectants
• appreciate the broad concepts behind minimizing contamination during sx

Question 25

Disinfection

Answer 25

destruction of most pathologic microorganisms on inanimate objects

Question 26

antisepsis

Answer 26

destruction of most pathologic microorganisms on animate (living) objects