Surface and Equipment

Asepsis
Dr. Dyann Pena
Types of Environmental Surfaces

Clinical Contact Surfaces Housekeeping surfaces

Surfaces touched
• Do not come in contact with hands
frequently with
gloved hands

May become
• May be cleaned at the end of the day
Need to be contaminated
cleaned in with blood, saliva
between patients or potentially
infectious
materials
2 General 1. Use of surface covers
Approaches
to Surface 2. Preclean and disinfect the surface after
contamination and before reuse
Asepsis
1. Surface
Covers
2. Precleaning &
Disinfection
(Spray-wipe-spray)
2. Precleaning
& Disinfection
(Wipe-discard-wipe)
 • Antibiotics – for killing microorganisms IN or ON the
body

Characteristics • Antiseptics - for killing microorganisms ON THE SKIN

or other body surfaces
of Disinfectants
• Disinfectants - for killing microorganisms on
environmental / inanimate surfaces or objects

• Sterilants - for killing ALL microorganisms on

inanimate objects
 • Sterilant/ high-level disinfectant

Disinfectants
• for killing all microorganisms on submerged,
inanimate, heat sensitive objects

Based on • Intermediate-level disinfectant

Microbial • for killing vegetative bacteria, most fungi,
viruses, and M. tuberculosis var. bovis
Spectrum of
Activity • Low-level disinfectant
• for killing most vegetative bacteria, some
fungi, and some viruses
 • Virucidal
• kills at least some viruses
• Bactericidal
• kills at least some bacteria

Types of
• Fungicidal
• kills at least some fungi

Antimicrobial • Tuberculocidal
• kills the M. tuberculosis var. bovis bacterium
Agents • Sporicidal
• kills bacterial spores, which means it is a
sterilant
• Hospital disinfectant
• shown to kill the three representative
bacteria: Staphylococcus aureus, Salmonella
choleraesuis, and Pseudomonas aeruginosa
• Because M. tuberculosis var. bovis is
more difficult to kill than most other
microorganisms, disinfectants with
tuberculocidal activity are considered
as strong disinfectants.

• Use of a water-based disinfectant is

reported to provide better cleaning of
biological material, such as blood, than
use of an alcohol-based disinfectant.

• For dental infection control, a water-

based surface disinfectant that is
Environmental Protection Agency
(EPA)-registered and tuberculocidal
(such as iodophors, phenolics, or
chlorines) is appropriate if used as
directed by the manufacturer and
careful precleaning is performed.
Chlorine Compounds

• Intermediate-level disinfectants
• Kill a wide variety of microorganisms
• Tuberculocidal
• Commercial bleach is a good surface disinfectant
at 1:10 to 1:100 dilution with water
• Should be prepared fresh daily
• Can damage fabrics and metal surfaces; activity
is reduced in the presence of organic material.
Iodophors

• Intermediate level disinfectants

• Retain the broad-spectrum antimicrobial activity
(including tuberculocidal activity) of iodine, but
they are:
• less corrosive
• less irritating to tissues
• reduced staining activity

• Because hard water may reduce antimicrobial

activity, iodophor disinfectants should be diluted
with distilled or deionized water.
Alcohols

• Isopropyl alcohol or ethyl alcohol

• Less desirable properties:
• reduction in activity by organic material
• corrosiveness,
• destruction of some plastic surfaces
• Alcohols dry out the skin because they tend to
dissolve fat and oil that serve as natural skin
moisteners.

• Do not solubilize protein material in blood or saliva

well and have been reported to be poor cleaners.
Synthetic Phenolics

• First widely recognized disinfectant used in

hospitals.
• Lord Joseph Lister suggested the use of phenol
as an antiseptic during surgical procedures and
as an environmental surface disinfectant more
than 100 years ago.
• Toxic to tissues, and its use on human beings
was stopped.
• Synthetic phenolics are used as surface
disinfectants, mouth rinses and handwashing
agents.
Quaternary
Ammonium
Compounds

• Alcohol-free
• Low-level disinfectants
• None are tuberculocidal
• Appropriate for disinfection of walls and
floors
• ADA recommended that these should not
be used in dentistry.

• With alcohol
• Intermediate-level disinfectants
• Tuberculocidal
Equipment
Decontamination