This document discusses medical and surgical asepsis. Medical asepsis refers to practices that reduce pathogen transmission between patients, such as proper hand washing and cleaning supplies between patients. Surgical asepsis aims to keep surgical areas and equipment sterile to prevent infections. Methods of sterilization discussed include dry heat, moist heat like autoclaving, flaming, boiling, radiation, and chemicals like ethylene oxide. Guidelines for medical asepsis include hand washing, cleaning supplies between patients, proper disposal of soiled materials, and maintaining clean areas separate from dirty areas. Surgical asepsis requires maintaining sterility in operating rooms and for procedures.

1. Medical and Surgical
Asepsis
presented by: Astuti Mishra
BPKIHS Dharan

2. Introduction
• Sepsis: Presence of microorganisms
• A: Absence of or Lack of
Asepsis: The state of being free of pathogenic
microorganisms. or absence of the microorganisms that
produce sepsis or septic disease or Asepsis is the
methods of achieving a germ-free condition.

3. Medical asepsis
• It is synonym of clean technique.
• It means observing all those practices that are designed
to lessen the number and transfer of pathogens from
one person to another.
Purpose
• To ensure adequate removal of pathogens.
• To prevent cross infections.
(It is required to be maintained to break the chain of
infection)

4. Guidelines for Medical asepsis
1. Hand Washing:
• Follow correct procedure of hand washing
• Remove all jewellory and wrist watch
• Trim your nails
• Rinse the soap well before returning it to the soap
dish.

5. Guidelines for Medical asepsis cont--------
2. Clean the supplies used for one patient before using
the same for the next patient.
3. Carry soiled materials away from your uniform so
that it may not become a source of transmission of
pathogens.
4. Never through soiled linen or any materials in the
floor to prevent addition of more pathogens to it, but
dispose it properly.
5. Discard or return for recleaning any articles dropped
in floor.

6. Guidelines for Medical asepsis cont--------
6. Ask the patient to cover nose and mouth when coughing,
sneezing or laughing to prevent the spread of pathogens by air
borne droplet.
7. Be aware of clean and dirty areas in a unit and never
interchange these areas.
8. Keep supplies as minimum as possible in the patient’s room.
9. Minimize the number of visitors and do not allow the children
under 12 years in the hospital wards.
10. Teach the patient and visitors about the spread and prevention
of infection .

7. Following activities comes under Medical asepsis
• Maintain Ventilation: Keep the unit well ventilated.
• Cleanliness: Maintain general cleanliness of wad,
equipment and disinfect as indicated.(dusting, sweeping and
mopping the unit, rinsing and washing the equipment. Maintain high
degree of cleanliness of unit and equipment.)
• Maintain personal hygiene of the patient.
• Provide clean dress and linen to the patient.
• Provide safe food and water supplies.
• Dispose of excreta and refuse properly.
• Good hand washing practice
• Use of protective devices
• Use of disinfectants

8. Surgical asepsis (maintaining sterile technique)
Surgical asepsis: means observing all those practices
that are designed to render and keep the supplies/
articles and areas free from pathogens.
Purpose: To prevent entry of pathogens into the body.
Indication: Surgical asepsis or sterile technique is
required to be maintained in
• The operating room
• Labour room,
• Major diagnostic room, or
• Various bed side procedures eg IV canulation, urinary
catheterization, suctioning tracheobronchial airway and
dressing.

9. Methods of sterilization
• Classification: There are two types of sterilization:
1. Physical methods of sterilization
2. Chemical Methods of sterilization

10. Physical sterilization
• Dry Heat sterilization
• Moist heat sterilization
• Sterilization by flame
• Boiling
• Radiation sterilization
Chemical sterilization
• Ethylene oxide
• Chlorine bleach
• Glutaraldehyde and formaldehyde
• Hydrogen peroxide

11. • Dry heat sterilization : Dry heat typically requires higher
temperatures than moist heat
• It also is less penetrating and requires longer exposure
• Nevertheless, application of dry heat is cheap and easy
• Typically one bakes materials in an oven at
• (i) 171ºC for at least one hour
• (ii) 160ºC for at least two hours
• (iii) 121ºC for at least 16 hours
Note that the length of exposure necessary is inversely proportional
to the temperature (lower temps require longer exposures)

12. • 3. Moist heat sterilization: A widely-used method for
heat sterilization is the autoclave.
• Autoclaves commonly use steam heated to 121 °C or
134 °C.
• To achieve sterility, a holding time of at least 15 minutes
at 121 °C or 3 minutes at 134 °C is required.
Precautions:
• All articles must be clean and dry.
• The wrapper and container must allow penetration of the
steam in to the article
• The drum should not be to full nor the contains arranged
to compactly.
• Cans and jars must be opened and turned to the side so
that steam can penetrate the contents.

13. Sterilization by flame
Small instruments like BCG needles and trays are
sterilized by flaming with spirit and swab.
• This technique is done when there is a shortage of
equipment and in emergency situations.

14. Boiling
• Boiling for 10 minutes will kill most of the pathogenic
organisms. But spores forming bacterias and viruses are
resistent to boiling.
Precautions:
• Emerge the articles fully in the water.
• Close the sterilizer lid tightly.
• Note the time after the water has started to boil.
• Boil it for 7-10 min.
• Remove the articles with Chittle forceps.
• Do not boil sharp instruments.

15. Radiation sterilization
• This method is expensive. But now a days it is used for
the sterilization of plastic items such as disposable saline
sets, catheters, ryles tubes, disposable syringes etc.which
will not with stand heat sterilization and sharp instrument
such as hypodermic needles and scalple blades.
• In this method the articles can be packed before
sterilization in individual sealed plastic packs, so that
there is no re contamination after sterilization.

16. Chemical sterilization
• It is also called the cold sterilization or disinfection by the
disinfectants.
• A chemical disinfectant acts by coagulating the bacterial
protein or by changing the composition of protein so that
it no longer exist in the same form.
Precautions
• The article should be thoroughly cleansed to remove
organic materials.
• Instruments soaked in germicides must be adequately
rinsed with sterile water before being used.
• The article should be fully submerged in it.

17. Assignment
• Find out common chemicals used in BPKIHS for the
sterilization of instruments.

18. Thank u