Asepsi S: Surgical

Asepsi
Surgical
s
By: Krishel A. Caranguian
OPENING PRAYER
OBJECTIVES
• To explain the concept of
surgical asepsis
• To inform the students about the
importance/goal of surgical
asepsis
• To be able to discuss the
principles in aseptic technique
• To relate the roles and duties of
the members of the surgical team
regarding surgical asepsis
•
DEDICATION

This presentation is deeply
offered to all the significant
people in my life, my parents,
friends, and to GOD. I also
dedicate this to all the nursing
students who may get assistance
through this presentation, and
ACKNOWLEDGEMENT

I would like to express my
gratitude to all the people who
contributed much help in order to get
done with this meaningful presentation;
to God who gave me strength and
wisdom; to my parents for the financial
and loving support, to my friends who
stayed with me through sleepless
INTRODUCTION
Surgical Asepsis
ØThe method and practice that
prevents cross-contamination
in surgery.

ØIt is used for all procedures

involving the sterile areas
of the body.
• Asepsis – the freedom from
disease-causing
microorganisms through the
use of aseptic technique.
• Surgical asepsis involves
– Proper preparation of
facilities and environment
– Surgical site
– Surgical team and
– Surgical equipments

Why Surgical Asepsis?
 The act of surgery robs a patient
of protective barrier, the SKIN,
against infection or disease. Whenever
the skin is disrupted, microorganisms have
the opportunity to invade tissue and
proliferate. Therefore,
 it is a must to practice
 surgical asepsis during
 a surgery.
•
• Operating room activities pertaining
to asepsis and aseptic practices
have the greatest direct impact upon
the surgical team in helping to
reduce the patient's risk to
surgical site infection.
•
Goal of Surgical
Asepsis:
• Prevention of microbial contamination
of living tissues or sterile area
and objects by excluding, removing
or killing micro-organisms including
pathogens and spores.
• HOW: by creating and maintaining the
sterile field and by following
aseptic principles aimed at
preventing microorganisms from
contaminating the surgical wound.
The Surgical Team
Ø is made up of sterile and nonsterile members.
• Sterile members o

"scrubbed" personnel

work directly

in the surgical field

• Nonsterile members

work in the periphery

of the sterile surgical

field.
Surgical Team
Requireaments:
• no jewelry, no nail polish.
• Short fingernails
• Little or no make-up
• No open wounds, hangnails,or cuts
• Not compromised immune system
 or respiratory condition,
 or any infections
•
STERILE FIELD
ØIs a microorganism-free area.
ØContains all sterile items

Surgical Attire
• Provides a barrier between sources of
contamination-the patient and
personnel
– Clean surgical scrub suit
– Masks
– Surgical caps
– Shoe covers
– Sugical gloves
Sterile supplies
• Commercially packaged sterile
items: use until expiration date
• use unless seal is broken
• use unless package is damaged
STERILIZATION
ØThe process that destroys all
microorganisms, including spores
and viruses.

Øis required for all instruments

or supplies that will penetrate
a patient’s skin.

Sterilization methods
• Autoclave
• Gas
• Boiling water
• Radiation

1. Autoclave - For items able to withstand high

 temperatures and moisture Temperature must
be 250 degrees for 15 minutes. (spores can

survive temps of 240 degrees for longer than 3
hours)

2. Gas – ethylene oxide gas destroys


microorganisms by interfering with their

metabolic processes.

3. Boiling water – most practical and inexpensive


method of sterilization

4. Radiation – uses alpha, beta, x-rays, and


SURGICAL ASEPSIS TECHNIQUES
PREOPERATION
A VIDEO PRESENTATION
ICEBREAKER: PRACTICE THE
PRINCIPLES
• Instruction: The class will be
divided into 6 groups. Each group
will act out the principles in
surgical asepsis assuming they’re
inside the Operating Room. This is
to test their ideas about the
principles in sterile technique.
After the role play, note the
common mistakes done by the
group and discuss. (Any surgical
operation may be used)
Principles and
PRACTICES
of
surgical
asepsis
#1: All objects used in a
sterile field must be sterile.
• Sterile items are kept separate from non-
sterile items.
• Commercially packaged sterile items:
 use until expiration date
• Use sterile items unless seal is
 broken or wet
• Use sterile items unless package is
 damaged
#2: Sterile objects become unsterile
when touched by unsterile objects.
• Touch open wounds or body cavities
with sterile forceps or with sterile
gloved hands only.
•
•
• Discard or resterelize objects
 that come into contact with
 unsterile objects.
#2: Sterile objects become unsterile
when touched by unsterile objects.
• Whenever an object’s sterility
 is questionable, it is assumed
?
 as unsterile.

