module 2 surg lec

Regardless of the sterilization technique used, instruments and linens (e.g., towels, gowns, drapes) must be cleaned of gross contamination. True or False

True

__________ should be done as soon as possible after use of the instrument to prevent drying and caking of blood and other debris on the item.

Cleaning

In disinfection, High-level disinfectants destroy all microorganisms with the exception of some bacterial spores. True or False

True

___________ destroy all microorganisms with the exception of some bacterial spores

High-level disinfectants

_____________ destroys vegetative bacteria, as well as some viruses and fungi, but typically does not kill spores or mycobacteria.

Low-level disinfection

Practical Use Spot cleaning; injection site preparation

Disinfectant Properties Good

Antiseptic Properties Very good

Mechanisms of Action Protein denaturation, metabolic interruption, and cell lysis

Precautions Corrosive to stainless steel; volatile; damage to shellac mountings of lensed instruments; hardens rubber and some plastic tubing after prolonged use; irritating to tissues

Alcohol: isopropyl alcohol (50%–70%); ethyl alcohol (70%)

Practical Use Cleaning floors and countertops

Disinfectant Properties Good; available as liquid (sodium hypochlorite) or solid (calcium hypochlorite)

Antiseptic Properties Fair

Mechanisms of Action Release of free chlorine and oxygen

Precautions Inactivated by organic material; corrosive to metal; may cause skin irritation and esophageal burns if ingested; discolors fabric

Chlorine compounds: hypochlorite

Practical Use Cleaning dark-colored floors and countertops

Disinfectant Properties Good

Antiseptic Properties Good

Mechanisms of Action Iodination and oxidation of essential molecules

Precautions Stains fabric and tissue; do not use on silicone tubing

Iodine compounds: iodophors (7.5%) scrub solution

Practical Use

Disinfectant Properties

Antiseptic Properties

Mechanisms of Action

Precautions

Practical Use Disinfection of lenses and delicate instruments

Disinfectant Properties Good; sterilizes

Antiseptic Properties None

Mechanisms of Action Protein and nucleic acid alkylation

Precautions Tissue reaction; odor; rinse instruments well before using; can be highly toxic

Glutaraldehyde: 2% alkaline solution

Practical Use Often used as an antiseptic; stabilized form used on environmental surfaces

Disinfectant Properties Good

Antiseptic Properties Very good, particularly against anaerobic bacteria

Mechanisms of Action Formation of free hydroxyl radicals (OH), which oxidize thiol groups in enzymes and proteins

Precautions May be irritating to skin at high concentrations; irritating to eyes

Hydrogen peroxide

Practical Use Chemical sterilant similar to glutaraldehyde but not irritating to eyes and nasal passages

Disinfectant Properties Good; sterilizes; fast acting

Antiseptic Properties None

Mechanisms of Action Aldehyde binds to the outer cell wall of the organism (similar to glutaraldehyde)

Precautions Doesn’t smell but wear personal protective equipment when handling; provide good ventilation; rinse equipment thoroughly

Ortho-phthalaldehyde (OPA)

Practical Use Used in automated machines to chemically sterilize instruments

Disinfectant Properties Good; effective in presence of organic material; very rapid kill; no harmful residue

Antiseptic Properties None

Mechanisms of Action Denatures proteins, disrupts cell wall permeability, and oxidizes sulfhydryl and sulfur bonds in proteins, enzymes, and other metabolites

Precautions Unstable; quickly loses activity, particularly when diluted; corrosive; irritating to eyes, skin, and respiratory system; can corrode copper, brass, bronze, and galvanized iron

Peracetic acid

_______________may be used for heat tolerant critical and semicritical items; however, the high tem perature and moisture of a steam autoclave make it unusable for many of today’s devices. Likewise, dry-heat sterilization produces temperatures that cannot be tolerated by most devices and is seldom used.

