Disinfection

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ASEPSIS, ANTISEPSIS,DISINFECTION & STERILIZATION : 

ASEPSIS, ANTISEPSIS,DISINFECTION & STERILIZATION DR. SANDEEP V. KANSAL ASSOCIATE PROFESSOR OF SURGERY GOVT. MEDICAL COLLEGE SURAT

Learning objectives : 

Learning objectives Define the following key terms related to microbial control: sterilization, disinfection, antisepsis, degerming, sanitization, biocide, germicide, bacteriostasis, and asepsis. Describe the patterns of microbial death caused by treatments with microbial control agents. Describe the effects of microbial control agents on cellular structures.

Slide 3: 

Compare the effectiveness of moist heat (boiling, autoclaving, pasteurization) and dry heat. Describe how filtration, low temperature, high pressure, desiccation, and osmotic pressure suppress microbial growth. Explain how radiation kills cells. List the factors related to effective disinfection. Identify the methods of action and preferred uses of chemical disinfectants. Identify the appropriate uses for surface-active agents.

Slide 4: 

Sepsis (Greek word) refers to microbial contamination. Asepsis is the absence of significant contamination. Aseptic surgery techniques prevent microbial contamination of wounds. Terminology

Sterilization and Disinfection : 

Sterilization and Disinfection Disinfection – destroys all pathogenic organism except spore Sterilization – The process by which all microorganisms including spores are destroyed

Slide 6: 

Antisepsis: Removal of pathogens from living tissue (not disinfection!) Degerming: Removal of microbes from a limited area (such as swabbing with alcohol-doesn’t kill bacteria-only removes)

Slide 7: 

Sanitization: Lower microbial counts on eating utensils (does not completely get rid of organisms) Biocide/Germicide: Kills microbes Bacteriostasis: Inhibiting, not killing, microbes

Cleaning Agents : 

Cleaning Agents Antiseptic – inhibits the growth of bacteria Antibacterial – kill bacteria or suppresses their growth

The Control of Microbial Growth -Terminology : 

Sterilization: Removal of all microbial life Disinfection: Removal of pathogens Degerming: Removal of microbes from a limited area Sanitization: Lower microbial counts on eating utensils Biocide/Germicide: Kills microbes Bacteriostasis: Inhibiting, not killing, microbes The Control of Microbial Growth -Terminology

The Control of Microbial Growth -Terminology : 

The Control of Microbial Growth -Terminology Sepsis refers to microbial contamination. Asepsis is the absence of significant contamination. Antisepsis: Removal of pathogens from living tissue Aseptic surgery techniques prevent microbial contamination of wounds.

DISINFECTION : 

DISINFECTION

Slide 12: 

CLASSIFICATION OF DISINFECTANTS (a)ACIDS Acetic acid Boric acid Benzoic acid (b)ALCOHOL Ethanol Isopropyl alcohol (c)ALDEHYDES Formaldehyde Glutraldehyde (d)QUARTERNARY AMMONIUM COMPOUNDS Cetrimide Benzalkonium chloride (e)CHLORHEXIDINE

Slide 13: 

(f)CHLORINE AND CHLORINE RELEASING SUBSTANCES Sodium hypochlorite Chlorinated lime (g)DYES Acriflavin Gention violet (h)IODINE AND IODOPHORES (i)HEAVY METALS Mercurochrome Silver nitrate Silver sulfadiazine (j)OXIDIZING AGENTS Hydrogen peroxide (k)PHENOLIC COMPOUNDS Phenol Hexachlorophene Chlorophene Chloroxylenol Cresol

Slide 14: 

MECHANISM OF ACTION Coagulation of bacterial protein wall Alteration in the properties of the cell wall Binding of free sulfhydryl (SH) group essential for enzyme action Competition with essential substance for important enzymes in the bacterial cell wall

Slide 15: 

PROPERTIES OF AN IDEAL ANTISEPTIC Germicidal Broad spectrum of activity Prevent superinfection Rapid action and sustained activity Degree and incidence of resistance should be low Should be active in presence of organic matter Should be effective in acidic as well as alkali medium Should be stable, high penetrating power Not corrosion of metals Lipid soluble Offensive odour, colour and staining activity should be minimum/ absent Should not produce local cellular damage and should not interfere with wound healing Should not produce systemic toxicity on local application. Should be cheap, easily available Should be safe and easy to use NO SUCH IDEAL AGENT HOWEVER, IS AVAILABLE.

