SURGICAL INFECTIONS

Prevention of sepsis by exclusion, destruction, or inhibition of growth or multiplication of microorganisms from body tissues and fluids.

antisepsis

Inorganic chemical compounds that combat sepsis by inhibiting growth of microorganisms without necessarily killing them.

antiseptics

Used primarily on skin to stop the growth of resident flora.

antiseptics

Absence of microorganisms that cause disease.

asepsis

Method to prevent contamination by microorganisms.

Aseptic technique

A material used to reduce or inhibit the migration or transmission of microorganisms in the environment: personnel attire and gowns, furniture and patient drapes, equipment and supply packaging, and ventilating filters.

barrier

Carrying or infected by microorganisms.

contaminated

Transmission of microorganisms from patient to patient or from inanimate object to patient.

cross contamination

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

decontamination

Chemical or mechanical (friction) destruction of pathogens.

disinfection

Used for equipment/instruments that contact the skin or mucous membranes but do not penetrate the body and where sterility is not required.

high level disinfection

Microbial burden cannot get any lower; item is sterile to its highest degree.

Irreducible minimum

Used for noncritical items where the instrument or device contacts skin but does not penetrate the body or mucous membranes.

low level disinfection

Awareness of sterile, unsterile, clean, and contaminated areas, objects, and individuals and their proximity to each other.

Spatial relationships

Procedures followed to protect personnel from contact with the blood and body fluids of patients.

Standard precautions

Free of living organisms.

Sterile

Area around the site of incision into tissue or the site of introduction of an instrument into a body orifice that has been prepared using sterile supplies and equipment.

Sterile field

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

Sterile technique

Procedures carried out for the destruction of pathogens at the end of the surgical procedure in the operating room after the patient has been removed.

Terminal sterilization and disinfection

E.g. a cat is being prepared for an OVH. The preparation of skin is first treated (meaning to say it is shaved and remove all hairs on the abdominal area).

Decontamination

The most popularly used antiseptic is

povidone iodine

The most popularly used antiseptic is

aseptic technique

designed to prevent the transmission of microorganisms into the body during surgery or other invasive procedures.

aseptic technique

General principles of _____ should be familiar to all personnel working in and around the surgical environment.

aseptic technique

aseptic technique: Use only sterile items within a

sterile field

aseptic technique: Sterile (scrubbed) personnel are

gowned and gloved

aseptic technique: 1.____personnel operate within a 2.____field (sterile personnel touch only sterile items or areas, 3.____personnel touch only 4.____items or areas).

1. sterile

2. sterile

3. unsterile

4. unsterile

are used to create a sterile fields.

sterile drapes

All items used in a sterile field must be

sterile

should be maintained and monitored constantly.

sterile field

Surgical staff should be trained to recognize when they have _____ and should know how to remedy the situation.

broken technique

If Sterile Technique is Broken: Since it is an emergency situation it is called a

flash sterilization

from inside to outward in spiral motion.

iodine

Levels of Sterility and Disinfection

1. critical

2. semi-critical

3. non-critical

Equipment/implants entering sterile tissue of the vascular system. (level)

Critical

Requires sterilization and handle with sterile technique. (level)

Critical

E.g. Implants, catheters, surgical instruments, laparoscopes, suture material, biopsy forceps, arthoscopes.

Critical

equipment that does not penetrate the body; they contact the skin or mucous membrane only

semi-critical

requires HIGH-LEVEL DISINFECTION, must be cleaned before disinfection

semi-critical

sterility generally NOT MAINTAINED during procedure

semi-critical

E.g. Vaginoscopes, colonoscopes, flexible endoscopes, some dental instruments, endotracheal tubes

semi-critical

Instruments that contact the mucous membranes or intact skin NOT directly associated with surgery

non critical

Terminal cleaning recommended between patients

non critical

Disinfection appropriate in some cases

non critical

E.g. Laryngoscopes, ultrasound probes not used in the body, blood pressure cuffs, ECG leads, pulso oximeters, stethoscopes

non critical

Members of the operating team never turn their ____ on a sterile surface.

backs

An ______ should not be touched or leaned over.

unsterile area

Sterile instruments should never fall ____the ____of the surgical table.

below the edge

Arms and hands should remain _____ and _____

1. above the waist

2. below the shoulder

The FRONT of the surgical gown between the 1. ____ and 2.___ is the area considered sterile.

1. waist

2. shoulder

When receiving instruments or materials, ___. Do not drag them over the edges of their containers.

lift them up

Keep all sterile surfaces

dry

____may cause contamination of a sterile field. Place the saline bowl in the instrument pan.

moisture

Avoid excessive movement during surgery such as

1. arm waving

2. traffic in/out

Avoid _____of gowns, towels, drapes, and other materials; let them fall open by GRAVITY. _____increases air currents and the possibility of contamination.

shaking

Never 1.___ your arms, 2._____them in front of the body above the waist.

1. fold

2. clasp