SRG 130 Aseptic Technique

1
SRG 130Aseptic Technique

• Disinfection
• Lecture 130 -3

2
S. Weir Mitchell

• He alone has lost the art to live who cannot win
  new friends.

3
Text

• Surgical Technology Principles and Practices, 4th
  Edition, Fuller,
• Chapter 8

4
Objectives

• Trace the development of sterilization techniques
• Identify the principles and procedures related to
  disinfection
• Distinguish between disinfection and
  sterilization
• Analyze the factors and variables of disinfecting
  agents
• Contrast and compare disinfecting agents

5
Ancient Times

• The Bible- Moses
• Rome- Aristotle
• Middle Ages- Girolamo Fracastorius
• Contributions to the advancement of
  sterilization- Surgical Technology for the
  Surgical Technologist Chapter 7 Page 131

6
Disinfection

• Process by which most but not all pathogenic
  microorganisms on inanimate surfaces are
  destroyed
• Suffix static refers to a process of controlling
  or inhibiting growth
• Bacteriostatic
• Suffix cidal means to destroy or kill
• Bactericidal
• Sporicidal
• Virucidal
• Germicidal

7
Goals of Terminal Disinfection

• Reduction in the bioburden created by surgical
  intervention
• Prevention of cross-contamination
• Prevention of nosocomial infection in the
  subsequent surgical patient
• Prevention of employee exposure

8
Process

• Confine
• Contain
• Reduce/eliminate

9
Classification of Patient-Care Equipment

• Category I Critical Items (High Level)
• Must be sterile
• Category II Semi critical Items (Intermediate
  Level)
• Come in contact with mucous membranes or skin
  that is not intact
• Category III Noncritical Items (Low Level)
• Come in contact with intact skin

10
Factors When Choosing a Disinfecting Agent

• Microbe resistance to chemicals
• Level of cidal action and their mechanism of
  destruction
• The nature of the microbe contamination
• Requirements of the cleaning agents vary
• Kill time
• Porosity of the surface/material
• Method of application
• Temperature
• Surface tension

11
Selection and Use of Disinfectants

• Most common is liquid disinfectant
• Selection is based on the result required
• Factors that affect a disinfectants activity
• Concentration
• Bioburden present- must clean and dry first
• Water hardness and pH
• Temperature of the solution

12
Precautions and Hazards

• Because of the toxicity of the disinfectant, the
  following precautions always should be exercised
• Store in well-ventilated rooms and their
  containers kept covered
• PPE
• MSDS
• Use measuring device and dilute correctly
• Do not mix
• Dispose of properly

13
Disinfectant Chemicals

• Alcohol
• Ethyl (grain) and isopropyl (rubbing)
• Water soluble
• Bactericidal, TB, virucidal, and HIV
• Optimum ability occurs at 60-70 dilution
• Corrosive to surgical instruments, plastic and
  rubber, and lens
• Can be used as an antiseptic
• Highly flammable and volatile

14
Halogens and Halogen Compounds

• Chlorine compounds
• Sodium Hypochlorite- Household bleach
• Broad-spectrum
• Limited in use because of corrosiveness to metals
• Deactivated in presence of bioburden
• Blood spills
• Do not mix

15
Halogen Compounds

• Iodophors/iodine-based compounds
• Oxidizes to kill TB, viruses, bacteria and fungi
• Corrosive to metal and stain fabrics
• Organic soils, hard water and heat inactivates
  them
• Should be replaced daily

16
Formaldehyde

• Formalin, 37 solution in water (8)
• Bactericidal, TB, fungicidal, virucidal, and
  sporicidal
• Preservation of tissue specimens
• Rarely used as high-level disinfectant agent
  because of toxicity

17
Glutaraldehyde

• Cidex- 2
• Widely used high-level disinfectant
• Sporicidal, bactericidal, and virucidal
• Safe to use on instruments
• Requires prolonged exposure and rinsing x3
• Sterilant- 10 hours
• High level- 20 minutes
• All items must be dry and free from bioburden
  prior to placement
• 14 or 28 day shelf life with daily testing
• Must be used with a ventilation hood

18
Ortho-Phthaldehyde

• Cidex OPA (non-glutaraldehyde)
• High-level disinfectant
• 12 minutes
• Rinse 3 times with fresh water each time
• 14 day shelf life
• Test daily

19
Phenolics

• Carbolic acid in detergent form
• TB, fungicidal, virucidal, bactericidal
• Disinfectant for low-level only
• Follow directions for dilution
• Caustic to skin
• PPE
• Isopropyl alcohol neutralizes

20
Quaternary Ammonium Compounds

• Quats- benzalkonium chloride and dimethy benzyl
  ammonium chloride
• Fungicidal, bactericidal, and pseudomonacidal
• Sensitive to environmental conditions
• Not as an antiseptic
• Do not use with a sponge or gauze

21
Physical Means

• Boiling Water
• Ultraviolet irradiation