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Flashcards in Aseptic technique Deck (52)
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1

Define sepsis

presence of pathogens +/- toxic products in tissues (asepsis = opposite of this)

2

Define antiseptic

chemical agent that kills or inhibits pathogenic microorganisms. ONLY for agents applied to the body

3

Defien disinfectant

chemical that kills microorganisms on inanimate objects - surgical equipment

4

Define disinfection

removal of organisms, not necessarily their spores

5

Define sterilisation

complete elimination of microbial viability including spores, by physical/chemical means

6

What may infection during surgery lead to?

adverse effect on procedure
adverse effect on general health
increased morbidity and mortality
further treatment needed
increased costs
increased hospital stay

7

True/false: almost all surgical wounds get contaminated but not all wounds become infected

True

8

What are 3 surgical factors

Bacteria
local wound environment
local and systemic defence

9

What are bacterial factors?

presence and growth of bacteria
number of bacteria (> 10^5 bacteria/g = infection)
type and virulence
duration of exposure
timing of exposure

10

What are surgical factors?

PROCEDURE
Duration (at 90 mins you are twice as likely to get infection than an operation lasting <60 minutes)
patient and surgeon prep
type of surgery

SURGICAL WOUND
dead space and seroma
foreign material
blood clots
devitalised tissue

11

What are patient factors?

patient - age and nutrition
Disease conditions
Therapy (concurrent)

12

What therapies may increase the likelihood of infection?

anaesthetic agents, corticosteroids, chemotherapy, radiotherapy, blood transfusion, vasoconstrictors, surgery

13

How does the NRC classify wounds from surgery? 4

Clean
Clean - contaminated
Contaminated
Dirty

14

When does contamination become infection?

Usually in the 'decisive period' = first 2-3 hours after wound exposure/inoculation (thus preventative AB only beneficial during first 3 hours).

15

What are Halstead's principles about?

Good surgical technique (e.g. minimal trauma, close all dead space, no tension on sutures)

16

What are the 4 main components of aseptic technique?

Surgeon prep
Surgical instruments
Patient prep
Operating theatre

17

What are non-sterile barriers?

e.g. scrub suits, cap, shoe/covers, face mask

18

What are sterile barriers?

gowns and gloves

19

What are scrub suits made from?

Loose weave lint-free fabric = a barrier for dander but not microbes. wear only in theatre, tuck top into trousers and trousers into boots.

20

How to scrub up ...

remove all jewellery
short and clean nails
mask on before scrubbing
appropriate antiseptic
brush and soap ready
water running (correct speed and temp)

21

What is another name for hibiscrub?

chlorhexidine

22

What is chlorhexidine active against?

kills broad spectrum of bacteria
variable against viruses
no action against spores

Kills by: precipitation of cellular contents, alteration in cell permeability. Rapid initial kill. Persistent residual activity. Not inactivated by organic material (farm vets1!)

23

Is toxicity a problem with chlorhexidine?

Note generally but it is ototoxic, neurotoxic and corneal toxic with direct contact

24

What is iodine/povidone-iodine?

Kills bacteria, viruses, fungi but not spores.Inhibits protein synthesis. requires 2 minutes contact time.
Action decreased by organic matter and hard water.

25

When to use iodine/povidone-iodine?

Mucosal surfaces and near open wounds

26

Disadvantages - iodine/povidone-iodine?

Corrodes instruments
Acute contact dermatitis
allergic reaction in sensitive people

27

What is an alcohol scruv?

Usually either ethyl alcohol 70% or isopropyl alchol 99%

28

What does alcohol kill?

broad spectrum of bacteria via protein denaturation, inhibition of cell division, rapid initial kill. Enhances action of chlorhexidine and iodine

29

Disadvantages of an alcohol scrub? 3

corrodes instruments
relatively non-toxic
avoid near open wounds

30

What is Alcohol-sterilium?

ethanol based 85% (bactericidal, fungicidal, virucidal, tuberculcidal)

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