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FACTORS DETERMINING THE POTENCY OF DISINFECTANTS Concentration of substance Time of action pH of medium Nature of organism Presence of any extraneous material

Slide 17: 

STATUS IN RELATION TO SYSTEMIC ANTIBIOTIC Because of – tissue toxicity - inadequate penetration into foci of infection - reduced activity in the presence of infection, body fluids they are less effective as compared to systemic antibiotics However local drugs are efficacious by limiting surface infection so that tissue defences can clean up below without continual reinfection from superficial foci They are widely used in burns superficial fungal infection

Slide 18: 

ALCOHOL Ethyl alcohol Isopropyl alcohol (more germicidal activity as compared to ethyl alcohol) Property: clear, colourless, volatile liquid, spirit odour, burning taste Storage: in a cool place in tight containers Spectrum: bactericidal, viricidal (variable action), fungicidal (variable action), ineffective against bacterial spores Mechanism of action: precipitation of bacterial protein, dissolution of membrane lipids

Slide 19: 

Formulation: 70% ethyl alcohol as a skin antiseptic Uses for disinfection of skin before injection, blood sample collection, venepuncture, surgical incision it kills 90% of bacteria within 2 MINUTES provided that the area is kept moist during that time it reduces >75% of bacterial counts when applied by a single wipe and left to evaporate post op dressing for clean stitched wound to clean skin surrounding the ulcer prevent development of bedsores by hardening of skin

Slide 20: 

NEWER PREPARATION PUREHANDS It is an ethanol based herbal hand sanitizer Spectrum – Antibacterial including MRSA Antiviral Antifungal It kills 99.9% of microbes and makes hands germ-free within 30 secs with rapid evaporation with no risk of recontamination It has lemon smell – keeps the hands fresh It is proved by DEPARTMENT OF CLINICAL MICROBIOLOGY, CMC, VELLORE. It is effective against E. Coli, Staph aureus, non-fermenting Gram –ve bacilli and Pseudomonas, aerobic spore forming bacilli at 1 minute, 2 minutes and 3 minutes

Slide 21: 

Uses In OPD before examination of patients In pre-operative period before wearing gloves and after removing gloves It is recommended in ICU also Preparations 50 ml, 500ml bottles are available

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HYDROGEN PEROXIDE It is an oxidizing agent Property: clear, colourless, odourless, deteriorates on exposure (standing, exposure to heat) Storage: in dark containers (otherwise absorbs thermal energy and decomposes) Spectrum: bactericidal (against anaerobes specially) fungicidal HIV(30%solution)

Slide 23: 

MECHANISM OF ACTION When hydrogen peroxide comes in contact with organic matter/ tissue it produces nascent oxygen - germicidal action Heat- achieves hemostasis Effervescence - mechanical cleansing USES after incision and drainage dressing of abscess cavity, sinuses, ulcer cleaning of contaminated, lacerated wound Other uses: mouth wash (after tonsillectomy, Vincent’s stomatitis), ear drops( in diluted form)

Slide 24: 

IODINES Chemistry: solubility in water at pH 7.5 is 0.15% and in ethanol is several times more. Spectrum: bactericidal (gram+ ve = gram-ve), sporicidal, fungicidal, protozoacidal, cysticidal, viricidal Majority of bacteria are killed within 10 minutes by 0.0002% solution and in 10 seconds by 1% solution More concentration and more duration of several hours is required for dry spores Ethanol enhances germicidal activity and also increases DISPERSIBILITY and PENETRANCE

Slide 25: 

