The principle of aseptic operation during operation is closely related to the success or failure of surgical treatment. Correct mastery of aseptic technology is the key to prevent incision infection and ensure patient safety. Everyone must fully understand the importance of aseptic operation, in order to better implement aseptic technology in all the work of the operating room. This rule, the principle of aseptic operation, must be carefully enforced by all those involved in the operation. If there is any violation, it should be corrected immediately.
1. To establish a sterile zone, all articles in the sterile zone must be sterilized. If there is any doubt, they should be replaced immediately. Articles with the following conditions should be considered as sterile and should not be used in sterile areas: 1) sterile dressings in non-restricted areas; 2) damaged or damp sterile packages; 3) sterile packages falling on the ground; 4) the effective time and effect of sterilization are uncertain; 5) suspected that sterile substances have been contaminated.
The establishment of aseptic zones should be as close as possible to the use time in order to reduce exposure and pollution opportunities.
2. The application of aseptic surgical clothing sterile surgical clothing scope is limited to the front shoulder plane below, waist plane above and sleeve. Other parts should be considered as bacterial areas. After wearing surgical clothes, the forearm should not be drooping and should be kept above the waist level. Hands should not be close to the face or crossed or placed under the armpit. Elbows should be adducted and close to the body. Since surgical clothes are considered to be bacterial below the waist level, they should not be exposed to sterile tables and paved operating tables. The principle of sterility is violated by the surgeon standing against the wall or sitting in an unsterilized place. They should not walk back and forth or walk out of the operating room. If the operation needs to be moved, it should be facing the sterile area. When transposing with another surgeon, one step back, turn around and turn back to another position. When passing in front of people wearing surgical clothes, they should keep away from each other in order to avoid collision and pollution.
3. Correct use of aseptic packages or containers Any aseptic packages and containers'edges should be considered to be bacterial. When opening packages, the four corners of the cloth should be turned over and held by hand to prevent them from slipping off the contaminated contents. Be careful not to touch the edge when using sterile substances. When the sterile zone is laid by wrapping cloth, the inner surface of the wrapping cloth is sterile, while the outer and edge of the wrapping cloth are sterile. If a sterile substance in the sterile bag is taken and the remaining sterile substance must remain sterile, it can be wrapped in the original bag, but the sterile substance in the bag must be applied within 4 hours, otherwise it must be re-sterilized.
Sterile containers are used for holding sterile dressings, instruments or liquid medicines. When opening sterile containers, the lid should be facing upward. After removing the sterile substance, the lid should be closed. When soaking disinfectants in containers, the soaking time should be written down, and other instruments should be put in the middle. The disinfection time should be recalculated.
Once the sterile solution bottle is opened, the liquid should be used up at one time and should not be retained. When pouring, the bottle mouth should be flushed, and the medicinal liquid flushing the bottle mouth should be discarded to ensure sterility and prevent impurities and glass debris at the bottle mouth.
4. The sterile range of the sterile table is sterile only above the table edge plane, but below the table edge plane, which can not keep the sterile integrity for a long time. It should be considered as sterile. Surgical nurses and itinerant nurses should not touch tablecloths below the level of sterile table margins in order to establish a safe zone. Articles falling on the edge of the operating table or below the level of the sterile table edge shall be deemed to be bacterial. Falling pipes, wires and seams should no longer be pulled up or reused. When the aseptic cloth sheet is soaked with water or blood, new aseptic sheets should be covered or replaced.
5. When contacting sterile areas, they must pass through the arms, wear sterile clothes and wear sterile gloves. Patrol nurses should clamp sterile articles with sterile holding forceps and keep a certain distance (about 30 cm) from sterile materials and sterile areas to avoid contact between sleeves and clothes and across sterile areas. Only the bottle mouth is allowed to enter the edge of sterile areas when pouring solution.
6. Reduce air pollution and maintain air purification effect. Operating room doors and windows should be closed. Personnel should walk through side doors to avoid gusts. During the operation, we should keep quiet and avoid unnecessary conversation. When coughing or sneezing, turn your head away from the sterile area to avoid droplet contamination. In order to prevent sweat dripping from the surgeon, a sweat-free belt can be added to the forehead. When inviting others to wipe sweat, the head should turn to one side so that the gauze fibers do not fall into the sterile zone. After the aseptic container is opened, it should be covered in time to reduce exposure.
7. Although the skin is disinfected, only the skin of the relatively sterile patient and the arm of the staff can be relatively sterilized after disinfection. The remaining bacteria in the pore are a threat to the open incision. Therefore, attention should be paid to the prevention of contamination.
When wearing sterile surgical clothes and gloves, hands should not touch the outside of surgical clothes and gloves. A gloved hand should not touch the patient's skin directly. All blades and instruments in contact with the skin should not be used again. During the operation, if gloves are torn or punctured by stitches or sharp instruments, they should be replaced immediately. Needles and instruments can no longer be used.
Before skin incision, sterile gauze pad was used to cover both sides of the incision, or sterile polyethylene film was used to cover the skin of the surgical field. The skin was cut through the film to protect the incision from contamination. Alcohol should be used to disinfect the incision before prolonging or suturing it.
8. When the isolation technology of contamination operation is applied to the gastrointestinal tract, respiratory tract, cervix and other contamination operations, gauze pads are used to protect surrounding tissues before opening the cavity, and the outflow contents are removed at any time. Contaminated instruments and other articles should be placed in contaminated pans and isolated. Contaminated stitches and holders should be rinsed in isotonic brine