Antiseptic

Dr. Kristanto Yuli Yarsa. SpB(K)Onk

SHORT HISTORY OF SURGERY

GALENUS- TOPOGRAPHIC ANATOMY AMBROISE PARE (1510-1590) = THE FATHER OF SURGERY THE DEVELOPMENT OF SURGERY WAS IMPAIRED DUE TO THE FAILURE TO ACT AGAINST BLEEDING, INFECTION, PAIN

THE SURGEON GIVES LIFE FROM HIS OWN

A good surgeon-3H- HEAD, HAND, HEART

SHORT HISTORY

WILLIAM MORTON, 1846, ETHER JOSEPH LISTER- FATHER OF ANTISEPSIA

LOUIS PASTEUR- FATHER OF ASEPSIA

SHORT HISTORY

JOSEPH LISTER (1827-1912) STERILE SURGERY CARBOLIC ACID SOLUTION- WOUNDS HANDS WASH AND STERILE GLOVES INSTRUMENTS WASHED WITH SOL.

SHORT HISTORY
LOUIS PASTEUR, 1860, germ theory of disease CHEMICAL AND PHYSICAL AGENTS KILL BACTERIAS STERILE SURGERY

HISTORY

WILLIAM STEWART HALSTED (1852-1922) High repute as a surgeon and diagnostician 1890-introduced the use of rubber gloves Halsted radical mastectomy Developed methods

Strict aseptic technique Gentle handling of tissue Low tension on the tissue Use of fine silk suture material

ASEPSIS

ABSENCE OF ANY INFECTIOUS AGENTS PROCEDURES FOR ASEPSIS

STERILIZATION OF GOODS AND SUPPLIES DISINFECTION OF THE HOSPITAL ENVIRONMENT ANTISEPSIS OF LIVING TISSUES ENVIRONMENTAL CONTROL OF THE OPERATING ROOM

STERILIZATION

IS THE PROCESS THAT KILLS ALL FORMS OF LIVING MATTER: BACTERIA, VIRUSES, MOULDS SPECIAL EQUIPMENT- PHYSICAL OR CHEMICAL AGENTS PRACTICAL CRITERION OF STERILITY IS THE FAILURE OF MICROBIAL GROWTH

STERILE= WITHOUT LIVING ORGANISMS

STERILIZATION= THE PROCESS OF OBTAINING STERILE OBJECTS THROUGH CHEMICAL OR PHYSICAL TREATMENTS

MOIST HEAT OR STEAM UNDER PRESSURE

DESTROYS ALL MICROBIAL LIFE INCLUDING SPORES- denaturation of intracellular proteins. THE PARAMETERS OF EFFICACY

Temp. 140* C Atmospheric pressure 2,5 Time of sterilization 30 min.

MOIST HEAT

SOFT SURGICAL SUPPLIES

MASKS SHOES GLOVES GOWNS DRAPES SHEETS DRESSINGS SWABS

DRY HEAT STERILIZATION

THE PARAMETERS OF EFFICACY

Temp. 180* C Time of sterilization 1 h.

FOR METALIC INSTRUMENTS AND GLASS MEDICAL ARTICLES

ETHYLENE OXIDE GAS STERILIZATION

FOR HEAT SENSITIVE OR MOISTURE SENSITIVE ITEMS:

LENSED INSTRUMENTS RUBBER GOODS SHARP AND DELICATE INSTRUMENTS PREPACKED COMMERCIAL MEDICAL PRODUCTS: syringes, suture materials, drainage tubes

PACKED ITEM THAT IS

OUTDATED, EXPOSED TO MOISTURE, DROPPED ON THE FLOOR OR PUNCTURED

IS CONSIDERED CONTAMINATED

OTHER METHODS OF STERILIZATION

RADIATION STERILIZATION

IONISING RADIATION BY COBALT FOR DISPOSABLE HOSPITAL SUPPLIES

CHEMICAL STERILIZATION

2% aqueous solution of GLUTARALDEHYDE FOR HEAT-SENSITIVE EQUIPMENT BEFORE USE, the instruments must be washed up with sterile water

DISINFECTION

DISINFECTANT IS A CHEMICAL SUBSTANCE- ON THE SURFACE OF INANIMATE OBJECTS Disinfectant at a low concentration can be used as an antiseptic OPERATING TABLE, INSTRUMENT TABLE FLOORS ARE CLEANED WITH DISINFECTANTS

ANTISEPSIS

CHEMICAL AGENTS ON ANIMATE SURFACES DESTROY BACTERIA A GOOD ANTISEPTIC:

TO KILL AT LOW CONCENTRATION NO TOXICITY FOR LIVING TISSUES TO ACT FOR A LONG TIME NOT TO STAIN OR HAVE A BAD SMELL TO BE ECONOMIC

ANTISEPSIS

SURGICAL SCRUB ON HANDS PREOP.PREPARATION OF THE PS SKIN

WOUNDS TREATMENT

TYPES OF DRAPES Plain overwrap drapes (Table Covers)

Single layered Used with other drapes to cover body regions Double layered with plastic outer layer Used to cover O.R. and Instrument Tables

TYPES OF DRAPES MAYO COVER

Used to drape Mayo stand May be in core pack or wrapped separately

MAYO COVER APPLICATION

GOWN AND GLOVE SURGEON

GOWN AND GLOVE SURGEON

ANTISEPTICS

70% ALCOHOL 2% IODINE BETADINE HYDROGEN PEROXIDE CHLORIDE SILVER NITRATE BORIC ACID IODOFORM

SURGICAL SCRUB

PROCESS OF MECHANICAL SCRUBBING WITH AN ANTISEPTIC SOLUTION

IMAGINED BY IGNAZ SEMMELWEISS, WIEN, 1846

SKIN FLORA

RESIDENT FLORA

TRANSIENT FLORA

ON HANDS DEPENDS ON PERSONAL HYGIENE HOSPITAL FLORA RESISTANT TO ANTIBIOTICS

PREPARATION OF THE PS SKIN

SHAVING SCRUBBING
DRAPING

A Disinfected or Sterile Area

TYPES OF DRAPES

TOWELS
TOWELS

Used to outline op site Secured with towel clips, staples or adhesive strips

TYPES OF DRAPES Fenestrated Drape

Reinforced window to allow op site exposure Top/bottom marked for proper placement

Fenestrated Drapes Laparotomy

FENESTRATED HEAD AND NECK DRAPE

TYPES OF DRAPES UNDER BUTTOCK DRAPES

FENESTRATED PERINEUM DRAPE

TYPES OF DRAPES SPLIT DRAPES

TYPES OF DRAPES STOCKINET CUFFS

TYPES OF DRAPES LEGGINGS

TYPES OF DRAPES INCISE DRAPES

FULLY DRAPED PATIENT SURGERY CAN START!

THE STERILE FIELD

The area of the operating room that surrounds the site of incision All items needed for the operation are sterile and are used within the sterile field It is created by the placement of sterile sheets and towels around the site of incision

The Early OR: No Masks Required

Masks and gowns for some

WHO My five (KEY) moments for hand hygiene

1. 2.

3.
4.

5.

Before touching a patient Before clean/aseptic procedure After body fluid exposure risk After touching a patient After touching patient surroundings

Health-care & Patient Zones

Technique
palm to palm backs of hands interdigital spaces fingertips thumbs and wrists nails

Areas most frequently missed:

Webs of fingers Thumbs Palms Nails Backs of fingers & hands Wrists