Aseptic Technique

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Asepsis

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The absence of infectious organisms.

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Aseptic techniques

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Restricts microorganisms in the environment and on equipment and supplies from contaminating surgical wound. It also prevents normal body flora from contaminating surgical wound.

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External barriers

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Skin and mucuos membranes which are usually impervious to most pathogenic organisms.

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Inflammatory Response

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Prevents an invading pathogen from reproducing and possibly involving other tissue.

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Immune response

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It involves the barriers that keep harmful materials from entering your body.

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Carrier

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Person who harbors one or more specific pathogens in the abscence of discernible clinical disease.

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Contamination

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Presence of pathogenic organisms on or in animate or inanimate object.

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Infection

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Invasion and multiplication of microorganisms in body tissues causing cellular injury attributable to competitive metabolism, toxins, intracellular replication or antigen antibody response.

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Superficial SSI

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Infection of the skin and tissue.

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Deep incisional SSI

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Infection of the deep soft tissue, fascia and muscle.

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Organ or space SSI

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Infection of any part of the anatomy other than the incision.

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Transmission of microorganisms

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-by direct contact with an infectious person's articles or skin.

- by air

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Characteristics of microorgansims

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-unicellular untis (one cell)

-protista (plant kingdom)

-microscopic

-protoplasm

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Classification of microorganisms

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cocci- round

bacilli- rod or tubular

spirilla- spiral or corkscrew- have the ability to move on their own.

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Cell membrane

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maintains the shape of the microorganisms.

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Cytoplasm

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Contains the microorganism's water content and most of the work is carried out here.

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Nucleus

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Contains the genetic makeup of the cell.

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Slime layer

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The capsule that completely surorunds the cell and acts as a protective layer which has disease producing power.

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Factors that affect growth in microorganisms

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Moisture, O2, Nutrition, Temperature

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Mesophilis

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37 deg celcius - body temp

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Thermophil

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100 deg celcius, can survive at boiling point og H2O.

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Psychropil

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0 deg celcius

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Aerobic

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need O2 to grow and survive

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Anaerobic

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can't grow if O2 is present.

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Facultative

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can survive with or without O2.

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Food sources for microorganisms

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Glucose, phosphorus, proteins, O2, Nitrogen, Sulphur

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Asexual reproduction

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Reproduction which does not involve fertilization. Reproduces at a fast rate (hrs/days).

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Bacteriostatic agent

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Inhibits growth and reproduction of bacteria without killing them.

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Bactericidal

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Destroys bacteria.

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Diplococci

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2 paird (dipole)

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Streptococci

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Chains.

Causes: rheumatic fever, endocarditis

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Staphylococci

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Harmless masses.

Clusters prevalent in the skin

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Bacterial endospores

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Bacteria that form hard outer shells to help them survive in unfavorable conditions.

e.g bacillus, cocci and closttridium

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Harmful bacterial endospores

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Anthrax and Tetanus

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Fungal spores

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Very resistant spores that are difficult to kill and spread through contact, floating on water or floating in the air. Most are helpful.

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Harmful fungi

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tinea pedis, ringworm, vaginitis, meningitis

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Yeast

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Non filamented organisms that contain no chlorophyll and gives off enzymes which cause chemical changes in sugar. They are generally beneficial.

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Candida

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Causes 70 percent of yeast infections.

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Mold

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Contain long filaments and can be found in decomposed organic matter. Also found in buildings where warm, moist conditions exist.

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Viruses

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Simplest form of life that is much smaller than bacteria and are avle to pass through bacteria filters.

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Skin

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First line of defense and protects the entire body.

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Mucus membranes

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Traps pathogens, dirt and particulate matter so that they can be sequestered and eliminated by the body.

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Lymph system

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Produce antibodes and contain nodes that act as a filtering system.

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Spleen

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Synthesizes antibodies in its white pulp and removes antibody coated bacteria along with antibody coated blood cells.

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Immune system

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Collection of organs, cells and tissues that work together to protect your body from disease caused mostly by pathogens.

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Inflammation

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Local tissue reaction due to injury.

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Causes of inflammation

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ChESTER- chemicals, excessive heat, sun, trauma, electricity, radiation

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Signs of inflammation

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PRISH- pain, redness, immobility, swelling and heat

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Boil

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A collection of pus beneath the skin

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Carbuncle

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Mass collection of boils

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Pus

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Dead bacteria and tissue

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Septicemia

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The presence of bacteria in blood and is often associated with severe infection.

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Cavitation

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The process of rising bubbles bursting which creates a vaccuum effect during ultrasonic cleaning.

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Factors that affect ultrasonic cleaning

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Temperature, detergent, time 20-60mins

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Sterilization wrappers

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muslin, paper, plastic peel packs (gas only)

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Sterilization

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Complete elimination of microbial viability.

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Types of sterilizations

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steam (safest most practical means)

chemical sterilization (cold sterilization)

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gravity or downwards displacement sterilizer

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Steam enters tube to release air. 250 deg F for 30 mins.

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prevaccuum or mechanical air removal high temp sterilizer

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Steam replaces vacuum. 272 deg F for 4 mins. 5 cycles.

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Bowie dick test

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Detects the presence of air leaks.

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High speed pressure sterilization

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utilizes high temperature by increasing pressure . Used for rapid sterilization. 270 deg F at 21 psi.

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5 phases of steam sterilization

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loading, heating, destroying, drying and cooling, testing phases.

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types of chemical sterilization

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liquid (cidex) -

gas (ethylene oxide)- colorless, inhalation effects of ammonia.

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Ethylene oxide

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colorless, inhalation effects of ammonia. 3-7 hours, gas concentrated at a temp of 70 to 140. Humidity of 40 to 60 percent.

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Cidex

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Activated 2% glutaraldehyde. Instruments submerged for 10 mins. Once activated it is only good for 14 days.

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Formaldehyde

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Oldest form of liquid sterilization. takes 12-24 hours to be effective and is caustic to tissue.

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Disinfection

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The process of destroying or inhibiting disease-producing microorganisms outside the body. May not destroy spores.

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Disinfectant

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Chemical used to disinfect inanimate object (outside the body).

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Antiseptic

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Chemical used to disinfect or inhibit microorganisms in an animate object (skin, hand)

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Bacillus stearothermophilus

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Control for spore forming organisms.

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Bacilus subtilis

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used to monitor ETO sterilization

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Surgical hand scrub

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The ‘Gold Standard’ for surgical asepsis.

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Gloving

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Provide a barrier between the patient and the health care worker, decreasing the probability of exposing the patient to exogenous organisms with a resulting surgical site infection or the heath care worker to exposure or to blood or other potentially infectious material.

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Closed-gloving Technique

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Technique of choice for initial gloving.