This document discusses asepsis in surgery. It defines asepsis as preventing wound infection through sterile techniques and conditions. It describes routes of exogenous and endogenous infection and outlines the structure of a surgical building with zones of different sterility levels. It also discusses operating room cleaning procedures, sterilization methods including boiling and autoclaving, and the importance of surgical scrubbing in maintaining asepsis.

1. ASEPSIS IN SURGERY

2. What is the difference between these
patients?

4. ARE THESE SURGERIES?
 laparotomy, thoracotomy;
 gastrostomy, colostomy;
 laparoscopy, thoracoscopy;
 gastroscopy, colonoscopy;
 selective breast resection;
 endovascular stenting of vessels…

6. ASEPSIS
- prevention the wound from infection.
- a complex of methods and work techniques
to prevent the wound and the patient's
body from infection entering and to create
sterile conditions for surgical work with
help of organizational measures, active
chemicals, as well as technical means and
physical factors.

8. Exogenous infection:
though air (dust particles, drops of saliva,
nasopharyngeal and purulent discharge) -
airborne droplet route;
through contact (surgeon’s hands, surgical
tools, surgical dressings and linen) – contact
route;
through implantation (sutures, stents, clips…)
– implant route.

9. Endogenous infection:
trough lymph and blood (sources of chronic
infection: chronic bronchitis, chronic adnexitis,
chronic pharyngitis) - lymphogenous and
hematogenous routes;
trough contact (patient’s skin) – contact
route.

10. Structure of our surgical building:
 the1st floor: admission and diagnostic departments;
 The 2nd floor: emergency resuscitation and intensive
care unit (ICU), «clean» surgical department;
 The 3rd floor: traumatology department;
 The 4th floor: traumatology department;
 The 5th floor: «clean» surgical department;
 The 6th floor: purulent surgical department;
 The 7th floor: operation block (unit, OR).

11. Zones in the operation block:
 Zone of absolute sterility (operation theatre,
sterilization room);
 Zone of relative sterility (preoperative room,
anesthetic room and washing room);
 Zone of restricted regime (instrument room,
corridor, rooms for storage of equipment, plaster
bandages and surgical linen, rooms for medical
stuff);
 Zone of general (usual) regime (room of the chief
and head nurse, room for dirty linen and waste).

12. O.R. сleaning:
 at the beginning of the working day;
 current cleaning (during a surgery);
 after every surgical procedure;
 at the end of the working day;
 general cleaning (spring-cleaning).

13. What is the difference
between
sterilization and disinfection?

14. STERILIZATION METHODS:
1. Physical methods:
- boiling;
- autoclaving;
- dry heating (hot air);
- radiation.
2. Chemical methods:
- gas sterilization;
- sterilization with antiseptics solutions;
- plasma sterilization.

15. Cold sterilization
- sterilization when we don’t use high
temperature!!!
We don’t sterilize anything with low
temperature!!!

16. Metal drum

19. Methods of sterility control:
1. Direct method:
- bacteriological method.
2. Indirect methods (mainly in thermal methods of
sterilization – we control temperature):
- use of thermometer;
- use of a test tube with a powdery substance
having a high melting point;
- thermal indicators.

20. Surgical scrubbing