pengantar dan asepsis antisepsis dr yuda umm
TRANSCRIPT
Dr Yuda handaya SpB,FInaCS,Fmas
Surgery is used to both as a treatment, and as an aspect of treatment, for many conditions, including:•Physical trauma, e.g. wounds •Anatomical Abnormalities •Disorders of function •Inflammation •Ischaemia and infarction •Metabolic disorders •Neoplasia •Other abnormalities of tissue growth, e.g. cysts, hyperplasia or
Organ hypertrophy, as well as some cancers, if caught early enough •Deformity and heavy scarring. •Brain damage and nerve damage
A.OMPHALOCELE B. GASTROSCHIZIS
C.TUMOR D. ATRESIA ANI
DSTC-Indonesia 4
Unit Kolonoskopisarana, prasarana, asesori, sarana, prasarana, asesori, kolonoskopkolonoskop
ROBOTIK LAPAROSCOPI
Antiseptics (Greek αντί, against, and σηπτικός, putrefactive) are antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis, or putrefaction. They should generally be distinguished from antibiotics that destroy microorganisms within the body, and from disinfectants, which destroy microorganisms found on non-living objects. Some antiseptics are true germicides, capable of destroying microbes (bacteriocidal), whilst others are bacteriostatic and only prevent or inhibit their growth
Aseptic TechniqueThe goal of aseptic technique is to reduce the
possibility of microbial.Components of successful aseptic technique
include:Preparation of the patient Preparation of the surgeon Sterilization of instruments and supplies Appropriate surgical technique Anesthesia and intra-operative monitoring Antibiotic usage Postsurgical care Record keeping
Sterilization of instruments and suppliesAll instruments and supplies that come in contact with the
surgical site must be sterile. A number of options are available to sterilize surgical equipment and supplies.
Autoclave- Relies on pressurized steam, is extremely reliable, and cost effective. However, instruments must be durable (e.g., stainless steel) and the process is relatively slow, from 15 to 60 minutes. Instruments are typically wrapped or sealed in packs that are opened as needed on the day of surgery.
Ethylene oxide- A gaseous sterilant that requires specialized containment equipment. This is a good sterilization method for supplies that cannot tolerate high heat such as plastics and catheters. It is more costly than autoclaving and typically is performed overnight.
Cold sterilant solutions (hypochlorite, glutaraldehyde, etc.)- Generally, cold sterilants must have prolonged contact time (15 - 60 minutes) to sterilize surgical equipment. In addition, the instruments must be rinsed completely with a sterile solution like saline to prevent tissue irritation. Note: Alcohol is not a sterilant.
Hot bead sterilizer- This device is a small tabletop unit, approximately 6 x 6 x 8 inches. The appliance heats a small container of Pyrex beads to approximately 250 C and can sterilize the tips of metal surgical instruments in 10-20 seconds. It is very useful for sterilizing instruments between rodents when performing multiple surgeries.
Pre-sterilized items- Many instruments and supplies can be purchased in sterilized packaging. Such items must be used prior to the label expiration date.
Sterile gloves must be used for all procedures. Prior to donning gloves, the surgeon must scrub the hands and forearms with a disinfectant soap for a minimum of 3 minutes, followed by drying with a sterile towel.
A new pair of sterile gloves must be worn for each patient.
A cap, face mask, shoe covers and sterile gown must be worn for all survival large animal surgeries.
Preparation of the surgeon and Nurse
1) Sterile procedure for opening
2) Instruments
3) Organization
4) Secondary Pack
Revised 7/12/01
Start with a Sterile Pack
Notice the edges, pull top edge away from you first, then, pull nearest edge toward you.
Secondary Pack-Purpose, to have the minimal amount of sterile equipment so that only the tips of the instruments need to be dry sterilized-Notice the silk suture for the muscle are already pre-swaged-there are ties, plugs, syringes, 2x2’s-most importantly, a sterile trochar
Topics
Preoperatif Aseptic Techniques
Preoperative Concerns
Surgical AreasSupport AreaTwo Preparation AreasOperating AreaPostoperative AreaDisinfecting vs. Sterilization
Preoperative ConcernsInstrumentation
Disinfection of InstrumentsAlcohols Chlorine Chlorohexidines
Preoperative Concerns
Sterilization of InstrumentsPhysical Methods
Autoclave Dry Heating Ionization Radiation
Sterilization of InstrumentsChemical Methods
Gas ChlorineHydrogen PeroxideAldehydes
Preoperative ConcernsSelfScrubbing
ClothesHands and Arms
GowningGloving
TERIMAKASIH