Presentation on theme: "Infection Prevention: A- and Antiseptic Techniques in Surgical Setting"— Presentation transcript:
1 Infection Prevention: A- and Antiseptic Techniques in Surgical Setting Interactive Training CD for Medical StudentsReproductive SystemModule :Infection Prevention: A- and Antiseptic Techniquesin Surgical SettingReproductive System, Medical School of Universitas Padjadjaran, Bandung MIR-C Corporate
2 Production Team: Director : Kiki Lukman, MD, MSc, FINACS (Dig.) Script writer : Kiki Lukman, MD, MSc, FINACS (Dig.)Main contributors : Kiki Lukman, MD, MSc, FINACS (Dig.)Yayat Ruchiyat, MD, FINACS (Dig.)Warko Karnadihardja, MD, FINACS (Dig.)Nurhayat Usman, dr., SpB-KBDLisa Hasibuan, MDNina K. Poetri T., SKp,Dadang Sunarya AMKDedy Rusnadi AMK,Alia Rahmi AMK,Editorial Team : Kiki Lukman, MD, MSc, FINACS (Dig.)Casting : Kiki Lukman, MD, MSc, FINACS (Dig.)Artistic : MIR-C CorporateProductions : Medical School of Universitas PadjadjaranBandung
3 Credits Special thanks to: Central Operating Theatre Unit of Hasan Sadikin General Hospital
6 DescriptionInfection Prevention in Surgical Setting is one of important preventive methods in order to achieve infection control in clinical and surgical practices.
7 Objectives The aims of this method are : To minimize surgical site infectionTo protect health personnelTo improve wound healingTo minimize disability, morbidity, & mortalityTo reduce the cost of hospital care
8 Specific Learning Objectives : To describe the definition and history of sterilization, disinfection, decontamination, anti and a - septic techniques.To describe six methods of sterilization.To describe three categories of surgical instrumentsTo describe 6 rules of aseptic techniques
9 Specific Learning Objectives : To perform aseptic techniques correctly, including (P5):Applying surgical attireHand washingSurgical scrubbingGlovingSurgical Gowning
10 Definition:Sterilization : Processes by which all pathogenic & non pathogenic microorganisms, including spores, are killed.Disinfection: Chemical or physical process of destroying all pathogenic microorganisms, except spore bearing ones; used for inanimate objects, but not on tissues.
11 Definition:Decontamination : Process or method by which all contaminated materials that can cause diseases are removed.Aseptic techniques : Methods by which contamination with microorganisms is prevented.Antiseptic techniques: Prevention of sepsis by the exclusion, destruction, or inhibition of growth and multiplication of microorganisms from body tissues and fluids.
13 Why should we apply a and antiseptic techniques ?
14 Historical backgrounds : Ignas Sammelweis ( )Puerperal fever increased maternal mortalityHand scrub with chlorinated-lime solution prior to examination.Father of nosocomial infection.Louis Pasteur (1860)Discover the process of fermentation by microorganismsGerm theory: against spontaneous generation theory.
15 Historical backgrounds : Joseph Lister (1865)Use carbolic acid solution on surgical dressing in the operating room mortality (Listerization)Father of modern surgery (Antiseptic technique)Ernst Von Bergmann (1886)Introduced “steam sterilizer”Basic of sterilization aseptic techniqueLater: “pressure & vacuum steam sterilizer” was developed
16 Methods of Infection control Anti septic techniquesDesign and traffic patterns of the operating theatreAseptic techniques
18 Sterilization The objective of modern surgery For inanimate objects Problem :Some items are not heat resistance
19 Techniques of Sterilization Physical:HeatRadiation/ ultraviolet rayBoiling waterUltrasoundChemical:LiquidGas
20 Heat Sterilization Dry : Moist : Commonly cause damage For powder, oils, and jellyMoist :SteamHigh pressure spores Vacuum constant temperatureAutoclave
21 Chemical Sterilization Generally as disinfectionMechanism of action :Protein coagulationEnzyme denaturation in cellsLysisDepend on : number of microorganisms, soiling, concentration, and temperature.
22 Solutions Jodium and Jodophor Good bactericide, but irritant Mixture : povidone-jodine 10%Alcohol Solution of 70% or 90%Glutaraldehyde (Formaldehyde Sol. in Alcohol 2%)Spores are killed within 3 hours
24 Gas SterilizationFormaldehydeEthilene-oxide- propionolactone
25 Boiling Water Mild boiling Vigorous boiling More active, if 2% sodium-carbonate or 0,1 % sodium-hydroxide being added
26 The Operating Theater Sterile core Clean Zone Transitional Zone UBITTransitionalZoneSterilecoreRestricted areaSemi –RestrictedArea
27 Traffic patterns of Operating Theatre The use of aseptic principles requires regulation of traffic and flow patterns of the personnel, patient, equipment, and supplies in operating theatreAims : to protect the safety and privacy of patients and the cleanliness and integrity of the environment.
28 unrestricted areaElevatorsCorridors outside surgical suite
29 unrestricted areaEntranceReception deskPatient suite
30 Transitional Zone (Video) Locker roomDressing room
31 Clean Zone (Video)Surgical suite and corridorsSterile core
37 Surgical Instruments in the Operating Theatre Critical items :Sterile, because of being used for penetrating skin or mucosaSemi critical items :In contact with skin or mucous membraneNon critical items :
39 Aseptic techniques Rules at clean zone Procedures in sterile area Talk as necessaryRestrict unnecessary movementsSterile instruments, remove non sterile oneAvoid & Replace wet surgical drapes/towels
41 Hand washing Indications: Between patient contacts Before performing or assisting with invasive proceduresBefore taking care of particularly susceptible patientsBefore and after touching woundsImmediately after gloves are removed
42 Hand washing Before and after performing sterile procedures After contact with blood or body substances, mucous membranes, soiled linen, waste, or contaminated equipment.Between tasks at different body sites on the same patient to prevent cross contaminationAfter taking care of infected patientAfter touching contaminated inanimate sources
45 Purposes:To remove debris and transient organisms from the nails, hands, and forearms.To reduce the resident microbial count to a minimum.To inhibit rapid rebound growth of microorganisms.
46 Purposes:To minimize the re-growth of microorganisms for the length of the procedure.To reduce the numbers of microorganisms on handsTo reduce contamination of the operative site by recognized or unrecognized breaks in surgical gloves.
57 Skin preparation The goals: to cleanse the skin and bring both the resident and transient bacterial counts to an irreducible minimum, therefore reducing the risk of wound contamination and subsequent surgical site infection.performed just before the surgical incision has been performed.