Preparations Tincture iodine: 2% iodine + 2.4% Na + 50% ethanol Lugol’s iodine: 5%iodine with 10% KI Iodine topical solution: 2% iodine with 2.4% Na Mucus membrane: 2% in glycerine Toxicity Iodine burns Application as irritating and painful Delays healing of wound Skin eruption, GI irritation

Slide 26: 

Uses Pre operative painting of skin (iodine is the best preparation) SPIRIT – IODINE – SPIRIT sequence used For dressings of minor cuts, abrasions, infectred wound Betadine bladder wash (0.1% solution used) Other uses: Lugol’s iodine- in thyrotoxicosis, in pre-op preparation

Slide 27: 

IODOPHORES Definition: it is a loose complex of elemental iodine with a carrier molecule which acts as a sustained of reservoir of iodine. Povidone iodine: povidone iodine is a complex with pyrolidone nitrogens of polyvinyl pyrolidone Povidone provides increased solubility and slow release of iodine Spectrum: same as that of iodine Toxicity Repeated application- contact dermatitis Prolonged use- thyroid suppression

Slide 28: 

Uses Preoperative preparation of skin and mucus membranes. Standard surgical scrubs with 10% povidone will decrese the bacterial count by 85% action lasts for 5-6 hours Preoperative scrubbing of hands Dressing of minor cuts, abrasions, burns, lacerated wound For burns it should be applied before eschar formation Preparation – Solution 5%, 10%, 20% & 7.5%, ointment 7.5% BETA SCRUB used pre-operatively scrubbing of the patient WOKADINE SOLUTION BETADINE SOLUTION

Slide 29: 

POVIDONE (5%) AND METRONIDAZOLE (1%) COMBINATION Spectrum – active against broad range of Gram positive and Gram negative pathogens Preparations Ointment Powder Solution Spray ADVANTAGES Improved antimicrobial spectrum Reduces the risk of irritation

Slide 30: 

USES Solution pre-operative irrigation post – operative irrigation Ointment non exudative wound Powder exudative wound venous ulcer diabetic ulcer Sprays children, fussy patientsCombination of Betadine with Brand Names – Metro-P ointment, solution, powder Drez solution, ointment, spray, powder

Slide 31: 

CHLORHEXIDINE It is a biguanide with antiseptic activity and anti-plaque activity Property: colourless to pale straw colour, odourless Spectrum: Bactericidal (Gram +ve = Gram -ve) Fungicidal (variable action) Not virucidal Mechanism of action: Disrupts the plasma membrane of bacterial wall and cellular contents are lost. Active even in the presence of blood or pus

Slide 32: 

USES Pre-operative disinfection of skin- scrubbing of hands 0.1% of solution kills 99.9% STAPH AUREUS, E COLI AND PSEUDOMONAS in 15 SEC however, hospital originated pseudomonas are resistant to Chlorhexidine Action lasts longer than povidone iodine Chlorhexidine mouthwash ADVANTAGES Rapid acting Long duration of action Non irritating Active in the presenceof blood, pus Less photosensitivity

Slide 33: 

PRECAUTIONS Freshly prepared solution should be used. Superinfection with pseudomonas can occur. Never leave the bottle open. It may lead to contact dermatitis. So all instruments, needle syringe immersed should be rinsed in sterile water before use. Should not come in contact with brain, meninges and middle ear

Slide 34: 

ALDEHYDES FORMALDEHYDE Bactericidal Fungicidal Virucidal High conc. against spores Mechanism of action – Precipitation of proteins in high conc. Preparations 40% aqueous solution containing methanol Formaldehyde gas Formalin tablets

Slide 35: 

USES 2 – 5% solution for disinfection of surgical gloves and instruments 10% solution for disinfection of excreta, sputum. 4% solution for preservation of pathological specimen Operation theatre fumigation 150 gm KMnO4 + 280 ml formalin for 1000 cu. Ft, doors should be closed for 48 hrs Formalin chambers – 7 tablets of formalin are kept and changed every month ADR Acute poisoning Abdominal pain, vomiting, acidosis, resp. depression, convulsions, renal failure Irritant to eye, allergic reaction

