Module #1
Sterile Technique & Ortho. Surgery Room Setup
James E. Carpenter, MD
Peter M. Murray, MD
Presentation #1: Sterile Technique and Ortho. Surgery Room Setup
Developed by the Surgical Skills Task Force of the American Board of Orthopaedic Surgery (ABOS) in collaboration with the American Academy
of Orthopaedic Surgeons (AAOS), and the American Orthopaedic Association (AOA)/Council of Orthopaedic Residency Directors (CORD)
Sterile Technique and Orthopaedic
Surgery Room Setup:
Hand and Microsurgery Surgery
ABOS/AAOS Surgical Skills Task Force
2013
Introduction
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Patient transfer
Hand table positioning
Tourniquet application
Draping
Appropriate cautery care
Maintenance of sterile field
Taking down drapes
Patient Transfer
• Lock bed and position as close as possible to
the OR bed at the same height
• Patient transfer
– Under own power
– Draw sheet
• Wear gloves and eye protection!!!
Hand Table Positioning
• Most designs lock to side of OR table.
Important to secure
• Legs deployed and flat on floor, no rocking
Tourniquet Application
• Choose appropriate size:
– 18 in for upper arm
– 12 in for forearm
• Cast padding applied beneath tourniquet
– Ensure that padding extends beyond edges
• Protective barrier to avoid scrub solution leaking
under tourniquet causing burns
• Hook up pneumatic hose and set alarm and time
– 100mm Hg above systolic pressure
– 110 minutes
Draping
• Place down sheet on hand table first
– Avoid gown contamination
• Take arm from scurb nurse using stockinette
– Impervious stockinette if hand is not prepped
• Tourniquet towel
• 2 layers of drapes
• Apply custom hand table drape with aperature
– Follow directions on drape
• Consider underneath side of drape unsterile at all
times….can’t go back!!
Cautery care
• < 40 for most hand surgery procedures
• Always have a holder for the bovie or bipolar
– This is a dangerous insturment!!
Maintenance of the Sterile Field
• Do not violate sterile pathway once created