Surgical Suite & Attire (3) Flashcards
Dr. Devine
What is the difference between clean versus contaminated and dirty?
clean: free of obvious dirt, debris, etc
What is the difference between asepsis and sterile? (*)
asepsis: removal of pathogenic organisms
sterile: removal of all microorganisms (+/- spores)
What are the barriers of infection?
environmental barrier
surgical staff barrier
patient barrier
What is included in the environmental barrier?
surgical suite (operating room), equipment and instruments
What is included in the patient barrier?
draping
skin preparation
What can contribute so much contamination potential?
number of people in the OR
talking, skin exposure, activity/movement
What is the primary source of contamination from the surgeon? What is the goal then?
skin debris
cover the body of people nearest to surgical site
What are the components of surgical scrubs?
- first barrier against shedding skin debris from humans - men more than women
- changed after each case, launder, sterilized
top tucked in! and also cover scrubs when out of surgery suite
T/F: This is acceptable
FALSE - open lab coat = no effect
What are the purposes of surgical gowns?
water resistant - but comfortable and breathable
lint free
T/F: The cuffs on the surgical gown can either be under your surgical gloves or below it
FALSE - should always be underneath the gown
What is the purpose of face masks?
redirects airflow away from the surgical site
What is NOT the purpose of face masks?
NOT effective bacterial filters - sides are not sealed
T/F: Partially removing the mask causes contamination of it
TRUE - also is only effective for less than 2 hours
When are foot covers NOT useful?
in reducing contamination to the operating floor in an equine surgery suite
What is the best option for footwear in the surgery suite?
dedicated surgery shoes, usually waterproof
What are the types of gloves?
latex and non-latex (vinyl, nitrile) - sterile, single use
What are the special circumstances for surgical gloves?
- orthopedic gloves (thicker)
- double gloving - LA surgery for draping and ortho
- sleeves
Where are the most likely locations on the hand for a glove puncture wound?
thumb and index finger of non-dominant hand
Where are a surgeon’s hands the dirtiest?
around the fingernails
What does scrub do?
reduces normal bacterial flora and other skin protective barriers
but increases the chance of colonization by pathogenic bacteria
What are the goals of scrubbing?
- remove dirt and oil
- remove and/or transient organisms
- reduce resident population of bacteria
T/F: Hand disinfection removes only the transient bacteria
FALSE - reduction of all bacteria - normal, transient, and infectious/pathogenic flora
What hand maintenance should you do to be adequate to perform surgery?
- short finger nails < 2mm
- clean nails
- no jewelry
- moisturized hands
What are the types of scrubs?
chlorhexidine gluconate
povidone-iodine
What are the pros and cons of chlorhexidine gluconate?
- immediately bactericidal
- residual activity
- potentially inactivated by hand cream and soap
What are the pros and cons of povidone-iodine?
- possibly better activity versus resistant bacteria
- poor residual activity
- can cause skin irritation in some people
What are the characteristics of alcohol-based rubs normally post-scrubbing?
rapid and immediate action
prolongs activity of chlorhexidine
- does not further reduce flora
How should you disinfect your hands?
clean under nails, first scrub with brush, scrub from tips of fingers to elbows
How long should you scrub? How many strokes?
2-5 minutes dependent on antiseptic
20-30 strokes per 25 anatomical parts of the hands
What is “dirty” surgery?
using sterile gloves only
In field surgery, what is different for surgical attire?
variation - usually no hat or mask, gown over coveralls with gloves, coveralls with sterile sleeves and gloves
T/F: Studies have shown there is not much of a difference in bacterial counts in keeping the OR door closed or open
FALSE - have minimal traffic flow and keep doors closed
What are some necessary qualities surgery facilities should have?
- easy to clean surfaces
- well-placed drains
- 68-73 F with 30-60% humidity
- air under mild positive pressure
- laminar air filtering system
- well placed electrical outlets and anesthesia hook-ups
Who should be in the surgery area ideally?
anesthetists, technician, surgeon
