Asepsis 1

Question 1

What is the purpose of aseptic preparation?

Answer 1

Minimise bacterial contamination that can be a result of cutting through the skin (protective layer) during surgery, exposing underlying tissues and organs

Question 2

What is meant y the term “sterilisation”?

Answer 2

Sterilisation = process of destruction of all forms of microbial life (including spores)

Inanimate objects can be rendered 100% sterile but hands/arms cannot

Question 3

What is the difference in antiseptics and disinfectants?

Answer 3

Antiseptics - used on living tissue to prevent or reduce growth/action of pathogenic agents, therefore preventing infection
- used for patient and surgeons prep

Disinfectants - used on inanimate objects such as surgical instruments and surfaces, aim to destroy most pathogenic organisms (cannot destroy their spores)

Question 4

What antiseptics are most commonly seen in practice ?

Answer 4

Chlorhexidine (e.g. hibiscrub, normally pink)

Iodophors (povidone iodine, normally dark red-brown)

Alcohol/alcohol based combinations (e.g Sterillium)

Question 5

How sterile can hands be rendered after hand scrubbing?

Answer 5

70 - 80% when done properly

Therefore sterile gloves are always required

Question 6

What other areas of the surgeons body may compromise asepsis?

How can these be avoided?

Answer 6

1. Nose/mouth body secretions - surgical mask (doesn’t need to be sterile)
2. Hair/dander from your head - theatre cap (doesn’t need to be sterile)
3. Your arms - should be aseptically prepared - rub instead of scrubbing with a brush (abrasive nature induces inflammatory secretions that bring bacteria deep within hair follicles to skin surface)

Question 7

What is “open” gloving?

Answer 7

Allows you to down a pair of surgical gloves without your hands contaminating the outside of the glove

Arms are left exposed - only 70/80% sterile - potential contaminant of surgical site

• should only be used for minor surgical procedures that don’t invade the body cavity

Question 8

What is “closed” gloving?

Answer 8

Allows you to don a pair of surgical gloves and a sterile surgical gown.

Gown will render your arms and front sterile if they inadvertently come into contact with surgical site.

• preferred approach for all surgeries

Question 9

What steps are involved in aseptic preparation?

Answer 9

1. Hand washing (5 minutes)
2. Patient skin preparation (10 minutes)
3. Hand asepsis (10 minutes): two methods
4. Open gloving (5 minutes)

Question 10

(Patient skin prep)

What is the “spiral” method?

Answer 10

1. Using swab, start scrubbing outwards from centre outwards in a spiral
2. Once you reach the edge of the clipped area, discard the swab
3. Repeat step 1 & 2 with fresh gauze swab for min. 5 minutes. Ensure both clockwise and anticlockwise directions are completed.

Question 11

(Patient skin prep)

What is the “crosshatch” method?

Answer 11

1. Using a swab clean incision site longitudinally in back & forth pattern
2. Once clipped area has been cleaned discard the swab
3. With a fresh swab switch direction and clean ina transverse back and forth pattern
4. Repeat steps 1-3 with a fresh gauze for a min. 5 minutes.
5. Area around periphery of the site should then be wiped with a fresh slab without touching central area