This document provides an overview of basic concepts in pediatric surgery. It discusses asepsis and antisepsia, which aim to prevent the introduction of foreign microorganisms into areas that will be surgically breached. Proper surgical attire and techniques are outlined to maintain sterile conditions. Steps for proper hand washing and the use of sterile materials are also reviewed.

1. CONCEPTOS BÁSICOS EN
CIRUGÍA PEDIÁTRICA
R1P María Fernanda Capetillo
Izquierdo
HRX “Dr. Luis F. Nachón”

2. CONTENIDO
Asepsia y Antisepsia: Conceptos y técnicas
Los procesos de Reparación y regeneración tisular
Estados preoperatorio, transoperatorio y postoperatorio

3. ASEPSIA Y ANTISEPSIA: INTRODUCCIÓN
● ASEPSIA  “Impedir el ingreso de vida microscópica extraña a los
sitios donde se abrirá una brecha temporal en las barreras de
defensa”
● 1874 por Pasteur con instrumental estéril
● Lawson Tait limpieza rigurosa y lavado de manos sistemático
● Consolidacion de técnica quirúrgica en siglo XX
● Terrillon y Terrier en Paris combinaron asepsia y antisepsia para
técnicas en quirófano
● Von Bergman y Halsted  uso de guantes esteriles

4. ASÉPSIA
Elementos que permitan que la intervención quirúrgica sea un procedimiento sin
gérmenes que puedan infectar la region a operar
ACTITUD ASÉPTICA:
Personal que domine
el concepto de
esterilidad
bacteriologica
División de funciones:
Cirujano, 1º y 2º ayudante
 grupo estéril
Todo el grupo debe usar
lavado quirúrgico

5. pRESENTACIÓN DEL PERSONAL
Aséo personal, uñas cortas, no esmalte, postizos, no joyeria, no ingresar con
ingeciones agudas, no heridas (quemaduras o lesiones abiertas)
pIJAMA
QUIRÚRGICA
GORRO Y
CUBREBOCAS
CALZADO Y
BOTAS
PROTECCIÓN
FACIAL
● Exclusiva para
quirófano
● Lavado previo
● Preferir colores
claros
● Gorro de tela
● Cabello
recogido
● Cubrebocas
(método de
aislamiento)
● Calzado
comodo y
lavable
● Exclusivo de
quirófano
● Botas
quirúrgicas
● Mascarillas y
escudos
faciales
● Salpicaduras
de productos
orgánicos

6. BULTOS ESTÉRILES Y SU MANEJO
Instrumentos esterilizados previamente, previo recibimiento con lavado
meticuloso. Se recibe empacado y rotulado.
ABERTURA DEL
BULTO DE ROPA
Externo no estéril
CAJAS METÁLICAS/
CONTENEDORES
BULTOS DE MATERIAL
PLASTICO
PAPEL GRADO MÉDICO

7. LAVADO QUIRÚRGICO
Flora bacteriana
Eliminación de capas corneas externas,
estratos inferiores con flora residente, bacterias
en glándulas y foliculos, flora se desprende con
la piel, transpiracion favorece
Tiempo de lavado
Lavado de 10 min, lavado de 5 min con
Yodóforos y lavado con Triclosán sin cepillo 3
min.
Lavado de manos
Arrastrar flora transitoria, disminuir flora
residente. No uso de cepillos agresivamente.

8. tÉCNICA DE LAVADO DE MANOS
Duracion 5-10 min con jabón antiséptico sin secuencia / metodo UNAM 10 min con
patron anatómico
1. Verificar
presentación
3. Limpiar uñas,
enjuagar con las
manos hacia
arriba
2. Abrir agua,
enjuagar 5 cm
arriba del
pliegue de codos
y lavar
4. Cepillo con
jabon, cepillado
anatómico 3
tiempos uñas-
codo
6. Mantener
manos arriba,
codos
flexionados
5. Dejar caer
cepillo en lavabo

9. OTRAS TECNICAS DE LAVADO DE MANOS

10. Practice Problem-Solving
Big problems
Mercury is the closest planet to
the Sun and the smallest one in
the Solar System
20%
Small problems
Venus is the second planet from
the Sun. It’s hot and has a
poisonous atmosphere
80%

11. SOLUCIONES ANTISÉPTICAS

12. Practice Problem-Solving
Creativity
Neptune is far away
from Earth
persistence
Mars is full of iron
oxide dust
initiative
Venus is the second
planet from the Sun
Analysis
Saturn is composed
of hydrogen
Respect
Jupiter is the biggest
planet of them all
listening
Earth is the third
planet from the Sun
Put limits
Mars is actually a
very cold place
Team work
Mercury is a very
small planet
Problem
solving
skills

