L03: Preparation for Aseptic Surgery (Kim) Flashcards Preview

Surgery (Spring 2015) > L03: Preparation for Aseptic Surgery (Kim) > Flashcards

Flashcards in L03: Preparation for Aseptic Surgery (Kim) Deck (24):
1

sources of infection during a surgery

instruments
local skin flora
hair/dirt/debris
surgeon skin flora
surgeon attire
operating table
air-borne from room

2

Halsted's Principles for good surgical outcomes

asepsis
gentle tissue handling
hemostasis
preserve blood supply
reduce dead space
avoid tension
anatomic dissection

If all are followed, should achieve <5% infection rate for clean procedures

3

sterilization vs. disinfection/antisepsis

sterilization: destruction of ALL living organisms w/ no toxic residue and no instrument damage
disinfection/antisepsis: decreases number of organisms, but does not get rid of all of them

4

methods of PHYSICAL sterilization

dry or wet heat
radiation
filtration

5

methods of CHEMICAL sterilization

ethylene oxide (most common)
H2O2 plasma
gluteraldehyde ("cold sterilization")

6

Dry vs. Wet Heat sterilization

Dry Heat: no humidity, slow, death by oxidation, can burn objects and temper metal, rarely used
Wet Heat: 100% humidity, rapid, water catalyst for coagulation and protein denaturation, reliable, inexpensive, non-toxic

7

how does steam sterilization (autoclave) work?

-attains appropriate temperature and duration
-pressurization used to achieve higher temperature (but doesn't in itself kill the bacteria)
-the higher the temp used, the less time required to sterilize

8

FLASH method

270 degrees for 3 minutes; often used when instrument dropped
-not protocol or gold standard
-used on emergency basis

9

shelf life of single wrap muslin

2 days

10

shelf life of double wrap muslin

3 weeks

11

shelf life of crepe paper and single layer muslin

10 wks

12

shelf life of polypropylene peel pouches

12 mo. (probably indefinitely)

13

what not to autoclave

many plastics
suture material
electronics
powders, glassware, liquids

14

danger of ethylene oxide

-colorless, odorless, toxic gas
-can create ocular irritation: must aerate objects for hours to days to prevent this

15

adv. of ethylene oxide

can manipulate concentration, humidity, and temp. to alter sterilization times

16

radiation

works via lethal ionization
gamma radiation most popular
-used to sterilize commercially products (mass quantities of suture, gauze sponges, implants, etc.)

17

type of indicators

physical
chemical (ie. turns black when get to certain temp, but doesn't tell you how long something was exposed to that temp)
biological (disad: delay in knowing since culture takes several days)

18

can you sterilize skin?

no; will be about 20% residual bacteria left over

19

antiseptic agent

-used for scrub onto patient, clinician
-reduces bacterial population on patient and surgeon
-can be toxic to tissues; use at appropriate dilution

20

antiseptic vs. disinfectant

antiseptic: used on living tissue
disinfectant: used on inanimate object
*same agent can be classified as both*

21

properties of chlorhexidine

non-irritating
good residual activity
not affected by organic matter
effective against wide array of microbes
allergies/irritation possible after chronic exposure
ototoxicity
corneal toxicity
most common antiseptic used

22

properties of iodophors

cheap
effective against wide array of microbes
can cause dermal irritation
decreased activity in organic matter
unreliable residual activity
stains

23

properties of alcohols

very rapidly acting
cheap
decreased activity in organic matter
poor residual activity*
drying effect on skin
rapid heat dissapation (can expedite hypothermia during surgery)

24

anything belowe waist or on back is considered sterile/not sterile

not sterile