INTRAOPERATIVE PERIOD

12 PRINCIPLES OF OR TECHNIQUE

1. All articles in the operating room are previously sterilized.
2. Persons who are sterile touch only sterile articles, persons who are unsterile touch only unsterile articles.
3. If in doubt of sterility of something, consider it unsterile.
4. Non-sterile persons avoid reaching over sterile field, sterile persons avoid leaning over unsterile field.
5. Tables are sterile only at table level.
6. Gowns are considered sterile only from waist to shoulder level, in front and on the sleeves.
7. Edge of anything that encloses sterile articles is considered unsterile
8. Sterile persons keep well within the sterile area.
9. Non-sterile persons keep away from sterile area.
10. Sterile persons keep in contact with sterile areas in a minimum.
11. Moisture may cause contamination
12. When bacteria cannot be eliminated from a field, they must be kept at an irreversible minimum.

SURGICAL CONSCIENCE – inner voice that tells us what is right or wrong.

Ø   Should be present to every member of the surgical team.

Inner voice for the conscientious practice of asepsis and sterile technique at all times.

A surgical conscience is the foundation for the practice of strict asepsis and sterile technique.

SURGICAL SCRUB – it is the process of removing as many microorganisms as possible from the hands

            and arms by mechanical washing and chemical asepsis before participating in an operation

Skin and nails should be kept clean

Fingernails should not reach beyond the fingertip to avoid glove puncture

Fingernail polish should not be worn.

No artificial nails allowed.

ASEPSIS – absence of any infectious agents and therefore it is aimed at eliminating microorganisms

            present in the surgical environment including harmless microorganisms living in the body

            surface or within.

MEDICAL ASEPSIS – prevention of pathogenic microorganism to spread

SURGICAL ASEPSIS – prevention of microorganisms to enter the patient

PREP. IMMEDIATELY BEFORE SCRUB:

1. Inspect hands for cuts and abrasions. Skin integrity of hands and forearms should be intact.
2. Remove all finger jewelry
3. Be sure all hair is covered by headgear
4. Adjust disposable mask snugly and comfortably over nose and mouth

OR TEAM

1. STERILE TEAM – team members scrub their hands and arms, don sterile gown and gloves, and enter the sterile field.

STERILE FIELD – area in the OR that immediately surrounds and is especially prepared for the

     patient. All the items in the sterile field needed for surgical procedure are sterilized, which are

     the processes by which all living microorganisms are killed.

               a. Operating surgeon
               b. Assistant to the surgeon
               c. Scrub nurse

2. UNSTERILE TEAM

               a. Anesthesiologist