Slide 36: 

GLUTERALDEHYDE (CIDEX) 2% gluteraldehyde acidic solution Spectrum – Bactericidal Fungicidal Virucidal Mycobacterial cidal Pseudomonacidal Uses Rubber, plastic, metal appliance like fibreoptic endoscopes, catheter, sharp instruments – scissors Respirator Duration Complete disinfection requires 10 mins

Slide 37: 

SILVER SULFADIAZINE Chemistry White powder Insoluble in water Mechanism of action – Bactericidal Most effective against Pseudomonas Uses 2o – 3o burns Should be applied before eschar forms and becomes dry & firm Advantages Painless Not soluble in water, so less silver ion released to precipitate significant amount of chlorine to cause electrolyte imbalance

Slide 38: 

DISADVANTAGES Allergic reaction 3 – 5% Leucopenia 3 – 5% Bacterial resistance to topical application

Slide 39: 

PHENOLS First antiseptic used Introduced by Lord Joseph Lister All antiseptics are compared to phenol PHENOL COEFFICIENT It is a ratio of minimum inhibitory concentration of an antiseptic against a bacterial strain to that of phenol Mechanism of action: denatures the bacterial proteins Spectrum: Bacteriostatic upto1% conc, Bactericidal>1.6% Fungicidal >1.3%. Ineffective agaist bacterial spores and viruses

Slide 40: 

Toxicity when applied to a large area it produces CNS stimulation may be Carcinogenic fetal neonatal hyperbilirubinemia can occur Uses: USE OF PHENOL AS AN ANTISEPTIC IS OBSOLETE Application of appendicular stump first PHENOL- SPIRIT – NS Entamoeba histyolitica in caecum and is a homeground and colour comes out destroys all the vegetable form within 1 min. so after 1 min wash with SPIRIT and NS

Slide 41: 

OTHER USES 5% in almond oil-1st -2nd piles, varicose vein, chemical sympathectomy (2) 5% solution for disinfection of excreta (3) dressing of minor cuts and abrasions

Slide 42: 

CHLOROXYLENOL It is a chlorinated phenol Less toxic in comparison to phenol Spectrum – both Gram positive & Gram negative Composition Dettol – Chloroxylenol 4.8% Trepineol 9.0% Absolute alcohol 13.1% Preparations Skin antiseptic cream 1.44% Surgical instrument 6.25%

Slide 43: 

MECHANISM OF ACTION Denatures bacterial protein USES Disinfection of hands before and after examination in OPD, ward Sitz bath Keep Cheatal forceps, spatula, tongue depressor, thermometer Superficial burns TOXICITY Non-irritant, rarely skin sensitivity

Slide 44: 

CRESOL Meta derivative of phenol 3 – 10 times more active and toxic potential is same as that of Phenol CHEMISTRY Colourless Light brown yellow ? becomes dark on exposure to light Phenolic odour PREPARATION 2% solution is used

Slide 45: 

LYSOL CONCENTRATED CRESOL SOLUTION Saponification of cresol with vegetable oil Uses Sterilization of sharp instruments like knife, scissors Animal waste product, inanimate objects Time 30 mins for 100% solution 2 hrs for 1:100 solution Remarks Irritant nature so instruments should be cleaned in water before use

Slide 46: 

HEXACHLOROPHENE Polychlorinated bisphenol White to light tar Crystalline powder Mechanism of action – Inhibition of membrane bound enzymes Interruption of bacterial protein chain High conc. – rupture bacterial membrane Spectrum – Gram positive more than Gram negative Bacteriostatic Little effect on bacterial spores Initially reduces bacterial count to 30 – 50% BUT 90% REDUCTION CAN OCCUR WITHIN 1 HR Action gets terminated by alcohol and unmedicated soap Presence of organic matter like pus its activity decreases

Slide 47: 

