Asepsis

IS THE FOUNDATION

ANTIBIOTICS – NOT A SUBSTITUTE

Definition

Asepsis is the state of being free from disease-causing contaminants (such as bacteria, viruses, fungi, and parasites) or, preventing contact with microorganisms.

The term asepsis often refers to those practices used to promote or induce asepsis in an operative field in surgery or medicine to prevent infection.

ASEPSIS

Medical Surgicalany practice that helps reduce the number and spread of microorganisms.

the complete removal of microorganisms and their spores from the surface of an object

Source of infectious organism

sExogeno

us

Endogenous

Operating room(air)

Surgical instruments

Surgical team

• Patient’s resident flora

• MOST IMPORTANT SOURCE

CHAIN OF INFECTION

Surgical asepsis involves proper preparation of

Facilities & environment

Surgical site

Surgixcal equipment

Surgical team

Surgical asepsis

Interrupting at the level of casuative

organism & reservoir

Interrupting at the level of portal of exit & entry

Hand washing Patient skin

preparation Disinfectants on

objeects Sterilisation of

instruments & drapes

Proper attire Gloves, gown,

mask, surgical drapes

During the procedure The following precautions must be taken by the

scrub practitioner:

The sterile field should be constantly observed and not left unattended at any time

Conversation should be kept to a minimum in the surgical area

The number of personnel in the theatre and around the surgical field should be limited

Movement around the sterile field, including the opening and closing of doors should be kept to a minimum

Non-perforating devices should be used to secure equipment to the sterile field

Non-sterile equipment should be covered with sterile barriers before placing them in or over the sterile field

Scrub staff should remain should remain close to the sterile field

When changing positions scrub staff should pass back-to-back or face-to-face

Scrubbed staff should avoid changing levels, ie sitting and standing

A wide space should be observed between scrubbed staff and non-scrubbed staff

The level of the surgical field is established by the level of the surgical site

The following precautions must be taken by unsterile staff:

Unsterile staff should face the sterile field on approach Unsterile staff should not touch or lean over the sterile

field Unsterile staff should not walk between two

components of the sterile field

If extra items are required to be added to the sterile field the packaging must be inspected to ensure that:

It is the required item. The package integrity has been maintained. The sterilisation indicator is present. It has not exceeded its expiry date. The packaging is not wet

Removal of microorganisms and their spores must be complete, or the article is not sterile.

Disinfection To remove as many micoorganisms as possible from

a surface by physical or chemical means.

Articles or surfaces that cannot be sterilized in the OR or special procedure room must be disinfected.

Methods of Sterilization and Disinfection

Proper hand washing

Opening sterile pack

Passing sterile object to a sterile person

Putting an object in the sterile field

Transferring a sterile object

Draping for Sterile Procedure

Removing and Reapplying Dressings

• You must not remove or reapply dressing • All dressings must be treated as if they are

contaminated, because drainage from wounds may harbor pathogenic microorganisms

• By following such simple day to day practices in the operating room we can minimise the infection rates

• Hence surgeons may even not rely on antibiotics for the complete result of their surgical outcome without any infective complications