13. Practice Problem-Solving
Trial-And-Error
Venus has a beautiful name and is
the second planet from the Sun
Creative
Thinking
Mars is full of iron oxide dust, which
gives the planet its reddish cast
Brainstorming
Mercury is the closest planet to the
Sun and the smallest of them all
Common
methods

14. Practice Problem-Solving
play
Saturn is
composed of
hydrogen
and helium
Teach
Mercury is
the smallest
planet in the
Solar System
Read
Jupiter is the
biggest
planet of
them all
Ask
Earth is the
only planet
with live. We
all live there DIY
Venus is the
second
planet from
the Sun

15. Practice Problem-Solving
How can you figure out the level of the problem?
People
Earth is the
beautiful planet
where we all live
danger
Venus is the
second planet
from the Sun
time
Jupiter is the
biggest planet of
them all
Solution
Mercury is the
closest planet to
the Sun

16. Practice Problem-Solving
When you need to ask for help, here are some people you can count on at school
teacher
Venus is the second
planet from the Sun
Nurse
Neptune is far away
from Earth
My friends
Jupiter is the biggest
planet of them all Custodian
Mars is actually a
very cold place
Principal
Earth is the third
planet from the Sun
Helping
people

17. Practice Problem-Solving
Don’t forget you have problem solving tools available
Ignore their
attitude
Ask a grown
up for help
Walk away
if nothing
works
Ask “what is
wrong?”
Say “please
stop!”
Apologize
Problem
solving

18. Practice Problem-Solving
Example of contingency map
when This
happens…
I react in a
helpful way
Positive
outcome
I react in a
hurtful way
Negative
outcome

19. Practice Problem-Solving
How to help your kids learn problem-solving skills
Let them explore
Venus has a beautiful name and is
the second planet from the Sun
Have Playtime
Mercury is the closest planet to the
Sun and the smallest of them all

20. Practice Problem-Solving
Helpful behavior sort cards
talk to a
grown up
about it
ask
someone to
teach you
try to find a
solution
slow down
and try
again
take a walk
or a break
think about
what makes
you happy
try to be
flexible
about it
think about
something
else
talk to a
friend
How to use
thESE cards:
When you have a
situation to solve, you can
read these cards to
inspire you to resolve it

21. Practice Problem-Solving
yell about
the
situation
Not wanting
to find a
solution
try to
ignore your
emotions
Have really
angry
reactions
punch a
classmate
blame
everyone
Make faces
have
negative
thoughts
Crying and
not wanting
to try
How to use
thESE cards:
When you have a
situation, you can look
at this cards to see how
certain reactions might
hurt you or other people
Hurtful behavior sort cards

22. Practice Problem-Solving
You have a problem and you now realize you act wrongly. Use this sheet to figure out
how you can do better by coloring the circles. To paint them, double click to select
the circle and go to the fill color pot in the tool’s bar above and choose yellow
What can i do
to solve it?
Next time i
will…
What
happened?
You can describe the
situation here
Take a break
Ask for help
Be kinder
Use my words
Fix what I broke
Do something nice
Give space
Apologize

23. Practice Problem-Solving
If you have been in a situation where someone hurt you, then you can use this slide
to practice how you can put some limits in conflict situations by selecting each
prompt and writing your own
I feel… When you… Can you…?
You can describe your
feelings here
You can describe the
situation here
You can describe how
you want to avoid this to
happen again

24. Practice Problem-Solving
Your friend
took your
workbook
Handle it myself tell an adult
Your friend
hit you on
your arm
You got
glue on
your hands
Someone
stole your
drawings
Your friend
took your
workbook
Read the situations and answer if it is a situation you can handle easily or if you
need an adult for it by dragging the cards below in their corresponding cell

25. Practice Problem-Solving
Ask him if he is gonna use it much longer
Take it from him without saying anything
Just leave and choose another color
Cry until he gives it to me
Which one is the best solution for this situation? "You need the green marker, but
your friend is coloring with it." Answer by dragging the check circles to the right
answer and the unchecks circles (x) to the wrong ones

26. Give space
Ask for help
Practice Problem-Solving
Read the solutions and paint green the correct answer by selecting the answer
with double click, then finding the fill color pot in the tool’s bar and choosing green
Apologize
Big problem
Small problem
Big problem
Small problem
Big problem
Small problem