Uses Pre-operative hand scrubbing (wash) Pre-operative preparation of patient – several days preparation required Dressing of infected wound Toxicity Less compared to phenol Myelinopathy , encephalomalacia can occur Super infection with candida can occur Preparation For skin 0.25% - 3% emulsion 0.25% - 3% solution

Slide 48: 

GENTIAN VIOLET (CRYSTAL VIOLET) Spectrum – bactericidal to Gram positive bacteria not against Gram negative MECHANISM OF ACTION It coagulates the serous discharge on oozing surface and makes the ulcer dry. USES Bed sore Chronic ulcer Dermatitis Also used previously in burns to a pliable eschar and helping to control infection against Gram positive organisms Other Use – for marking of skin for incision

Slide 49: 

DISADVANTAGE When applied locally to ulcer site staining of floor So cannot judge the progression of ulcer PREPARATIONS Gentian violet cream 1.2% - 1.6% Gentian violet solution 0.5% - 1.2%

Slide 50: 

ACETIC ACID Mechanism of action – release hydrogen ion Spectrum – Bacteriostatic <5% Bactericidal >5% Uses 5% solution for suppressing growth of Pseudomonas 0.25% - urinary bladder irrigation 2 – 5% solution for otitis externa 1% solution is used over the wound for decreasing bacterial infection

Slide 51: 

STERILIUM It contains quaternary ammonium compound with alcohol Contents – Each 100 ml contains 2-Propanol 45 gm 1-Propanol 30 gm Ethyl hexadecyl dimethyl ammonium 0.2 gm% Ethyl sulfate Mechanism of action It penetrates the crypts of skin into the horny layer and there it forms a defense barrier against microbes

Slide 52: 

Spectrum – Bactericidal Fungicidal Virucidal Mycotuberculous bacilli HBsAg HIV USES Eliminates 99.99% of transient skin flora in 30 sec Useful in reducing cross infection in hospital, more common in critical care unit

Slide 53: 

MERCUROCHROME Contains merbromine Red colour compound Mechanism of action – Inhibition of sulfhydryl enzymes of bacteria Spectrum – Bacteriostatic Fungicidal Uses Minor wounds Abrasions Burns Bed sores Irrigation of urinary bladder

Slide 54: 

DISADVANTAGE It stains the floor of ulcer, so not used of non healing ulcer and halts the progression Mercury toxicity, if absorption occurs systemically

Slide 55: 

STERILIZATION STERILIZATION Destroys all forms of microbial life including bacteria, virus, fungi and spores

Slide 57: 

FLAMING Used for sterilization of Inoculating wire loops Points of forceps Spatulas HOT AIR OVEN Used for sterilization of Glass wares (syringes, slides) Sharp instruments Swabs Dressings Fat, oil, Vaseline, chalk and powder are impervious to heat and hence should be sterilized by dry heat

Slide 58: 

HEAT AT 100O C (BOILING) Used for sterilization of Syringes Needles Surgical instruments except scisors, knife HOWEVER SURGICAL INSTRUMENTS MUST BE AUTOCLAVED AND BOILING IS RECOMMENDED ONLY WHERE FACILITY OF AUTOCLAVE IS NOT AVAILABLE.

Slide 59: 

HEAT MORE THAN 100O C (AUTOCLAVING) It sterilizes without extensive damage to instruments. PRINCIPLE The water boils when vapour pressure equals to that of surrounding atmosphere. Hence, when pressure inside a closed vessel increases the temperature at which water boils also increases and saturated steam has greater penetrating power. When it comes in contact with cooler surface it condenses to water and gives up its latent heat to that surface.