High-temperature (steam autoclave or dry heat) sterilization

___________ (e.g., EtO gas, hydrogen peroxide gas plasma, hydrogen peroxide and ozone, hydrogen peroxide vapor are used for heat-sensitive critical and semicritical items

Low-temperature sterilization systems

___________ includes chemical sterilants such as glutaral dehyde, glutaraldehyde with phenol, and various concentrations of hydrogen peroxide with peracetic acid .Devices cannot be wrapped when using liquid sterilants, and they typically need to be rinsed with water that often is not sterile, which limits their usefulness

Liquid immersion

Saturated steam under pressure is a practical and dependable agent for sterilization of heat-tolerant medical supplies and packaging. Steam rapidly destroys all known microorganisms by means of coagulation and cellular protein denaturation. To ensure the destruction of all living microorganisms, the correct relationship between temperature, pressure, and exposure time is critical.

Steam Sterilization

The unit used to create this high-temperature, pres surized steam is called an ________

autoclave

The most commonly used steam sterilizer in veterinary practice is the __________. This sterilizer works on the principle that air is heavier than steam

gravity (or “downward”) displacement sterilizer

The ___________ relies on air being actively pulled out of the inner chamber, thereby creating a vacuum. Steam is injected into the chamber to replace the air. This method of sterilization provides greater steam penetration in a shorter time than the gravity displacement sterilizer (

prevacuum sterilizer

_________ is performed when an unwrapped, nonsterile item must be sterilized quickly.

Immediate-use, emergency, or “flash” sterilization

__________ is a flammable, explosive gas that kills microorganisms by altering their normal cellular metabolism and replication through alkylation of proteins, deoxyribonucleic acid (DNA), and ribo nucleic acid (RNA)

Ethylene Oxide EtO

low-temperature steriliza tion technique that has become a method of choice for sterilizing heat-sensitive items.low-temperature steriliza tion technique that has become a method of choice for sterilizing heat-sensitive items.

Plasma sterilization

Most items are sterilized at ____ for approx. 2.5 hours

54.4 C

Heat sensitive items are sterilized at ______ for approx. 5 hours

37.7 C

_______________ is a form of plasma sterilization that uses hydrogen peroxide to process instruments quickly and efficiently

Vapor phase hydrogen peroxide sterilization

A low temperature chemical method that uses a strong oxidizing agent to kill microorganism effectively sterilizing heat sensitive medical devices like endoscope

Peracetic acid sterilization

Most equipment available prepackaged from the manufacturer has been sterilized by____________ (i.e., cobalt 60 gamma rays or electron accelerators). This low-temperature sterilization process is restricted to commercial use because of its expense.

ionizing radiation

Resterilization by other means may not beResterilization by other means may not be possible for prepackaged sterilized items that have been opened but not used, because an alternate technique could damage the item and create a health hazard. True or False

True

Chemicals used for sterilization must be noncorrosive to the items being sterilized. Glutaraldehyde is a saturated dialdehyde that has gained wide acceptance as a high-level disinfectant and chemical sterilant.

Cold Chemical Sterilization

______ is a saturated dialdehyde that has gained wide acceptance as a high-level disinfectant and chemical sterilant.

Glutaraldehyde 2%

_______ allow monitoring of the effectiveness of sterilization. Indicators may undergo a chemical or biological change in response to some combination of time and temperature.

Sterilization indicators

___________, which are available for steam, gas, and plasma sterilization, generally consist of paper strips or tape impregnated with a material that changes color when a certain temperature is reached

Chemical indicators

_____ is the surest way to determine sterility. A strain of highly resistant, nonpathogenic, spore-forming bacteria (Bacillus stearothermophilus for steam, Bacillus subtilis for gas), which is contained in a glass vial or a strip of paper, is placed in the load of goods to be sterilized.

biological indicator

__________ are typically rigid, boxlike devices made from heat-resistant and steam-sterilizable high-performance plastic or other materials in which instruments can be placed and sterilized

Sterile container systems

The original sterilization wraps were ___________.

140 thread count muslin cloth

The introduction of _______ allowed the development of wraps possessing strength, barrier, and repellent properties.

polypropylene

SMS materials feature a composite of three layers— ____________—normally using a polypropylene resin and then stacked together.

spunlace, meltblown, and spunbonded