Surgical Technology Principles Notes

Contamination in the Perioperative Environment

  • Definition of Contamination:

    • An area or item that was previously sterile comes into direct contact with a nonsterile object and becomes contaminated
    • Example:
    • Surgical instrument falls to the floor: the instrument is now contaminated
    • A surgeon's gloved hand accidentally touches the nonsterile edge of a surgical drape, thus contaminating the glove
    • A surgical technologist pierces her glove with a suture needle (skin is nonsterile)

  • Gross Contamination:

    • Occurs when an infectious material spills into a sterile area, for example, a ruptured infected appendix spilling into the abdominal cavity.

  • Strikethrough:

    • A specific type of contamination where a nonsterile fluid penetrates a sterile covering, compromising the sterility of the surface underneath.
Disinfection
  • Definition:
    • A process that destroys microorganisms on inanimate (nonliving) objects.
  • Variable Effectiveness:
    • Different disinfectants have various levels of microorganism destruction capability.
  • For in-depth details, refer to Chapter 10 of the referenced material.
Antisepsis
  • Definition:
    • The destruction of microorganisms on living tissue, primarily on the skin.
  • Application:
    • Used in hand hygiene and during the perioperative preparation of the patient's surgical site.
  • Referencing:
    • For a full description of surgical hand antisepsis, see Section V.
Barriers in Sterile Technique
  • Concept:
    • Fundamental principle of sterile technique is the use of barriers to prevent contamination.
  • Containment and Confinement:
    • Physical barriers separate nonsterile surfaces from sterile ones (e.g., sterile gloves).
Functional Zones in the Operating Room (OR)
  • Overview:
    • The operating room is divided into different functional areas: unrestricted, semi-restricted, and restricted zones.
  • Unrestricted Areas:
    • Places like staff locker rooms, administrative offices, and patient-changing areas that allow general access.
  • Semi-Restricted Areas:
    • Preoperative patient care and postoperative patient care areas where special attire is required but are not entirely sterile.
  • Restricted Areas:
    • This includes corridors leading to sterile areas, scrub sinks, and the sterile processing clean and decontamination room.
    • For a zone to be classified as restricted, it must maintain a standard of asepsis as per guidelines from professional organizations like AAMI (Association for the Advancement of Medical Instrumentation).
Important Reminder
  • A fully unrestricted area is considered semi-restricted when located within a semi-restricted zone, highlighting the need to continuously monitor boundaries between sterile and nonsterile zones.