Aseptic Technique

Terminology Microbe Exogenous Endogenous Pathogen Infection Resistance Sepsis Asepsis Sterile

Terminology Surgical Asepsis Medical Asepsis Disinfectant –cidal Microcidal Virocidal Germocidal –static Virostatic Germostatic

Methods of Sterilization Filtration Radiation Cold Sterilization   Thermal energy Dry heat Moist heat Flash Sterilization

Sterilization indicators Tape Chemical sterilization indicators

Gas Sterilization Ethylene Oxide is a colorless gas that is flammable, explosive, and toxic. This gas penetrates paper and plastic film to kill microbes. Sterilizer Indicator

Storage Item Closed Cabinet Open Cabinet Single wrapped items 1 week 2 days   Double wrapped items 7 weeks 3 weeks Paper/plastic pouches 1 year

Common Antiseptic and Disinfectant Agents Examples Common Uses Spectrum of Activity   Povidone-Iodine Betadine, Iodine Preoperative Scrubs, wounds Bacteria, virus, fungi, protozoa, yeast Chlorhexidine Nolvasan , Surgical Scrub, Hibiclens Bacteria, virus, fungi, yeast Alcohol Preoperative Scrubs, disinfectant, do not use on open wounds Bacteria, some fungi Phenols Hexachlorophene Lysol Preoperative hand scrub Inanimate objects Bacteria Quarternary Ammonium Rocal Used on inanimate objects Chloride Bleach Disinfectantf Bacteria, virus Aldehyde Formaldehyde Glutaraldehyde Tissue specimen Antimicrobial

Patient Preparation Shave the area using a #40 blade and remove the shaved hair by hand or vacuum. Surgical Scrub Start in the center of the incision area and in a circular motion working from the inside out, scrub with iodine or chlorahexadine. Then with the same technique, scrub with alcohol. Repeat this rotation 3 times. Never go back into the center of the incision area from the outside. Some clinics will spray iodine over the incision area after the surgical scrub prior to making the incision.

Sterile Fields/Sterile Packs Patient Personnel   http://www.youtube.com/watch?v=BwXYJOurcOY&feature=endscreen&NR=1 Opening a sterile Pack http://www.youtube.com/watch?v=-ggM1sTpYaM

Surgical Instruments General parts of instruments: Scapel blades boxlock – hinge ratchet mechanism Jaws finger rings Scapel blades

Surgical Instruments Non-operating scissors Needle Holders Scisssors Mayo-Hegar Olsen-Hegar Mathieu Scisssors Operating scissors Mayo Metzenbaum General surgical scissors Non-operating scissors Bandage scissors Suture removal scissors Surgical wire cutting scissors

Surgical Instruments Thumb Forceps Brown-Adson Rat-Tooth tissue forceps  Adson-Hudson   Standard thumb forceps

Surgical Instruments Tissue Forceps Mosquito Crile Kelly forceps   Kelly forceps Rochester-Pean forceps Rochester-Carmalt  Allis tissue forceps

Surgical Instruments Towel Forceps Retractors Hand-held retractors Backhaus towel clamps Jones towel clamps Retractors Hand-held retractors Army-Navy retractor Senn retractor Spay hook

Surgical Instruments Retractors Self-retaining retractors Gelpi Weitlaner

Suture Material Terminology Suture Ligature Approximation Tensile strength  Multifilament suture  Monofilament suture

Suture Uses of suture material Suture Size Opposing the edges of a wound or incision Eliminate dead space Tightening and stabilizing joints that have sustained ligament injury Strengthening or replacing weakened tissue Ligating blood vessels or tissues Suture Size Smallest--------------------------------------------------Largest 10-0, 4-0, 3-0, 2-0, 1-0, 0. 1, 2, 3, 4

Suture Absorbable suture Nonabsorbable Surgical Gut Vicryl (Polygalactin): synthetic polyester PDS (Polydioxanone) Nonabsorbable Silk Nylon Polypropylene Stainless steel

Suture Suture Reaction Infection/abscess Inflammation Redness Lump over the incision site Tissues pull apart from the suture

Suture Needles Types of needles Swagged on needle Taper Point Cutting Reverse cutting