asepsis.ppt

8/15/2019 Asepsis.ppt

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The asepsis is a complex of actionsaimed to prevent the contamination of

wound, tissues, organs and organismas a whole. Unlike of antisepsis, that

destroy microorganisms already fallen

into the wound, asepsis preclude its

penetration in the patient’s organism.

DEFINITIONDEFINITION


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The purpose of surgical asepsis

is to prevent the contamination of

the open surgical wound by

isolating the operative site from the

surrounding nonsterile

environment.

PURPOSEPURPOSE


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The main rule ofThe main rule of

asepsis is –asepsis is –

““One and all that getOne and all that getinto the contact ithinto the contact ith

ound o!ligate to !eound o!ligate to !e

sterile"sterile"#


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Source of infection$Source of infection$

Caries as a nidus

of infection

Wound

E%oE%ogenous

source of

infection

EndoEndogenous source of

infection


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There are three a&s ofe%ogenous contamination $

'#(ir!orne spread)*#+ontact spread)

,#+ontamination !& implantation

of infected materials

-implantation infection.#

/(0S$/(0S$


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(ir!orne a& of contamination(ir!orne a& of contamination

Infection from respirator&

tract of patients and

health1care or2ers

Infected !andages andinfected ound discharge

Infected dust in the

operating roomPathogenic germs from

clothes and s2in of

or2ers and patients

INFE+TED (IR IN

OPER(TIN3ROO4

INFE+TED

/OOND


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Pre5ention of air!orne infection#Pre5ention of air!orne infection#

Separation of patients#

SEPTI+

SUR3I+(6

DEP(RT4ENT

(SEPTI+

SUR3I+(6

DEP(RT4ENT


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Pre5ention of air!orne infection#Pre5ention of air!orne infection#

+onsecution of operations #

“(!solutel& clean" inter5entions

!vascular surgery, hernia repair "

“Relati5el& clean" inter5entions

!cholecystectomy, gastric re#ection "

“Infected" inter5entions

!colon surgery, purulent surgery "


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Restricted access of

unauthori7ed persons into

department and operating room

especiall

Pre5ention ofPre5ention of

air!orne infectionair!orne infection


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'#7one of general regime

*#7one of restricted regime

,#relati5e sterile 7one

8#a!solute sterile 7one

Four 7ones of operatingFour 7ones of operating

room$room$


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Persons or2ing in a!solutePersons or2ing in a!solute

sterile 7onesterile 7one $$

STERI6E

-“S+RU99ED".4E49ERS$

surgeon

surgeon’s

assistants

scrub nurse

NONSTERI6E

PERSONNE6$

anaesthetist

nurses

students, medical

re#idents


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The second and third 7ones are di5ided

!& mar2ed red linered line painted on the

floor#

IIII

IIIIII


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4edical clothes#4edical clothes#

:one of general

regime

Sterile 7one


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4edical clothes#4edical clothes#

“Scru!!ed" persons in sterile 7one

Sterile

surgical

glo5es

Sterile

surgical

gon


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Test for carrier ofTest for carrier of

Staph&lococcus#Staph&lococcus#


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cleaning prior to start operations

current cleaningcleaning after each finished

operationcleaning after termination of

or2ing da&

+leaning in the operation+leaning in the operation

room#room#


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The complete cleaning; ith

profound and prolonged

disinfection of all accessi!le

surfaces and facilities in

operating room should !e

performed ee2l& and that da&

is considered operation1free#


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+6OSED +IR+UIT OF (IR IN+6OSED +IR+UIT OF (IR IN

OPER(TIN3 ROO4#OPER(TIN3 ROO4#


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Proph&la%is ofProph&la%is of

contact infectioncontact infection

““One and all that getOne and all that getinto the contact ithinto the contact ith

ound o!ligate to !eound o!ligate to !esterile"#sterile"#


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surgeon=s hands ith glo5es

surgical gon

drapes and !andages

surgical instruments

operating field -patient=s s2in.