Slide 60: 

DURATION Metal instruments 20 mins Syringe (unwrapped) 20 mins Threads (linen, silk, nylon) 20 mins Metal instruments and 30 mins Linen, towel, gown, gauze, dressing cotton 45 mins POINTS Steam tends to move in vertical direction, particles should be placed in vertical direction ? quicker and better steam penetration Steam inlet should be adequate size Material take longer time should be in upper part Steam escape valve should be checked periodically Material inside should be packed loosely for steam penetration

Slide 61: 

RADIATION Mass sterilization of Disinfecting enclosed areas Plastic syringes syringes entry lounge Catheters hospital wards Suture materials operation rooms Surgical instruments IV infusion sets BT sets Scalp vein

Slide 62: 

GAS STERILIZATION Ethelene oxide gas Formaldehyde Beta propiolactone Used for sterilization of Surgical instruments Tubing Plastic pan Heart lung machine Respirator Syringes Pillows

Slide 63: 

PRECAUTIONS Dissolves plastic, rubber, fabric and leather Chemical burns may occur when material applied to the tissue with ethelene oxide ? minimum 24 hr duration is necessary for removal of gas from sterilized article

Slide 64: 

FILTRATION Millipore filters Efficient for removing large particles and bacteria Not exactly equivalent to sterilization as viruses esp. small ones may pass through such filters

ASEPSIS AND ANTISEPTIC : 

ASEPSIS AND ANTISEPTIC

TOPIC INCLUDES: : 

TOPIC INCLUDES: INTRODUCTION HISTORY DEFINATIONS ASEPSIS TODAY IN SURGERY

Slide 67: 

IT IS THE MOST IMPORTANT BUT THE MOST IGNORED SECTION OF THE HOSPITAL PRACTICE.

HISTORY : 

HISTORY Beginning in 1860 with JOSEPH LISTER studies with gangrene influenced by PASTEUR: filter, burn and expose to chemicals Carlisle used carbolic acid for sewers.

Slide 69: 

Technique Wash hands and instruments with carbolic acid wear gloves spray OT with carbolic acid LISTER - LANCET 1867 amputation Mortality reduced from 46% to 15%

Slide 70: 

RESPONSE : “Show us the Little beasts” Franco Prussian war 1870 13,200 amputations – 10,000 deaths. Slowly accepted – “LISTERISM”. Gloves and clean clothes were accepted as the standard by 1900.

ASEPSIS AND ANTISEPSIS IN SURGERYASEPSIS: Freedom from infection or prevention of contact with microorganism.It is the ideal state which we want to achieve.Aseptic technique can be defined as all the measures we take to purposefully reduce the number of microorganisms (germs) to an irreducible number for the purpose of preventing transmission of infection. Antisepsis is the use of antimicrobial chemicals on human tissue, whereas disinfection is the employment of these agents on inanimate object. Sterilization is the highest level of aseptic technique. : 

ASEPSIS AND ANTISEPSIS IN SURGERYASEPSIS: Freedom from infection or prevention of contact with microorganism.It is the ideal state which we want to achieve.Aseptic technique can be defined as all the measures we take to purposefully reduce the number of microorganisms (germs) to an irreducible number for the purpose of preventing transmission of infection. Antisepsis is the use of antimicrobial chemicals on human tissue, whereas disinfection is the employment of these agents on inanimate object. Sterilization is the highest level of aseptic technique.

ASEPSIS = Common Sense : 

ASEPSIS = Common Sense There Are Many Levels of Asepsis The Seven Keys of Asepsis1. Know what is clean2. Know what is contaminated3. Know what is sterile4. Keep clean, contaminated and sterile items separated5. Keep sterile sites sterile6. Resolve contamination immediately7. Train yourself to realize when you have broken technique

ASEPTIC PROCEDURES IN SURGERY : 

ASEPTIC PROCEDURES IN SURGERY THE OPERATION THEATRE THE PATIENT THE OR TEAM ASEPSIS & SURGICAL TECHNIQUE ASEPTIC PRACTICE IN WARDS.

OPERATION THEATRE : 

OPERATION THEATRE STERILE ZONE OR DESIGN CONTROL OF AIR QUALITY MAINTAINANCE OF ASEPSIS BY CLEANING, STERILIZATION & FUMIGATION.