27. Practice Problem-Solving
big problem
Small problem
Your friend is using your pencil
Read the situations and paint them according to their size by selecting the answer
with the mouse, then find the fill color pot in the tool’s bar and choose the color
Your STOMACH HURTS!
SOMEONE CALL YOU “MEAN”
You lost your favorite toy

28. Practice Problem-Solving
Read the phrases on your left, answer them on the text box below them and then
think of two possible solutions for each of them on your right
1. You can write your solution here
2. You can write your solution here
A problem i have a
lot is…
You can write your
problem here
1. You can write your solution here
2. You can write your solution here
A problem i have
sometimes is…
You can write your
problem here

29. Practice Problem-Solving
Read the problem examples and then answer how that would make you feel if that
happened to you by selecting the text next to the problem and writing your answer
Problem example How i would feel
Your pet run away from home You can write your answer here
Your mom is away for 3 weeks You can write your answer here
You have too much homework to do You can write your answer here
You have fallen at recess and have
an injury
You can write your answer here

30. Behavior helpful hurtful
You invited someone to
play with you
You were mean to other
kids at school
You made a mistake
and start yelling
Practice Problem-Solving
Analyze the behaviors and paint them green if it is a helpful behavior or red if it is
hurtful. You can paint them by selecting the cell you want to color, going to the fill
color pot in the tool’s bar and choosing green

31. Practice Problem-Solving
Read the behaviors on the left, and answer how it would make you feel if you acted
that way and how it'd make others feel by selecting the text below of each column
and writing your answer instead
Behavior
How it makes
me feel
How it makes
others feel
You punched a
classmate
You can write your
answer here
You can write your
answer here
You apologized for
what you did
You can write your
answer here
You can write your
answer here
You took away
someone else pencil
You can write your
answer here
You can write your
answer here

32. Practice Problem-Solving
Read the situations and answer the questions by selecting the card you want to
color, going to the fill color pot in the tool’s bar, and choosing green
Kevin was talking to
Sarah about his trip,
but she wasn't paying
attention, so he left
her alone
yes No
Do you think Kevin’s
reaction matches the size
of the problem?
Laura wanted to play
with the toys but
timmy was using them,
so she hit him and
took the toys
yes No
Do you think Laura’s
reaction matches the size
of the problem?

33. Practice Problem-Solving
Read the situations and check the ones that are helping behaviors by dragging
them from the white box on the left to the empty box next to the situation
Ask someone to
teach you how
to do it
blame everyone
but you
Cry and yell
about it
try to find a
solution

34. Practice Problem-Solving
Read the responses to the situations and answer if it is a problem solver o blamer
response by selecting the answer with the mouse, then finding the fill color pot in
the tool’s bar and choosing green for “problem solver” and red for “blamer”
“My friend
make me
push him”
Problem solver
Blamer
“I know i’ve
acted
wrongly”
Problem solver
Blamer
“Let’s share
this toy”
Problem solver
Blamer
“It’s not my
fault. I had
a bad day”
Problem solver
Blamer

35. Practice Problem-Solving
A great way to solve a problem is to apologize when we have acted wrongly
towards the other person. To use these cards, select the text under each prompt to
write what you are sorry for and your future solution in the card below
I’m sorry for…
You can write
what you are sorry
for here
Next time I will..
You can write
what you are sorry
for here
I’m sorry for…
You can write
what you are sorry
for here
Next time I will..
You can write
what you are sorry
for here
I’m sorry for…
You can write
what you are sorry
for here
Next time I will..
You can write
what you are sorry
for here

36. Practice Problem-Solving
Read the cards and paint them green if it is a good solution and red if it is a bad
one. You can paint them by selecting the card you want to color, going to the fill
color pot in the tool’s bar, and choosing green or red
Ask someone
to teach you
how to do it
Not trying to
find a
solution
yell about
the
situation
think about
what makes
you happy
blame
everyone
talk to a
friend
take a walk
or a break
talk to a
grown up
about it

37. Practice Problem-Solving
Answer what you need to solve the problem by dragging the correct icon from the
white box to the circle to complete the answer
You are at recess
and want to play You need

38. Practice Problem-Solving
What do you need to solve these situations? Answer by selecting the card you
want to color, going to the fill color pot in the tool’s bar, and choosing green
You went outside but
it’s raining a lot
You are making a
chocolate cake
You are going to a
friend’s party

39. Julia wants to
read something
Practice Problem-Solving
Read the solutions and paint green the correct answer by selecting the answer
with the mouse, then find the fill color pot in the tool’s bar and choose green
What does she need?
What should SHE do?
You can write your answer here

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