Good Theater Practice

Sepsis

presence of pathogens

Asepsis

free from infection

antisepsis

prevention of sepsis

sterilisation

completely eliminate microorganisms inc spores

disinfection

removal of microorganisms not inc spores

disinfectant

agent to destroy microorganisms. chemical agent made up in different prep

what has to be considered when cleaning equipment

-COSHH

-sharps

-delicate instruments

-when to clean instruments

-what to clean with

-ultrasonic cleaners

-lubrication

areas needed for theatre

-kit prep

-sterile store

-scrub area

-changing rooms

-theatre

ALL need cleaning/ caring

theater cleaning routine

-morning damp dusting

-between cases immediate action required

-at the end of the day, disinfectant solutions

-once a week, deep cleaning, all areas hard to reach places

what pre op prep is needed for the patient (food and water)

-starvation period needed for those that can vomit

-younger pets require less starvation

why might you recommend bathing and grooming before surgery

ideal to ensure clean

clipping for surgery

-before surgical day can cause irritation and bacteria

-prior to induction

-once induction done

when is specific surgical prep needed and why

-GI tract

• procedure to remove food particles

  • Enema for lower

  • Upper : preps to remove any contents (eg. Starvation)

urinary tract

• catheterise bladder out of way

-flush mouth before oral surgery

-hibi scrub bag for foot surgery

what surgical scrub solution are there

-chlorhexidine

-povidone iodine

-isopropyl alcohol

ensure they are not allergic

oral prep

0.1% chlorhexidine dogs

open wounds prep

no chlorhexidine

what prep for ocular

• povidone iodine 0.2%-2% or 1:50 dilution

• Bc chlorohexidine can be irritant to mucus mems

what is the ocular povidone iodine issue

not good bactericidal effects in presence of dirt

aural prep

flushed with saline then 0.2% chlorohexidine

feet prep

Wrapped in a bag with 2% chlorohexidine for 5 mins to remove gross contaminants, then clipped then prepped

how do you prep with chlorohexidine

• 2% dilution

• Min 5 mins

how do you prep with povidone iodine

• Good for patients with chlorohexidine sensitivity

• 7.5% conc for 3 mins

how do you prep the surgical site

cirular motion working from inside out

Diff areas may need diff prep

why do we prep the skin

commensals can be on skin and if enter body can go in and cause problems

what do we flush open wounds with

Open wounds can be flushed with saline

• Chlorohexidine can be an irritant and is toxic to cells to can cause delayed wound healing

oral rinses in cats

get ulcers if use chlorhhexidine

why do we not want to make the skin too wet in prep

hypothermia and strike through

what is the sterile field

Maintain asepsis most

Waist shoulders ands and arms

Avoid infectious microbes and reduce risk of post op complications

why drape patient

-asepsis and reduce contam of surgical site

-only surgical site visible, cover whole patient

what types of drapes are there

1.  Disposable

2.  Reusable

disposable drapes

-better as less strike through

more cost effective?

better at repelling liquids

what is strike through

(is when blood and liquid soak through and can cause an area for bact to harbour and grow

when do you throw away reusable drapes

frayed or stained then throw away

draping styles

1. Plain 4 corner draping - better for larger procedures

2. Draping a limb

3. Fenestrated drapes - pre-cut hole to drape over surgical area, good for small procedures

4. Adhesive barrier drapes - stick on one side, can be fixed to patient, provide 'second skin' and full barrier between skin and surgeon, useful for limb surgery, Can put idonie into them too for extra barrier