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    Surgery Practical Solutions

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    mininobitashizuka

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    © All Rights Reserved
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    Surgery Practical Solutions

    Uploaded by

    mininobitashizuka
    3 views30 pages

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    3 views30 pages

    Surgery Practical Solutions

    Uploaded by

    mininobitashizuka

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    : SOLUTIONS :

    Prashant Parmar
    Definitions:-
    Sterilization :-

    The complete destruction or removal of all


    viable microorganisms which includes
    spores and viruses from….
    • instruments & equipments
    • surfaces
    • medium
    Autoclave
    • Autoclave :
    is a process (method) of sterilization by
    saturated steam under high pressure.

    (above 100' C temperature)

    (safe, reliable, most accepted & widely used)


    Autoclave
    • The principle is based on the fact that with
    increasing the pressure, the boiling point of the
    water is increased.
    (temp is directly proportional to pressure)
    e.g.
    • 132’C to 134’C (30 lb / in2) 3-5 min.
    • 126’C (20 lb / in2) 10 min.
    • 121’C (15 lb / in2) 15 to 20 min.
    • 115’C (10 lb /in2) 30 min.
    • 105.5’C (5 lb /in2) 45-60 min.
    Definitions:-
    Disinfection:-
    A process used to reduce the number of viable microorganisms on
    a object or surface but may not necessarily inactivate some
    viruses and bacterial spores (rarely destroy all
    microorganisms or spores)
    – should only be used on heat sensitive items or equipments
    (e.g. endoscope)
    – disinfectant or germicide is a chemical agent.
    Properties:-
    – bactericidal or bacteriostatic
    – sporicidal
    – viricides
    – fungicides
    Definitions:-
    • Disinfectant :- (inanimate)
    A chemical agent which can deactivate &/or
    destroy the microorganism from inanimate
    objects/surfaces

    Antiseptic :- (animate)
    A chemical agent (usually bacteriostatic) that can
    be safely applied to the skin or mucous
    membrane. (Living tissue).
    Definitions:-
    Asepsis :-
    • A technique of preventing excess of organisms
    into the patient’s uninfected tissues.

    Antisepsis :-
    • The term indicates the prevention of infection
    usually by inhibiting the growth of bacteria in
    wound or tissues.
    1. Spirit:
    • Skin antiseptic (inj. , Stitch wound,
    - Ethanol 70% painting, surro. ulcer)
    • Alcoholic Hand Wash
    • Emergency disinfection of
    3-5 min surgical instruments in vicinity to
    the patient.
    • To disinfect oral /rectal
    • Disrupting cell thermometers
    membrane (wall) &
    denaturing bacterial • To disinfect–external surfaces of
    proteins and so bacteria equipments eg. stethoscopes,
    destroyed. manual ventilation bags,
    *Bacterial spores X ventilators, cardiopulmo.
    resuscitation manikins.
    1. Spirit:
    • Advantages. • Disadvantages.

    - It is volatile & so - Severe irritation


    Evaporate rapidly
    leaving treated - Poor penetrative power & their
    surfaces dry. activity is lower in presence of
    - It is non staining proteins.
    - Rapid action, killing - Flammable – cool & well-
    vegetative bacteria, ventilated areas
    M. tuberculosis & many - Rubber & plastic – swell, harden
    fungi, & inactivating & discolor
    lipophilic viruses.
    - Tonometer tips- damage tips
    - Cheap
    corneal opacity
    - Easily available
    - *Bacterial spores X
    2. Povidone Iodine

    Povidone Iodine •
    Surface Disinfectant
    2% - 15min •
    Topical Antiseptic
    5% - 2-3 min •
    Surgical Scrub
    7.5% - 1 min. &
    10% - ½ to 1 min.
    •
    Low Conc. Mucous membrane
    antiseptic
    ( 2%, 5%, 7.5%, 10% ) Sol .
    n
    • Instrument tray, head rest, hand
    • Disruption of bacterial protein piece etc.
    & nucleic acid synthesis/structure • Thermometers, endoscopes,
    . Hydrotherapy tanks etc.
    • Scolicidal agent
    • Effective Gram +ve,-ve Bacteria,
    Fungi, Viruses, Spores &
    Protozoa. (Soln., powder, ointment,
    shampoo & vaginal pessary)
    It’s action persists as long as
    its color persist.
    2. Povidone Iodine

    • Advantages. • Disadvantages.
    - Microbicidal - Discolor the skin
    - Film forming - Skin reactions
    - Safe - Inactivated by organic
    matters
    3. Savlon

    • Detergent-Disinfectant-
    • Chlorhexidine Gluconate
    Antiseptic
    7.5 % w/v
    • Cleansing & Disinfection of
    •Cetrimide 16%w/v surgical Equipments.
    • Isopropyl Alcohol 6.8% v/ • Storage of previously
    v
    sterilized Instruments
    • ? Disinfection & Prolong
    Reduces surface tension & Storage of Thermometer &
    damage cell wall membrane. Cheatle Forceps
    ( of microorganisms) • Scolicidal agent
    3. Savlon

    • Advantages.
    - Can safely apply to raw areas & MM
    - Detergent-Disinfectant- Antiseptic

    - Disadvantages.
    - Skin reactions
    - Growth of Pseudomonas
    - Soppy & viscid
    4. H2O2 6%, 20 volume

    H2O2 30 min  It is an antiseptic &


    cleansing agent

     Destroy anaerobic
    • Production of
    organisms
    destructive hydroxyl
    free radicals - which  Very diluted form is
    attack on membrane used in ear syringes
    lipids, DNA, & other to remove wax & FB
    essential cell
    components  To remove blood
    stains from clothes.
    4. H2O2 6%, 20 volume
    • Advantages.
    - Kills anaerobic organisms
    - Frothing – brings out debris from the depth of the wound.
    - Heat – stops capillary oozing (Local Thermo coagulation).

    • Disadvantages.
    - Irritant.
    - Can not used in limbs in DM & PVD.
    - Poor penetrability & weak transient action.
    - Loses potency on keeping open, hence has a restrictive use.
    - It has a Photo-oxidative property, hence stored in amber
    colored bottle
    H2O2
    5. Gluteraldehyde 2% (Cidex)

    Gluteraldehyde 2% • Metal Instruments


    10 -30 min
    • Face masks
    • Alkylation of sulphydryl, • Plastic endotracheal
    hydroxyl, carboxyl & amino tubes
    groups of micro-organisms
    • Polythene tubing
    which alters RNA,DNA &
    protein synthesis • Rubber tubing

    • Anesthetic tubing
    Complete sterilization → 10
    Hrs
    5. Gluteraldehyde 2% (Cidex)
     Scopes
    Gluteraldehyde 1. Upper GI & Lower GI
    2% 2. Bronchoscopes

    10-30 min 3. Urethroscopes/ Cystoscopes

    4. Pharyngoscopes

    5. Otoscopes

    6. Laparoscopes

    7. Colposcope

    8. Arthroscopes

    9 . Endoscopes
    No deleterious effect on lenses and
    cement.
    5. Gluteraldehyde 2% (Cidex)

    • Advantages.
    - Heat sensitive instruments.
    - No deleterious effect on lenses and cement.
    - Best disinfectant with rapid action
    - Effective even in presence of protein.

    - Disadvantages.
    - Irritant
    6. Glycerine Solution
    7.Eusol (edinburgh university sol.)
    8. Mgso4 Crystals
    • Hygroscopic effect
    • Reduce the oedema
    All
    The
    Best

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