1887

Aseptic technique

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Abstract

The aim of aseptic technique is to ensure that surgery can be performed with minimal risk of contamination by microorganisms. The patient itself is a major source of contaminating organisms; however, any wound open to the atmosphere will be become contaminated and with time those contaminant organisms may colonize the wound and establish an infection. The longer a wound is open, the greater the risk of contamination and, potentially, infection. The chapter discusses Preparation of the patient; and Preparation of the surgical team.

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Figures

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16.1 Hair should be removed in a two-stage process: first clipping with the lie of the hair; a second cut against the lie of the hair to achieve the close surgical clip, but with minimal skin trauma.
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16.2 Clipper rash results from skin trauma, and traumatized skin may be colonized by bacteria. (Courtesy of S Baines)
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16.3 With repeated sharpening, the distance between the tips of the clipper guard and cutting blades reduces. The blades in have been sharpened too many times and the tips of each blade are so close together that trauma to the skin is likely. In there is still an appropriate gap between the two rows of tips.
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16.4 Rather than clipping all the hair from a foot, it can be draped out of the surgical field by the use of a sterile impervious layer and sterile cohesive bandage.
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16.6 Applying skin scrub. Using cotton wool, gauze swabs or sponges, the skin is cleaned gently, working from the site of the incision to the periphery with a circular motion.
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16.7 Rolled towels make versatile positioning aids. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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16.8 A single large drape is placed over the entire animal, fenestrated to expose the limit of the proposed skin incision. Four drapes are placed with a folded leading edge and fastened securely with Backhaus towel clips, to define the limit of the scrubbed area.
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16.9 Dedicated theatre clothing is inexpensive, helps to enforce the discipline of theatre protocols and is a valuable component of the whole aseptic technique. A theatre hat is arguably as important as a sterile gown.
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16.10 The scrubbing brush is still a valuable tool for cleaning the nails, but its role on the skin of the hands and arms is now being questioned.
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16.12 An example of mild dermatitis resulting from type IV (delayed) latex allergy.
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