unit six

Question 1

what is the difference between medical and surgical asepsis?

Answer 1

• medical (clean technique) includes the absence of almost all pathogens
• surgical (sterile technique) includes the absence of all microorganisms including pathogens, and uses a sterile field

Question 2

when and where is surgical asepsis used?

Answer 2

• OR, L+D, ambulatory care, endoscopy, any unit for sterile procedures
• when handling sterile equipment
• procedures involving broken skin (burns, open wounds, surgical incisions, IV/drain sites
• entering sterile body cavities/systems (naso/orotracheal suctionion, catheter insertion)
• intentional perforation of skin (IV/subQ lines, injections)

Question 3

what are the 8 principles of surgical asepsis?

Answer 3

1. all items in a sterile field must be sterile
2. sterile barrier permeated by punctures, tears, or moisture are contaminated (event related expiration)
3. 1 inch border is unsterile
4. tables are only sterile at table level
5. if there is doubt about sterility, it is unsterile
6. sterile + sterile = steriel; sterile + unsterile = unsterile
7. sterile object/field out of range of vision or below waist level is contaminated
8. sterile field/object becomes contaminated by prolonged air exposure

Question 4

what are the 3 types of wound healing?

Answer 4

1. primary intention: edges remain close together and heal quickly
2. secondary intention: wound is left open, healed by scar formation; granulation tissue and epithelization fill wound
3. tertiary intention: “delayed primary intention, wounds left open during surgery

Question 5

what are the 4 types of wound drainage?

Answer 5

1. serous: clear, watery plasma
2. sanguineous: bright red, indicated fresh bleeding
3. serousanguineous: pale red, more watery than sanguineous
4. purulent: thick, yellow/green/tan/brown, indicates infection

Question 6

what are the 3 types of wound tissue?

Answer 6

1. granulation: red = new blood vessels in wound, healthy
2. slough: yellow (presence of infection), sometimes purulent drainage
3. eschar: black/brown, necrotic tissue

Question 7

what 6 factors affect wound healing?

Answer 7

• decreased oxygen perfusion
• nutritional status
• wound infection
• diebetes
• corticosteroid/immunosuppressive drugs
• advanced age

Question 8

what are you assessing at a surgical drain?

Answer 8

• drain site (color, edema, dressing)
• drainage (type, amount in mLs)
• patency of tubing