#3:Sterile items that are out of vision or below the
waist level of the nurse are considered unsterile.
• Once left unattended, a sterile field is

considered unsterile.
• Sterile objects are always kept in
 view.
• Nurses do not turn their
 backs on a sterile field.

• Sterile
to
steril
e
(front
to
front)
•
•
CONSIDERED STERILE:
• front part of sterile gown
• From nurse’s shoulder to waist or
table height(whichever is higher)
• cuff of sleeves to 2 inches above the
elbows
• Sterile draped tables are considered
sterile at surface level only.
•
#4: Sterile objects can become unsterile by
prolong exposure to airborne microorganisms.
• Keep doors closed (rationale: moving

air can carry dust and
microorganisms)
• Refrain from sneezing or coughing
 over a sterile field.

• Keep talking to a minimum:

 avert the head from the field if
 talking is necessary.
• Non-scrubbed personnel don’t reach over the

sterile Fields
#5: Fluids flow in the direction
of gravity.
• Unless gloves are worn, always hold wet
forceps with the tips below handles.
• Surgical Scrubbing: hold hands
 higher than the elbows (rationale:
 to prevent contaminants from
 the forearms reach the
 hands)
#6: Moisture that passes through a sterile object
draws microorganism from unsterile surfaces above or
below to the surface by capillary reaction.
• Keep the sterile covers on sterile dry.

• Replace sterile drapes that do not
have a sterile barrier underneath
when
 they become moist.

#7: The edges of a sterile field are
considered unsterile.
• A 2.5cm (1”) margin at the edge of

an open drape is considered
unsterile
• Place all sterile objects more than
 2.5cm inside the edges of a sterile
 field.
• Any object that falls outside
 the edges of a sterile field is
 considered unsterile
#8: The skin cannot be sterilized
and is unsterile.
• Use sterile gloves or forceps to
handle sterile items.
• Prior to surgical asepsis procedure,
 cleanse the hands to reduce the
 number of microorganisms
 on them.
#9: Conscientiousness, alertness and
honesty are essential qualities in
maintaining surgical asepsis
• When a sterile object becomes
unsterile, it does not necessarily
change in appearance.
• The person who sees a sterile object,
 which becomes contaminated,
 must correct or report the
 situation.
• Do not set up a sterile field
 ahead of time for future use.
ROLE OF SCRUB NURSE
• Works directly with surgeon within
the sterile field, passing
instruments, sponges and other items
needed during the procedure
•
• Members of the surgical team who
prepares and preserves a sterile
field in which the operation can
take place

ROLE OF SCRUB NURSE
• Responsible for the sponge counts,
the blades and needles and
instruments check throughout the
operation
•
• Has a job requiring anticipation,
quick reaction and conscientious
observation as well as knowledge
of anatomy and of operative
procedures
ROLE OF CIRCULATING
NURSE
• Responsible for managing the
nursing care of the patient within
the OR and coordinating the needs
of the surgical team with other care
provider necessary for completion
of surgery
•
• Observes the surgery and surgical
team from broad perspective and
assists the team to create and
maintain a safe and comfortable
ROLE OF CIRCULATING
NURSE
• Asses the patient’s condition before,
during and after the operation to
ensure an optimal outcome for the
patient
•
• Must be able to anticipate the scrub
nurse’s needs and be able to open
sterile packs, operate machinery
and keep accurate records
closING PRAYER
THANK YOU!!!!!

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Asepsi

ØIt is used for all procedures

Øis required for all instruments

1. Autoclave - For items able to withstand high

be 250 degrees for 15 minutes. (spores can

2. Gas – ethylene oxide gas destroys

microorganisms by interfering with their

3. Boiling water – most practical and inexpensive

4. Radiation – uses alpha, beta, x-rays, and

• Once left unattended, a sterile field is

• Keep doors closed (rationale: moving

• Keep talking to a minimum:

• Non-scrubbed personnel don’t reach over the

• Keep the sterile covers on sterile dry.

• A 2.5cm (1”) margin at the edge of

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