ASEPTIC TECHNIQUE
SURGICAL TECHNOLOGY PROGRAM
INFECTION CONTROL AND ASEPSIS
1. Issues in infection control
Items to be addressed before measures can be taken to prevent the occurrence
and spread of invasive microorganisms that can multiply and cause damage
and disease
a. Transmission
b. Susceptibility
c. Containment
d. Prevention
Pathogens or carriers of microorganisms spread via airborne contaminants or
direct contact
Weakened state of the body allows the transmission of infections to have a
higher impact and greater chance of impact
Segregation of highly-infectious materials or patients
Hygiene and asepsis that drops the possibility of infection to its lowest
possible potential
2. The hospital environment
Exposure to infections is higher because illness is so prevalent and the concentration level of pathogens is high
a. Potential areas for contamination containment and prevention
Airborne microorganisms
Bacteria and pathogens from respiratory tract or other source
Contact contaminants
Spread of microorganisms through contact
Wound infections
Infected purulent body fluids within the wound
Bloodborne pathogens
Infection/pathogens that have invaded the bloodstream
Surgical-site infections
Bacteria that invades an area of surgical incision
Nosocomial infections
Diverse group of infections acquired during
hospitalization
Absence of pathogens
Asepsis
Contamination
A condition of being soiled, stained, touched, or otherwise exposed to harmful
agents, such as by entry of infectious or toxic materials into a previously clean
or sterile environment, making an object potentially unsafe for use as intended
Contaminant
An agent that causes contamination, pollution, or spoilage
Purulent
Containing pus
Sepsis
Infection with disease-causing microorganisms or other toxins in the
bloodstream
b. Methods of infection prevention in the restricted zone of OR
Aseptic Technique
Procedures designed to protect against infection before, during and after
surgery by rendering and maintaining sterility of the surgical environment.
Surgical Conscience
Procedures designed to protect against infection before, during and after
surgery by rendering and maintaining sterility of the surgical environment.
OTHER TERMS RELATED TO ASEPTIC TECHNIQUE
Antiseptic
Substance that prevents growth of pathogens
Bacteriocidal
Substance that destroys or kills bacteria
Bacteriostatic
Substance that inhibits the growth of bacteria (sterile water can be bacteriocidal)
Bioburden
The number of microbes found on an object (organic debris)
Cross-contamination
One person contaminates another
Decontamination
The process of reducing the number of microbes to the lowest number possible
Disinfectant
It is a chemical agent that will kill all microbes with the exception of spores
Droplets
Small beads of moisture
Event related sterilization
Items are sterile if there is no damage to the sterile package. Sterile indefinitely.
Fomite
Inanimate items that has microbes
Fungicide
Spore
Sporicide
Sterile
Sterile technique
Sterilization
Strike-through contamination
Surgically clean
Terminal disinfection
Vector
Viricide
OR Functional and Aseptic Area
1. OR is divided functionally
2. OR is divided aseptically
Chemical the destroys fungus
A bacteria that is resistant to certain forms of sterilization. It can survive under
many adverse conditions
Chemical or substance that can kill spore stage bacteria
Fee of microorganisms including those in the spore stage
Creating a sterile and working with it throughout the case by having the lowest
possible microbe count
The act of rendering an item bacteria free
The passage of fluid through the sterile field by puncturing through the sterile table
cover which are a microbe barrier
Not sterile but cleaned and disinfected with chemicals
High level disinfecting of items
Living carrier that transmits disease
Agent that destroys a virus
Support services for surgery
Surgical Area
Unrestricted area
Restricted area
Shaded Areas Represent Unrestricted Areas
Shaded Areas Represent Unrestricted
Areas
1. OR personnel
a. Respiratory Tract
contaminants
b. Skin contaminants
c. Hair contaminants
d. Clothing and shoe
Sources of Contamination In OR
Sources of contamination include contaminants from their respiratory tracts, skin,
hair, clothes and shoes
Expelled when OR personnel talk, cough, or sneeze. These contaminants may be
directly transmitted to others when expelled, or they may settle on surfaces and are
indirectly transmitted when other personnel contact these surfaces. These
contaminants are controlled in the OR by personnel wearing masks that cover the
mouth and nose.
Resident flora and transient flora that are attached to skin particles when they are
shed. This microbial shedding is controlled most effectively in the OR by
personnel covering their skin with sterile scrub attire.
