Flashcards in Aseptic technique Deck (52)
presence of pathogens +/- toxic products in tissues (asepsis = opposite of this)
chemical agent that kills or inhibits pathogenic microorganisms. ONLY for agents applied to the body
chemical that kills microorganisms on inanimate objects - surgical equipment
removal of organisms, not necessarily their spores
complete elimination of microbial viability including spores, by physical/chemical means
What may infection during surgery lead to?
adverse effect on procedure
adverse effect on general health
increased morbidity and mortality
further treatment needed
increased hospital stay
True/false: almost all surgical wounds get contaminated but not all wounds become infected
What are 3 surgical factors
local wound environment
local and systemic defence
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
What are surgical factors?
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
dead space and seroma
What are patient factors?
patient - age and nutrition
What therapies may increase the likelihood of infection?
anaesthetic agents, corticosteroids, chemotherapy, radiotherapy, blood transfusion, vasoconstrictors, surgery
How does the NRC classify wounds from surgery? 4
Clean - contaminated
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).
What are Halstead's principles about?
Good surgical technique (e.g. minimal trauma, close all dead space, no tension on sutures)
What are the 4 main components of aseptic technique?
What are non-sterile barriers?
e.g. scrub suits, cap, shoe/covers, face mask
What are sterile barriers?
gowns and gloves
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.
How to scrub up ...
remove all jewellery
short and clean nails
mask on before scrubbing
brush and soap ready
water running (correct speed and temp)
What is another name for hibiscrub?
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!)
Is toxicity a problem with chlorhexidine?
Note generally but it is ototoxic, neurotoxic and corneal toxic with direct contact
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.
When to use iodine/povidone-iodine?
Mucosal surfaces and near open wounds
Disadvantages - iodine/povidone-iodine?
Acute contact dermatitis
allergic reaction in sensitive people
What is an alcohol scruv?
Usually either ethyl alcohol 70% or isopropyl alchol 99%
What does alcohol kill?
broad spectrum of bacteria via protein denaturation, inhibition of cell division, rapid initial kill. Enhances action of chlorhexidine and iodine
Disadvantages of an alcohol scrub? 3
avoid near open wounds