Slide 76: 

STERILE ZONE

` : 

` OR design is more important than site of OT of course it should not be nearer to incinator. OR should be of at least of 25m2 & ideally of 42 m2 to provide enough space for maneuvering & parking trolleys, stretcher. Atleast 6 ft space should be cleared on either side of the operation table. The ceiling should be of atleast 3.5metres high. Ideal joint less flooring should be done with epoxy sulphide floors which are a lot cheaper than marble floors or with kotah stone which is still better than marble, which can be made dust proof by Polyurethane top coat.

Slide 78: 

There should not be any corners in the operation theatre, floor should have slop of 1:1000 for better cleaning. Wall should be made of material which does not shed particles because they can carry bacteria which can travel through the air to reach the wound and can contaminate it. Use trolleys rather than shelves if at all they are needed keep it 50mm away from the wall on metal rods. The OR should have double-door entrance from the anaesthetic room and a double-door exit into the clean corridors. There should also be two small entrances from the clean store room and an opening from the scrub room.

Slide 79: 

There should be single exit door to the dirty corridor for removal of drapes, instruments and waste products at the end of the procedure. THE SCRUB ROOM: Should have two doors leading to the corridor and the theatre. Sinks with good drainage & suitable panels to prevent splashing. The taps & soap holders which can be manipulated by foot pedals or elbows. Easily cleaned shelves for gown packs and gloves ideally situated above the elbow level. Anti-slip floors & facility for proper disposal. Brushes for cleaning finger nails.

CONTROL OF AIR QUALITY : 

CONTROL OF AIR QUALITY We need at least 20 to 30 airchanges per hour to have the maximum benefit. Reduction in bacterial count is significant. The basic principle is always maintain positive pressure at operative site by providing rapid high volume of flow of air. Avoid unnecessary traffic in OR. Make sure that door are closed.

Slide 81: 

HEPA filter with prefilter. Laminar air flow. Pressurized air modules. Split type air conditioners. NO FAN & NO WINDOW.

Slide 82: 

MAINTAINANCE OF ASEPSIS BY CLEANING IN BETWEEN OT & AFTER OT , PROPER STERILIZATION PROCEDURES & FUMIGATION.

THE PATIENT : 

THE PATIENT Major source of infection Infection that develops from operations classified as CLEAN, CLEAN-CONTAMINATED, OR DIRTY are primarily caused by bacteria already present in operative field or by procedure performed. GOOD BATH. SHAVING. Send the patient to OT in clean OT gown. PREPARATION. DRAPPING. Monitor the sterile field.

OR TEAM : 

OR TEAM ENTERING THE THEATRE SCRUBBING FACE MASK / PARTICULATE FILTER RESPIRATORS/PAPR DONNING THE GOWN WEARING STERILE GLOVES PROTECTIVE EYEWEAR MAINTAINING THE STERILE FIELD

ASEPSIS & SURGICAL TECHNIQUE : 

ASEPSIS & SURGICAL TECHNIQUE Adhere to principles of asepsis when placing intravascular devices (e.g. central venous catheters), spinal, or epidural anesthesia catheters or when dispensing and administering intravenous drugs. Handle tissue gently, maintain effective hemostasis, minimize devitalized tissue and foreign bodies (i.e., sutures, charred tissues, necrotic debris), and eradicate dead space at the surgical site. Use delayed primary skin closure or leave an incision open to heal by second intention if the surgeon considers the surgical site to be contaminated heavily. Use closed suction drain taken out through separate incision. Remove it as early as possible.

ASEPTIC PRACTICE IN WARDS : 

ASEPTIC PRACTICE IN WARDS Hand washing & Hand antisepsis. Proper isolation of infected patients. Proper waste disposal. Following the seven keys of asepsis as previously mentioned.

CARING ATTITUDE, SENSE OF RESPONSIBILITY & PERSONAL HYEIGINE DOES REQUIRE TO REACH TO THE HEIGHEST LEVEL OF ASEPSIS. : 

CARING ATTITUDE, SENSE OF RESPONSIBILITY & PERSONAL HYEIGINE DOES REQUIRE TO REACH TO THE HEIGHEST LEVEL OF ASEPSIS.

THANK YOU : 

THANK YOU

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