Asepsis

Asepsis - system of measures, aimed at prevention of hit of bacteria in the wound. Destruction of bacteria in the wound - task antiseptics. Means of asepsis and antisepsis are different, but they complement each other, thus achieving a single goal - to prevent infection of wounds. The tasks of the upgrades include disinfection of objects in contact with the surface of the woundand the protection of wounds from contact with objects that could not be freed from germs. The rules of asepsis should be observed when conducting operations, as well as all therapeutic and diagnostic procedures, where there is a risk of introducing bacteria into the tissues or organs (injections, injections, puncture, catheterization and other
The main links in the system upgrades are: 1) correct the content of the surgical dressing unit (see); 2) sterilization of materials and tools; 3) preparation of the surgeon, his assistants and the operating sisters for the operation; 4) preparation of the patient for surgery.
The bacteria can get into the wound in two ways - exogenous and endogenous. Exogenous path: from the air with dust, with liquid drops, splashes of saliva and mucus when talking, coughing, sneezing (droplet infection), through the items concerning wounds (contact infection), through the items left in the wound intentionally (sutures, drainages, tampons) or accidentally (thread gauze, gauze balls or napkin) - implant infection. The source of endogenous infection of wounds is the patient's body: the germs can enter the wound and the surrounding skin, or out of deep-lying organs (intestines, bronchi , etc.,) at operations on them. In addition, the possible penetration of bacteria in the wound by transferring them via lymph or blood vessels from distant from wounds foci of infection (carious teeth, tonsillitis etc).
The main method of preventing bacteria in the wound air and droplets is the correct device operating and dressing, and compliance with medical staff of the rules of conduct. On the degree of contamination of the air in the operating room and dressing judged by results systematically conducted bacteriological research. During operations and dressings are prohibited conversations. Before the operation of all parties involved in it need to take a shower, put on a special light cotton clothes, Slippers, cap, mask. Mandatory systematic wet cleaning operating and dressing.
In preparation for surgery must be followed in a specific order - the first operation is preparing operating sister. She wears a mask, processes hands (see hands Processing), puts on a sterile gown (with nurses) and then rubber gloves (as no one method of treatment of hands does not ensure their sterility during operation), then putting on of sterile table sterile instruments, suture material, linen.
The surgeon and his assistants handle hand, using sisters wear sterile gowns, gloves, and proceed with the treatment of the operative field (see), and then protect him sterile linen.
Visitors and spectators in the operating room must be in caps, masks, gowns, Shoe covers. They should take place prior to the operation. Walking in the operating and conversations during the operation is invalid. If the operating working on two or more operating tables, the tables must be placed in such a way that working on those teams do not interfere with each other and did not violate the rules of aseptics. No one except the operating sisters, should not take place between the operating table, with the sterile materials.
Dressings and surgical linen used only after appropriate processing them in the autoclave, surgical instruments, suture material, various devices, surgical needles - only after processing on special rules (see Sterilization surgery). Control over the sterility of the above items is done by systematically conducted bacteriological research. Responsibility for sterility bears operating sister.
Prevention of endogenous infection of a wound is to identify sites of infection in a patient, preparing for elective surgery. Planned the operation should be delayed, if the patient has increased body temperature, there furunculosis, tonsillitis, carious teeth or other pockets of purulent infections.
If near the surgical field or therein are infected areas, such as decaying cancerous ulcer, intestinal fistula , and so on, they carefully fenced off sterile napkins from the line of incision, stick with plaster, sometimes sew and only after a thorough treatment of the operative field to perform surgery.
If the surgeon during the operation has polluted hands, he should again to edit them to change the gown and gloves, as well as linen around the wound and only after that to continue the operation.
In the postoperative period the band or the label on the operating wound in her soaking should be immediately changed, because when soaking her wound it ceases to protect the wound, and under it there are conditions for the development of infection.
Preparation of the patient for operation - see the Preoperative period.
Careful observance of rules of aseptics minimizes the number of purulent complications as in planned and emergency surgical intervention.

Asepsis (from the Greek. aseptos - not rot; synonym bashniistroy method is a method of preventing infection by preventing the penetration of pathogens in the wound tissue or body cavity during surgery, dressings
and other therapeutic and diagnostic manipulation. Asepsis, and as an antiseptic (see), provides for the use of the same means of chemical and physical influence on microflora, but their fundamental difference lies in the fact that asepsis is aimed to prevent the introduction of pathogens and antiseptics - to deal with an already established microbes.
The main element of asepsis - sterilization (see). The lack of microbes on the tools, materials, etc. in contact with operating or other wound, introduced into the tissue, hollow organs and so on, it will prevent contact and implant infection. A. includes a number of techniques of treatment with sterile and non-sterile objects, rules of conduct timely surgical procedures, as well as a system of measures designed to minimise the possibility of penetration of microbes air, drip or endogenous ways (see the Surgical dressing unit, Bandages, Surgical operation). Aseptic method is the most important pillar of modern surgery. A. mandatory in cases where the intervention is carried out on "the tissues that already contains microflora, as a violation of asepsis threatens penetration of pathogens, more dangerous than the already established (e.g. the pathogen faces, anaerobic superinfection), or worsen the course of the wound process (Bact. pyocyaneum). So the rules A. "festering" operating (dressing) shall be followed as strictly as p "clean". Violations A. when "clean" operations will certainly lead to an increase in the frequency of postoperative suppurations. If the wound is already contaminated or cannot completely prevent pollution, the asepsis combined with an antiseptic effect on the wound of the surrounding tissue (deep antiseptics) or on the body in General (chemotherapy). Antibiotics is the most reliable tool that can compensate for the disruption A. inevitable in some heavy interventions (for example, resection of the stomach, intestine, esophagus, radical surgery for pulmonary suppuration and others). However, reliance on such compensation may not justify disregard of rules and methods A.