Institute of Surgical Research Surgical Techniques A1 Practical Modul

Asepsis and the surgeon 1. Dressing 2. Cap, mask 3. Scrubbing 4. Gowning 5. Gloving

It is forbidden to wear: -bracelets -rings -wrist-watch -nail-polish 1. Dressing Change to scrub suit, shoes/clogs worn exclusively in the operating suite or wear shoe covers

2. Cap and mask Positioning the mask rightwrong

Correct position of the mask

Participation in a surgical intervention requires the implementation of the complete protocol of scrubbing and disinfection. Scrubbing has to be made according to the accepted and generally applied rules of the local surgical suite. Simple scrubbing with soap is not a disinfection! 3. Scrubbing

The goal of scrubbing To reduce the number of bacteria of the transient and resident flora and to inhibit their activity.

Scrubbing and disinfection Mechanical cleansing (3 min) 1. Cut nails and clean subungual areas. 2. Adjust water flow and temperature. 3. Wash hands and forearms to the elbows with soap. 4. Rinse hands (from fingers to the elbow). 5. Clean nails with a sterile brush and soap. It is forbidden to brush other parts of the hand! 6. Rinse hands (from fingers to the elbow). Chemical disinfection (5 x 1 min)

Scrubbing 1. Hand-wash with soap

Scrubbing 2. Hand- and arm-wash with soap

Scrubbing 3. Steps of rinsing the hands

Taking out the brush

Scrubbing 4. Cleansing the nails with brush

Scrubbing 5. Steps of rinsing the hands

Do not touch the basin!

Disinfection 1. rightwrong

Steps of chemical disinfection 2.

4. Gowning

Effective „sterile” area Certain parts of the gown can not be considered sterile: a. the back and the axillaries b. lateral from the axillaries c. under the waistline d. the sleeves from the shoulders to 10 cm distance over the elbows.

Taking out the sterile gown right wron g

Gowning 2. Grasping the neck of the sterile gown

Gowning 3. Unfolding the sterile gown

This is forbidden!

Gowning 4. Opening the sterile gown

Gowning 5. Position of the arms rightwrong

Gowning 6. Steps of pulling the gown over the shoulders

Pulling the gown rightwrong

Fixing the sterile gown

Fixing the sterile gown 2. rightwrong

Fixing the sterile gown 3.

This is (again) forbidden!

Gloving of the left hand 1. from inside!

Glowing of the right hand 2. from outside!

The gloved hands

Removing the gloves

The operating field before the isolation of the patient

The operating field after the isolation of the patient

SURGEON 2nd ASSISTANT 1st ASSISTANT ANESTHESIA SCRUB NURSE The position of the surgical team