Sterile Procedures
LESSON 2: Medical asepsis
2-1
2-1. GENERAL
Asepsis is the condition of being free from disease-producing microorganisms. Aseptic technique implies all those procedures that reduce or eliminate pathogens and their actions or minimize their areas of existence. Confusion sometimes results from erroneously thinking that medical asepsis and surgical asepsis are the same except one is used on a medical ward and the other is used in a surgical ward. This is not so. Some of the differences between medical aseptic technique and surgical aseptic technique are listed below.
a. Definitions.
(1) Medical asepsis. All of the procedures used to protect the patient and his environment from the spread of infectious organisms.
(2) Surgical asepsis. All of the procedures used to sterilize and to keep sterile any objects or articles that are to be introduced into a wound or body cavity or that is to penetrate the skin.
b. Emphasis.
(1) Medical asepsis. Cleanliness (freedom from most pathogenic organisms).
(2) Surgical asepsis. Sterility (freedom from all microorganisms).
c. Purpose.
(1) Medical asepsis. To reduce the transmission of pathogenic organisms from patient to another person.
(2) Surgical asepsis. To prevent introduction of any organism into an open wound on the patient or into a body cavity.
d. Isolation.
(1) Medical asepsis. Patients with a communicable disease are separated from the rest of the patients by room, ward, or unit.
(2) Surgical asepsis. Patients requiring surgery are taken to the operating room of the hospital.
e. Zone.
(1) Medical asepsis. A zone about the isolation unit is established as contaminated. Everything within the zone of isolation is contaminated. Nothing goes out of the zone without being disinfected or wrapped in a clean cover to permit handling in a clean zone.
(2) Surgical asepsis. A zone about the site of operation or wound is established as a sterile field. Once a sterile article touches an unsterile article, it is contaminated (unsterile). Only sterile articles are brought into the sterile field.
f. Handwashing.
(1) Medical asepsis. Hands and forearms are washed for 1 to 2 minutes to remove surface contaminants and soil. Hands and arms are dried with paper towels.
(2) Surgical asepsis. Hands and forearms are scrubbed for 10 minutes to reduce the bacterial count on the skin surface. Hands and arms are dried with a sterile towel.
g. Gowns.
(1) Medical asepsis. Clean gowns are worn to protect the worker. Inside of gown is clean; outside of gown in contact with patient and his environment is contaminated.
(2) Surgical asepsis. Sterile gowns are worn to protect the patient from the worker. Outside of gown that is in contact with the sterile field must be kept sterile.
h. Status of Patient.
(1) Medical asepsis. Reservoir of infection.
(2) Surgical asepsis. Potential host (other people and environment are reservoirs of infection).
i. Goals.
(1) Medical asepsis. Confine disease organisms and prevent spread to others.
(2) Surgical asepsis. Reduce number of organisms and prevent spread of infection to others.
