Theatre practice (SA10) Flashcards
What is a pathogen?
- Microbes capable of causing disease
- Virus, bacteria, fungi, etc.
What makes reproductive spores particularly resistant?
- Thick wall
- Remain viable in unfavourable conditions
What can risks be influenced by in theatre?
- Characteristics of patient
- Operation
- Personnel
- Environment
What reduces the patients ability to withstand infection?
- Disease
- Stress
Sepsis
- Presence of pathogen or toxic products in blood or tissue of patient
Asepsis
- Freedom from infection
Aseptic technique
- Steps taken to prevent sepsis
Antisepsis
- Prevention of sepsis
- Destruction or inhibition of microbes
- Using agent safe for living tissue
Sterilisation
- Destruction of ALL microbes
Exogenous microbes
- Found on outside
- May include environment
Endogenous microbes
- Originate from within the body
Nosocomial
- Originated from the environment
- Hospital acquired infection
- Surgical site infections
- MRSA
What does MRSA stand for?
Methicillin Resistant Staphylococcus Aureus
Do all microbes cause infection?
No
Commensal microbes
- Bacteria of skin and nasal passages in humans
- MRSA
- Commonly caused during hospitalisation
- Causes GI disease, septicaemia, skin infections, post-surgical wound infections
- Less common in animals, interspecies transmission can occur
- Very resistant to antibiotic therapy
- High standards of hygiene important to prevent spread
Commensal bacteria
- Live on animals
- Do not cause harm
Facultative pathogens
- Will cause harm in immunosuppressed
Obligate pathogens
- Will ALWAYS cause disease
Saprophytic bacteria
- Replicate on dead tissue
- Responsible for decay
What organisms are involved in wound infections
- Staphylococcus
- Streptococcus
- Proteus
- Pseudomonas
What factors affect infection?
- Virulence of bacteria
- Resistance of the patient, health, disease, age, nutritional status
- Duration of surgery, infection rates double every hour
- Technique of surgery
- Classification/contamination of wound
Virulence of bacteria
- How harmful bacteria is
- Amount of bacteria entering wound
- Environment for bacterial growth
- Poor blood supply
- Devitalised tissue
- Sources of contamination in theatre
- Equipment
- Environment - dust is reservoir of bacteria and contamination
- Personnel - 62% nasal staph carriers
- Patient
What may cause surgical infections?
- Primary surgical disease
- Post-surgical infection
- Poor theatre list planning
- Complications with diagnostic support - catheters, drains, etc.
- Complications unrelated to surgery - infectious or systemic disease
- Implants - suture material to metal implants/hip replacements
What is the main source of pathogens for surgical site infections?
- Endogenous flora of patients skin, mucous membranes, hollow viscera
- Excised skin risks exposed tissue
What are the classifications of surgery?
- Clean
- Clean contaminated
- Contaminated
- Dirty
What is a ‘clean’ surgery?
- Typically elective surgery
- Non-contaminated
- Non-traumatic
- Non-inflamed
- Neuter, routine laparotomy, elective orthopaedic
What is a ‘clean contaminated’ surgery?
- Potential for contamination
- Involves respiratory, GI or genitourinary system
- Often hollow organ
- Enterotomy, enterectomy, cystotomy
What is a ‘contaminated’ surgery?
- Contamination WILL occur
- Leakage or major break in aseptic technique
- Enterotomy, enterectomy, cholecystectomy, cystotomy
What is a ‘dirty’ surgery?
- Infection already present
- Hollow organ rupture
- Infected surgical site
- Septic peritonitis
- Abscess
- Ruptures GI, gallbladder or pyometra
What order should surgeries be completed in?
- Clean
- Clean contamination
- Contaminated
- Dirty
How are surgical patients classified?
- Elective
- Urgent
- Emergency
What constitutes an elective surgical patient?
- Non-urgent
- Healthy
- Usually young
- Routine neutering
What constitutes an urgent surgical patient?
- Necessary
- Not immediately life-threatening
- Required propmt care
- Fracture repair
What constitutes an emergency surgical patient?
- Life threatening
- Abdominal crisis
Ectomy
- Remove
Otomy
- Temporary incision
Ostomy
- Opening
- Can be temporary or permanent
- Stoma = hole
Desis
- Binding together
- Surgical fixation
Pexy
- Fixation of an organ
- Surgical suspension
Plasty
- Reconstructive/surgical repair
Gastrotomy
What is the prep room used for?
- Induction of anaesthesia
- Preoperative procedures; clipping, catheter placement, surgical prep
- Should lead directly into operating theatre
What is the recovery room used for?
- Allow patient to recover
- Close to operating theatre
- Quiet, warm, essential emergency equipment
- Allow for good observation to recover patient
What is the treatment room used for?
- Located off prep room
- Used for minor procedures
Additional areas/room for theatre suite?
- Washing/sterilising room
- Sterile storage
- Scrubbing area
- Changing room
What different categories of cleaning protocols should be used for theatre suite?
- Daily
- Weekly
- Monthly
What should be included in the daily theatre cleaning protocol?
- Floors
- Waste disposal
- Surfaces
- Equipment
- Tables
- Lights
- Scrub sinks
What should be included in the weekly theatre cleaning protocol?
- Thorough deep clean
- Floor and walls scrubbed
- Disinfectant not washed off
- Deep clean all equipment