Resident and transient flora present in hair follicles and filaments. The microbial
shedding from hair is controlled by keeping
Most effectively controlled by replacing street clothing with scrub attire and shoe
covers
contaminant
Resident flora
Transient flora
2. OR environment
Transmission in the air
Transmission in dust
Transmission in smoke
Sterile field
Infection
3. The patient
Ways the patient can
contribute to infection
Organisms that normally live in and on the bodies of healthy persons without
causing harm when located in specific sites, including the bacteria that are
normally present below the skin surface in sebaceous glands and hair follicles and
are usually harmless to their host but may be pathogenic to other
Organisms that take up residence in or on the body temporarily in a location where
they are not normally found through contact with other objects and can be easily
removed by mechanical friction
Air currents become vehicles of transport for microorganisms to open wounds and
other susceptible tissue. Every movement in the OR increases the chance
Circulate in the environment and on articles that are brought into the OR and used
in the patient's wound and inside the sterile field (linens, instruments, sutures, etc.)
Circulate on air currents, in the environment and on articles brought into OR
The area around an operative site including furniture covered with sterile drapes
and properly attired members of the surgical team
An invasion of a body by organisms and the reaction of the body to the presence
of those organisms and to the toxins that they produce; the presence and
multiplication of an organism that results in harm or disease to a host; the presence
of pathogens in a wound sit
Those organisms found in the patient's respiratory tract, skin, circulating
blood, and gastrointestinal (Gl) tract. In fact, the Gl tracts of patients support the
growth of innumerable organisms
3. Modes of contamination
The ways by which infecting organisms are transmitted to sterile objects
There are many means of physical contact by which contaminants can be
Physical contact
transmitted to sterile objects in the OR.
Example: When an unsterile object or person touches a sterile item.
Contaminants can be transmitted to sterile objects in OR through contact with
Moisture
moisture droplets from many sources: moisture from respiration through the
masks of OR personnel, moisture from perspiration that penetrates the gowns of
OR personnel, moisture from the patient's respiration, etc
Contaminants from sources such as dust or smoke circulate in the air of the OR
Air
Infecting organisms (hematogenous contaminants) can be transmitted in a
Patient blood
patient's blood
1.Create a protective
barrier
Purposes of Proper OR Attire
Prevents the spread of microorganisms. Gloves, protective
eyewear and masks are examples of protective barriers worn in
OR.
Restricts the passage of pathogens from staff to patients
2. Prohibit
contamination of the
sterile field
1. Semi-restricted area
Restricts the passage of pathogens from the patient to staff
Prevent the spread of pathogens in the operative wound by direct contact
Components of OR Attire
Any person from another department who is entering the area
only briefly for a specific purpose should wear a coverall suit
designed to cover his or her outside apparel
a. Long-sleeved jacket that is buttoned or snapped closed
b. Surgical cap or hood that covers all head and facial hair
2. Restricted area
All personnel entering a restricted area should be clothed in proper
OR attire, which includes scrub attire, proper head covering,
proper foot wear, a mask, and protective eyewear. Sterile gown
and gloves are added to this basic attire for members of the sterile
surgical team.
a. Scrubbed personnel
Members of the sterile surgical team; those who are within the sterile field
Scrub attire
Head covering
Shoes
Protective eyewear
Examples: Surgical technologist and surgeon
Shirt and pants, tunic and pants, or coverall (jumpsuit
Cap or hood
Shoe covers or shoes restricted to the OR
Goggles or glasses with solid side shields, chin-length face shields
Sterile gown and gloves
2. Non-scrubbed
personnel
Sterile
All other OR team members; those who are outside the immediate sterile area
Examples; Anesthesiologist and circulator
a. OR attire is same as for the scrubbed personnel with the exception of the sterile
gown and gloves
b. Non-scrubbed personnel may also wear a warm-up jacket. This provides comfort
in the cool OR environment and prevents contamination via skin slough.
Basic Principles of Aseptic Technique
1. The sterile field
The area near the operative site and the personnel who are draped
or robed in sterile attire and directly in contact with the operative site
a. A sterile field is created for each surgical procedure.
b. Only sterile items are used within a sterile field.
c. Gowns are considered sterile from table level (waist level) to mid-chest level in front, and from glove tips to
2 inches above the elbows on the sleeves.
e. A sterile field is created as close as possible to the time of use.
f. Sterile areas are continuously kept in view.
d. Draped tables are sterile only at the table level
e. A sterile field is created as close as possible to the time of use
f. Sterile areas are continuously kept in view
2. Personnel
Movement in and around the sterile field must not compromise the field
a. Sterile personnel
Touch only sterile items or areas
Avoid leaning over an unsterile area.
Keep within sterile areas.
b. Unsterile personnel
Touch only unsterile items or areas.
Avoid leaning over a sterile area.
Avoid sterile areas.
3. Contamination
a. As a sterile package is opened, the edges of the wrapper are considered unsterile,
Four-way folded package—1" margin or edge of horizontal surface
Peel packs—Width of the seal
b. Destruction of the integrity of microbial barriers results in contamination.
c. In OR, microorganisms must be kept to the lowest possible amount.
d. Items of doubtful sterility must be considered unsterile.