lecture1- principles of asepsis

8/13/2019 Lecture1- Principles of Asepsis

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Principles of Asepsis

Objectives

Difference between OR sterile technique & clean technique

used in clinic.

Be able to perform surgical hand scrub, gown & glove.

Be able to maintain a clean surgical field.

Be able to set up an instrument tray for dental extractions.

Sterility: Freedom from viable forms of

microorganism.

Antiseptics: applied to living tissue.

Disinfectant: applied to inanimate objects.

Usually too toxic for direct tissue application.

Sepsis: living tissue breakdown by

inflammatory process of microorganisms.

Sterilization

Chemical agents Antiseptics

Disinfectants

Ethylene oxide gas

Physical agents Heat

Mechanical dislodgement

Radiation

Instrument Sterilization

Heat

Dry

Moist

Water/ moisture can transfer heat better than air

Steam has more stored energy

Pressurized steam allows superheating

Gaseous

Dry Moist

Antimicrobial effect Oxidizes Denatures

cell proteins cell proteins

Time necessary to Long Short

achieve sterilization 121C (250 F) 121C (250 F)for 6-12 hr for 24 min.

Equipment complexity Low Highand cost

Tendency to dull or Low Highrust instruments

HEAT STERILZATION


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Gaseous Sterilization

Ethylene oxide:

Alkylating agent

Flammable, ( mix w/ 90% CO2 or Freon)

Used at room temp (used for porous, rubber,plastic material)

Highly toxic , need long aeration time

Not very practical for a dental practice

Instrument Disinfection

Glutaraldehyde ( Cidex)

Iodophores (Betadine)

Chlorine compounds ( Clorox)

Formaldehyde

SURGICAL SET-UP

IN THE OPERATING ROOM: UNDER

GENERAL ANESTHESIA AND STERILETECHNIQUE AND

IN THE OFFICE: UNDER LOCAL

ANESTHESIA AND STERILE (CLEAN)TECHNIQUE

SURGICAL SET-UP

Sterile (clean) technique usedin the office under localanesthesia and sedation


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Instrument set up


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Sterilization

Tests of sterilization equipment. Color-

coded packaging is made of paper and

cellophane; test areas on package changecolor on exposure to sterilizingtemperatures or to ethylene oxide gas


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Gloving


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Surgical set up in the

Operating Room

sterile technique

discard sponge when lateral margins have been reached.

repeat. prevent irritating antiseptic agents from contact with

eyes (can cause corneal abrasions)

protect eyes with eye ointment (e.g., Lacri-Lube).

protect internal ear with cotton ball.

open sterile towel and place over preparation site to dryit.

the prepared surgical site to be "painted" with antisepticsponge sticks .

Surgical site preparation


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Surgical site preparation

Facial, neck, and other skin sites

Use antiseptic agents for preparation.

iodophor compounds leg, Betadine).

chlorhexidme gluconate (eg, Hibiclens').

Use sterile gloves.

Technique.

proceed from center of surgical site to lateralaspects in circular motion.

Scrubbing

Mechanisms

Mechanical action of brush.

Residual antiseptic agents.

iodophor compounds (eg, Betadme).

hexachlorophene (eg, pHisoHex).

chlorhexidine (eg, Hibiclens).


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Important considerations beforescrubbing hands and arms

Clean beneath nails (trim nails short).

Make sure hair is completely covered.

Put on mask.

Remove rings and watch.

Surgical scrub techniques 30 strokes per surface scrub technique

fingers/thumb have four surfaces interwebbing of each finger ventral, dorsal, and lateral surface of hand

four surfaces of the forearm to 2 in. above elbow

progress from fingers to elbow

repeat opposite hand and arm rinse both, keeping hands and arms elevated above

waist, allowing water

to drain off elbow

Time technique is the most common (long =10min, short = 3 min

Final rinse: rinse arms so that the water runsfrom the hands down to the elbows

Drying technique

Nurse or technician will hand sterile towel to right hand.

Dry both hands and one arm well, progressing up fromhand to elbow

using one end and side of towel.

Use opposite end for the other arm, following the sameprocedure.

Because drying towel is sterile, do not let it touchnonsterile items such as scrub cloths, surgical tables,etc.

Discard soiled towel into linen receptacle


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lecture1- principles of asepsis

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