/hat enter into direct contact/hat enter into direct contact

ith a oundith a ound >>


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Surgeon=s hands#Surgeon=s hands#

''

/ashing ith soap and !rush in

running ater#


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**


(fter thrice1repeated ashing; hands

should !e dried ith sterile toel#


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,,


Decontamination ith antiseptic$

Per5omur; Degmin; Tserigel; Eurosept#


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In our clinic e use forthis purpose the

?#@ spirituous?#@ spirituous

solution ofsolution of

chlorhe%idinechlorhe%idine#


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88


(fter decontamination 1 sterile surgical

gon and sterile surgical glo5es#


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Sterili7ation of te%tile products#

',?A+

Sheemel!ush=s

container


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one hour under pressure of steam

eBual to '#' atm 8@ minutes under pressure of steam

eBual to '#@ atm

,? minutes under pressure of steam

eBual to * atm

Cariants of sterili7ation inCariants of sterili7ation in

autocla5eautocla5e $$


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rinsing

disinfecting

cleaning

dr&ing

sterili7ation

Processing of surgicalProcessing of surgical

instrumentsinstruments $$


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Sterili7ation ofSterili7ation of

surgical instruments#surgical instruments#

'1st step$

Rinsing of instruments

under arm running ater

for remo5ing of !lood andorganic tissue#


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Sterili7ation of surgicalSterili7ation of surgical

instruments#instruments#

Instruments immersed in solution

of h&drogen pero%ide during ?

minutes


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Sterili7ation ofSterili7ation of

surgical instruments#surgical instruments#

+leaning of instruments !& means of

soa2ing in the detergent ith

temperature of @? – ?A + for *?

minutes# (fter that; instruments should

!e ashed in this solution ith !rush

and rinsed ith running ater#


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Dr&ing of instruments in the special

electric o5en#

,?= 1 G?A


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Door closed and sterili7ation

performed #

?= 1 'G?A


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Hualit& control of thermalHualit& control of thermal

sterili7ationsterili7ation $$

DIRE+T 4ET


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Hualit& of sterili7ation#Hualit& of sterili7ation#

4elt su!stantionUnmelt su!stantion


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Decontamination of operationDecontamination of operation

field$field$

The s2in must !e cleaned more idel&

than area of planned inter5ention)

+leaning must !e performed from the

center to peripher&)

The more contaminated areas are cleans

in the latter time#


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Decontamination of operation field#Decontamination of operation field#

Three times !efore

limitation of operationfield ith surgical drapes

Prior to

incision

9efore and after insertion

of ound suture


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Implantation of infected material in

the human !od& ine5ita!l& results

in de5elopment of septic–purulent

process# This 2ind of suppuration is

5er& resistant to anti!acterial

treatment and remo5ing of infected

item is reBuired as usual#


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Surgical sutures#Surgical sutures#

N(TUR(6$N(TUR(6$

Silk

Catgut

S0NT


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Surgical sutures#Surgical sutures#


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Implanta!le surgical o!Jects#Implanta!le surgical o!Jects#

Sutures

(rtificial heart

5al5esOrthopedic de5ices

S&nthetic meshes

for hernia repair

Cascular grafts

S fSt ili ti f i l t !l


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Sterili7ation of implanta!leSterili7ation of implanta!lesurgical o!Jects#surgical o!Jects#

The methods ofsuture sterili7ation$

+laudis

Sit2o5s2&

Koher

3u!are5

3OIN3 DO/N IN


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Sterili7ation of implanta!leSterili7ation of implanta!lesurgical o!Jects#surgical o!Jects#

4ET(66I+

ORT


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Principal rules of !eha5ior intoPrincipal rules of !eha5ior into

operating room$operating room$'#Onl& sterile persons function ithin a

sterile field#

*#Sterile drapes are used to create a sterilefield#

,#(ll items used ithin a sterile field must

!e sterile#

8#( sterile field should !e maintained and

monitored constantl

P i i l l f ! h i i tP i i l l f ! h i i t


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Principal rules of !eha5ior intoPrincipal rules of !eha5ior into

operating room$operating room$

@#If there is dou!t regarding an itemMs

sterilit&; consider it not sterile#

#Nonsterile personnel should ala&s

remain in nonsterile areas and contact

onl& nonsterile items#

#Nonsterile personnel must ala&smaintain a margin of safet& hen

approaching sterile fields and personnel#


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Endogenous infection#Endogenous infection#

+hronic

inflammator&

diseases$

chronic

p&elonephritis;

chronic

!ronchitis;

chronic

tonsillitis;

caries

Surgical

siteinfection


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Nosocomial infection#Nosocomial infection#

The most common nosocomialinfections are ( urinary tract infections,

pneumonia and surgical(site infections.

)n most cases, the nosocomial infection

has been caused by antimicrobial(

resistant pathogens.


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INFE+TION

(SEPSIS

/OUND

asepsis.ppt

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