Page 172 - Assurance of Sterility for Sensitive Combination Products and Materials

154 Assurance of sterility for sensitive combination products and materials

admitted for acute myocardial infarction. Diabetic patients also benefit
from close control of glucose levels because it improves the patient’s
ability to combat infection.
(6) Postoperative Normothermia
Controlling body temperature is a critical element for preventing SSI.
The body loses heat during surgery through several mechanisms: ra-
diation from tissues, heat loss through conduction caused by contact
with cool surfaces, and convection or exposure to the environment
and the temperature of IV. The temperature of the OR is usually kept
cool to minimize microbial growth as well as for the comfort of the
sterile surgical team members. Hypothermia can result in impaired
wound healing, adverse cardiac events, altered drug metabolism, and
coagulopathies.
(7) Surgical Asepsis
The surgical team must practice surgical asepsis to prevent an SSI.
Surgical asepsis is a set of specific practices and procedures performed
under carefully controlled conditions to minimize contamination by
pathogens. Although the goal is to maintain sterility, all that one can re-
alistically achieve is to minimize the bioburden that is present. One key
concept is the creation of a sterile field that is free of all microorganisms
including bacterial spores. The sterile field is maintained by ensuring
products and personnel apparel that enters the field is sterile. This is ac-
complished with sterile drapes including sterilization wraps. Any doubt
about the sterility of products/devices being used or personnel must be
resolved as quickly as possible; the assumption is that they are unsterile.
The surgical team’s mantra is “when in doubt, toss it out.”
Skin is considered unsterile and must be covered with sterile drapes,
gowns, and/or gloves. If anything unsterile (product or persons) contacts a
sterile area, then the sterile area is considered contaminated. Sterile items
out of sight or below waist level are considered unsterile because if the area
is not visible, then it is not possible to ensure that it remains sterile.
In order to maintain the sterile field, it is necessary to ensure that sterile
supplies are used, and sterile techniques are observed. The scrub technician
or nurse is responsible for maintaining the sterile field and ensuring that
proper techniques are used. Basic sterile techniques from sterile gloves be-
ing pulled up over the non-sterile gown cuff, handling of sterilized pack-
aging ensuring the contents of the package remain sterile, using aseptic
techniques to handle surgical instruments to managing the sterile and
non-sterile surgical team must occur seamlessly. Sterile gloves are required