Sterile Technique Procedures

- Principles of sterile technique help control and

prevent infection, prevent the transmission of
all microorganisms in a given area, and include
all techniques that are practiced to maintain
sterility.

- Sterile technique is most commonly practiced

in operating rooms, labor and delivery rooms,
and special procedures or diagnostic areas.

-   All the item, mostly surgical

instruments necessary for the operation must be
prepared ahead of time. The functionality of it
must be checked before it will be wrapped and to
ensure the maintenance of the sterility. All these
items must be wrapped properly. 

- The intention of any sterilization packaging

system is to allow sterilization of the package contents, maintain sterility of contents until the
package is opened, and permit delivery of contents without contamination.

Prepare and Maintaining a Sterile Field

Sterile Field

- When performing sterile aseptic procedure, we need a sterile work area in which objects can be
handled with minimal risk for contamination. The sterile field should be prepared as close as
possible to the time of use. Sterile supplies should be opened for only one patient at a time in
the operating room.
Sterile Surgical Gloves

-       The primary purpose of surgical gloves is

to act as a protective barrier to prevent the
possible transmission of diseases between
healthcare professionals and patients
during surgical procedures.

-       Sterile gloves are worn by sterile team

members in performing all invasive
procedures. 

Appropriate Attire 

  - The evolution of special operating room (OR) attire as an adjunct to asepsis paralleled the
development of aseptic and sterile techniques in the latter half of the nineteenth century. Many
surgeons of that time continued to perform surgical procedures while wearing street clothes under
pus-and blood-encrusted aprons despite the expansion of germ theory knowledge. 

Surgical Hand and Skin Cleansing

   Surgical hand cleansing (also called the surgical scrub) is the process of removing as many
microorganisms as possible from the skin of the hands and arms by mechanical washing and chemical
antisepsis before participating in a surgical procedure. 

    The surgical hand and arm cleansing is done just before gowning and gloving for each surgical
procedure. 

APPROPRIATE ATTIRE, SURGICAL HAND

CLEANSING, GOWNING AND GLOVING

Appropriate Operating Room Attire

 Purpose of Appropriate Attire

 -To provide effective barriers that prevent the dissemination of microorganism to
patients.
-To protect personnel from blood and body substances of patients.

Components of Appropriate Attire

1. Body Cover
- A variety of scrub suits, either two-piece pantsuits or one-piece coveralls are available in
either a solid color or an attractive print.
- All should fit the body snugly
2. Head Cover
- Because hair is a gross contaminant, a cap or hood is put on before the scrub suit to protect the
garment from contamination by hair.
3. OR footwear/Shoe cover
- May be worn in the semi-restricted and restricted areas as needed to protect from blood and
fluid.
- Shoe covers can inadvertently become soiled and harbor microorganisms.
4. Mask
- Is worn in the restricted area to contain and filter droplets containing microorganisms.
- Mask should always be worn in the OR itself. Whether or not a surgical procedure is in
progress.

Operating Room Zones/Areas

 Unrestricted Areas – where street clothes are permitted. Ex. Changing Rooms
 Semi-restricted Areas – Hallways, corridors, O.R. offices, equipment & instruments’
storage rooms and staff sitting rooms.
 Restricted Areas – sterile storage room, inside operating theaters.

Personal Protective Equipment

- Personnel should be protected from hazardous conditions in the semi restricted and restricted
areas.
1. Apron
 - A decontamination apron worn over the scrub suit protects against liquids and cleansing
agents during cleaning procedures.
2. Eyewear or a face shield
- Is worn whenever a risk exists of blood or body substances from the patient splashing into the
eyes of sterile team members.
3. Gloves
- The most common type of PPE used in healthcare settings
- For patient care and other environmental services
- Clean gloves or sterile gloves

Surgical Gown

- Is worn over the scrub suit to permit the wearer to enter the sterile field.
- It prevents inter-contamination between the wearer and the field and differentiated sterile
(scrubbed) from nonsterile (unscrubbed) team members.
- Both reusable and disposable gowns, in a variety of styles are in use.

Surgical Gloves

- Sterile gloves complete the attire for sterile team members

- They are worn to permit the wearer to handle sterile supplies and tissues of the surgical site.

ANTISEPTIC TECHNIQUE

Surgical Hand Cleansing

- Is the process of removing as many microorganism as possible from the skin of the hands and
arms by mechanical washing and chemical antisepsis before participating in a surgical
procedure.
- In scrubbing, the skin is cleansed of as many microorganisms as possible.
- Also called the surgical scrub

Two Properties are Employed for Surgical Hand or Skin Cleansing

a. Mechanical – remove soil and transient organism with friction

b. Chemical – reduce resident flora and inactive microorganism with an antimicrobial or
antiseptic agent.

Gowning and Gloving

 - The sterile gown is put on after drying the hands and arms with a sterile towel, immediately
after the surgical hand and arm cleansing.
- The scrub person will do the gown before the gloves.

Gloving Techniques in two ways:

a. Closed Gloving Technique – the scrub person’s hands remain inside the sleeves and should
not touch the cuffs.
b. Open Gloving Technique – the scrub person’s hands slide all the way through the sleeves
out beyond the cuffs.

Assisted Gowning and Gloving of a Team Member

LABOR AND DELIVERY

The labor room, often known as the Labor Delivery Room (LDR), is the hospital's most

versatile place. The LDR is created to accommodate all types of deliveries. LDR can be used for
women who prefer not to be medicated or who want an epidural.

  These rooms may also manage minor crises and treatments such as forceps and vacuum
births.

To promote good labor and delivery experience, the labored mother will have to take particular
preparation : Maternal position and Perineal cleansing

1. Maternal Position  - with the exception of avoiding supine position, the mother may assume
any comfortable position for effective bearing down.
2. Perineal Cleansing - when delivery is imminent skin over the vulva, anus and upper thigh is
cleansed with antiseptic solution and draped.  

  The labored mother once reached a full cervical dilatation will be transferred to the Delivery room
for the complete expulsion of the baby. A Final perineal preparation must be done and to apply the
abdominal drape, buttocks drape and the pair of
leggings. 

Surgical Drapes

- Only sterile drapes should be used within

the sterile field. Drapes create a barrier
between the surgical field and possible sources
 of microbes. Microbial migration and contamination from nonsterile to sterile areas is
minimized by isolating the incision site and creating a sterile field with the use of sterile
drape.

     Before the abdominal drapes, buttocks and a pair of leggings will be sterilized or autoclave, it
should be folded properly to maintain the sterility of the drapes once it is open for application. 

Skin preparation will render the surgical site as

free as possible from transient and resident
microorganisms, dirt, and skin oil so that the incision can
be made through the skin with minimal danger of
infection from this source.

         This is also true to the perineal area of the pregnant

mother who is about to deliver her baby. It is important
to perform final perineal cleansing to remove normal
perineal discharges like blood and to prevent contamination of birth canal. 

DRAPING

   - is the procedure of covering the patient and surrounding areas with a sterile barrier to create and
maintain an adequate sterile field during 

   - an effective barrier eliminates or minimizes passage of microorganisms between nonsterile and

sterile areas. 

Style/Type of Drapes :

Perineal sheet/buttock drape- is of adequate size to create a sterile field within the patient's
buttocks while in lithotomy position. 

Abdominal drape - 

Leggings- leg drapes are supplied in pairs to cover

the legs of a patient in the lithotomy position. One
open edge is folded into a cuff to protect gloves from
contamination during application.