L2 Principles of surgical asepsis

Question 1

Asepsis

Answer 1

absence of microorganisms that cause disease

Question 2

Aseptic techique

Answer 2

method to prevent contamination by
microorganisms

Question 3

Antisepsis

Answer 3

exclusion, destruction, or inhibition of growth or
multiplication of microorganisms from body tissues and fluids

Question 4

Antiseptics

Answer 4

chemical compounds inhibiting the growth of
microorganisms without necessarily killing them

Question 5

Sterile

Answer 5

Free of living organisms (means absolutely non living organisms!!)

Question 6

To sterilize

Answer 6

to make an object sterile (destroying bacteria, viruses, fungi,
protozoa)

Question 7

Sterile technique

Answer 7

method by which contamination with microorganisms is
prevented to maintain sterility throughout the surgical procedure

Question 8

Disinfection

Answer 8

chemical or mechanical destruction of pathogens

Question 9

Decontamination

Answer 9

Cleaning and disinfecting or sterilizing processes carried out to make contaminated items safe to handle

Question 10

Are asepsis and sterile same?

Answer 10

NO!!!!

Question 11

Difference between asepsis and sterile

Answer 11

Antisepsis means that there are no micro-organisms that cause disease. Sterile means that there are no living organisms at all what so ever.

Question 12

What means infection

Answer 12

Invasion and multiplication or micro-organisms that are not normally present at the site. All possible measures should be taken to reduce the risk of iatrogenic infection.

Question 13

Iatrogenic

Answer 13

relating to illness caused by medical examination or treatment.

Question 14

What is included in sterile technique (5) + ideal goal of it

Answer 14

Ideal goal is to prevent the transmission of micro-organisms into the body during invasive procedures.

1. Sterile personnel gowned & gloved
2. Sterile personnel touch only sterile items/areas
3. Sterile drapes are used to create a sterile field
4. All sterile items should be opened, dispensed and transferred by methods that maintain sterility
5. The field should be monitored constantly ans the surgical staff should be able to recognize when they have broken technique & act accordingly

Question 15

General rules of aseptic technique (7)

Answer 15

1. Surgical team members remain within the sterile area
2. Talking and movement by all personnel is kept to a minimum
3. Nonscrubbed personnel touch only unsterile items and don’t reach over sterile areas
4. Drapes should be moisture proof
5. If the surgical team begins the surgery seated, they should remain seated until it has been completed
6. Gowns are considered sterile only from mid-chest to wait and from gloved hand to 5cm above the elbow
7. Items of questionable sterility are considered contaminated

Question 16

3 levels of sterility and disinfection

Answer 16

1. Critical
2. Semicritical
3. Noncritical

Question 17

Critical sterility level

Answer 17

Equipment/materials entering the body beneath the skin or mucous membranes require sterilization and are handled using sterile technique. (suture materials, intravenous catheters)

Question 18

Semicritical sterility/disinfection level

Answer 18

Equipment coming into contact with skin or mucous membranes without penetration must be cleaned and disinfected (endotracheal tubes)
Difference to noncritical that these might be also in the surgery!

Question 19

Noncritical sterility or disinfection level

Answer 19

Instruments that contact the mucous membranes or intact skin not directly associated with surgery should be cleaned and disinfected. (laryngoscope)

Question 20

Rules in surgical pack preparation (5)

Answer 20

1. Instruments and linens must be cleaned of gross contamination
2. Instruments cleaned manually or with ultrasonic cleaning equipment as soon as possible after surgery
3. Linens laundered (nowadays single used ones!)
4. Immersing instruments for long periods of time in any solution can prove damaging (never longer than 20min)
5. Cleaning is followed by packaging and sterilization

Question 21

What equipments or supplies have to be sterile?

Answer 21

Any equipment or supply that comes in contact with body tissues or blood!

Question 22

Methods to sterilize equipment

Answer 22

1. Steam
2. Chemicals
3. Plasma
4. Ionazing radiation
5. Cold chemical sterilization

Question 23

Details about steam sterilization

Answer 23

It destroys all known micro-organisms by coagulation and cellular protein denaturation. Practical and dependable. For heat-tolerant medical supplies and packaging. In practise autoclave

Question 24

What are sterilization indicators?

Answer 24

We use indicators because they allow monitoring the effectiveness of sterilization. They undergo a chemical or biological change in response to time and temperature. Not always trustworthy!

Question 25

What might be the reason why sterilization of equipments fails? (5)

Answer 25

1. Improper cleaning
2. Mechanical failure
3. Improper use of equipment
4. Poor loading technique of the machine
5. Not understanding the process of sterilization

Question 26

Function of preparation of the operative site

Answer 26

Preoperative preparation reduces the number of bacteria and the likelihood of infection. Sterilizing skin without impairing its natural protective function and interfering with wound healing is impossible. So antisepsis is the key.

Question 27

Preparation of patient includes

Answer 27

1. Treatment of any infections if elective surgery.
2. Dietary restrictions.
3. Confirmation of the patient’s identity, surgical procedure and site.
4. Treatment of hair. Leikkausta ennen, koska karvojen ajelu aiheuttaa vahinkoa iholle vaikka sitä ei näkyiskään => infektioriski!
5. Excretions before surgery outside.

Question 28

Removal of hair rules (5)

Answer 28

1. Done immediately before surgery and outside the operation theatre.
2. Clipping is initially done towards growth pattern, then against.
3. Loose hair must be removed (vacuum)
4. Prepared area should be large enough (20cm on each side of incision)
5. Paws can be excluded from the surgical area by placing a latex glove
   over the distal extremity and covering it with self-adherent
   bandanging tape

Question 29

General cleansing rub (5)

Answer 29

1. Prepuce is flushed with antiseptic solution in case of abdominal procedures in male dogs
2. Skin is scrubbed with germicidal soaps and warm water to remove derbis and reduce bacterial populations
3. Incision site => moving from center to the periphery (unless infected wound or abscess)
4. Continued until all visible dirt and oils have been removed
5. Antiseptic is applies

Question 30

When and how “sterile” skin preparation should be done?

Answer 30

1. It should be done after positioning the patient
2. Aseptic technique used

Question 31

Purpose of the preoperative skin preparation (3)

Answer 31

1. To remove soil and transient microorganisms
2. To reduce the resident microbial count to subpathogenic levels with the least amount of tissue irritation
3. To inhibit rapid rebound growth of microorganisms

Question 32

Aseptic technique in preoperative skin preparation (4)

Answer 32

1. Antiseptics are used
2. Gloved hands
3. Avoid contaminating sponges/gause swabs
4. From the center to the periphery, then discard (remember exceptions!)

Question 33

How long scrubbing hands should last?

Answer 33

According to science it should last 2-7 minutes

Question 34

Rules of draping (6)

Answer 34

1. Idea is to create and maintain sterile field around the operative site with nonabsorbant towels
2. Performed by a gowned and gloved team member when antiseptics have dried
3. One drape at a time
4. Drapes should not be flipped or shaken and not readjusted after once placed!
5. After the animal and nearby nonsterile surfaces have been covered with sterile draped, the instrument tray can be arranged and surgery can begin!