Principles of Asepsis and Sterile Techniques

Primary goal of the surgical team,

Preventing surgical site infection in the operating room
includes
o patient risk assessment
o environmental cleaning
o disinfection and sterilization of instrumentation
o patient antibiotic prophylaxis
o use of standard precautions.
The goal of asepsis
is to prevent the contamination of the open surgical wound by isolating the
operative site from the surrounding nonsterile environment.
o accomplished by creating and maintaining the sterile field
o by following aseptic principles aimed at preventing microorganisms
from contaminating the surgical wound.
Personalities
Ignaz Semmelweis handwashing
Louis Pasteur germ theory
Robert Koch use of bichloride of mercury as an antiseptic
Joseph Lister Father of modern Surgery
Gustav Neuber used mercuric cholride in cleaning his apron
Transmission Based Precautions
Airborne
transmission of infectious agents that remain infectious over long
distances when suspended in the air (e.g., rubeola virus [measles],
varicella virus [chickenpox], Mycobacterium. tuberculosis, and possibly
SARS-CoV
Droplet
is, technically, a form of contact transmission, respiratory droplets
carrying infectious pathogens transmit infection when they travel
directly from the respiratory tract of the infectious individual to
susceptible mucosal surfaces of the recipient, generally over short
distances.
Contact
Direct
occurs when microorganisms are transferred from one infected
person to another person without a contaminated intermediate
object or person

 blood or other blood-containing body fluids from a patient

directly enters a caregivers body through contact with a
mucous membrane or breaks (i.e., cuts, abrasions) in the
skin
mites from a scabies-infested patient are transferred to
the skin of a caregiver while he/she is having direct
ungloved contact with the patients skin
Indirect
involves the transfer of an infectious agent through a
contaminated intermediate object or person

Hands of healthcare personnel

Patient-care devices
Shared toys
Instruments that are inadequately cleaned between patients
before disinfection or sterilization
Human Bourne Sources of Contamination
SKIN
HAIR
NASOPHARYNX
HUMAN ERROR
CROSS-INFECTION
NON-Human Factors in Contamination
FOMITES
any inanimate object or substance capable of carrying infectious
organism
Air
Sources of Infection
Community Acquired Infection
Communicable Infection
Spontaneous Infection
Nosocomial Infection Exogenous and Endogenous
Control of Airborne Contamination

 Air-Conditioning System
Doors
Traffic and Movement
Lint
Standard Precautions
Protective barriers and personal protective equipment
Prevention of puncture injuries
Management of puncture injuries
Oral Procedures
Care of specimens
Decontamination
Laundry
Waste
Handwashing
No touching of mucous membranes
Prophylaxis
Principles of Sterile Technique
Principle #1
Scrubbed persons function within a sterile field.
Principle #2
Sterile drapes are used to create a sterile field.
Principle #3
All items used within a sterile field must be sterile.
Principle #4
All items introduced onto a sterile field should be opened, dispensed, and
transferred by methods that maintain sterility and integrity.
Principle #5
A sterile field should be maintained and monitored constantly.
Principle #6
All personnel moving within or around a sterile field should do so in a
manner to maintain the sterile field.
Principle #7
Policies and procedures for maintaining a sterile field should be written,
reviewed annually, and readily available within the practice setting.
In Summary:
Know what is sterile
Know what is unsterile
Keep the two apart
Remedy the contamination immediately

PLEASE REMEMBER!!!!
When there is doubt, throw it OUT!!!
THERE should be NO COMPROMISE on Sterility