THE UNIVERSITY OF

DODOMA

SURGICAL NURSING I (NS 225)

Theatre technique

Mr. Gibonce kibona –University of Dodoma

07/01/2024
Introduction

2
Learning objectives
•At the of this session, the trainees will be able to show
•specific areas within the operating room
•Identify the role of each member of the operating
room team
•Discuss how environmental layout contributes to the
aseptic technique
introduction
 An operating room is a particular room
where the surgery and the surgical
procedures are conducted
 is the place/department/& its physical
environment where surgical interventions take
place
 is simply the place where invasive procedures
are conducted in a collaborative & integrated
manner with multidisciplinary health teams
Introduction
• Operating room or the theater block is one of the
important special departments of a hospital
• This is where we have to practice a high standard of
aseptic techniques and sterilization of supplies in
order to reduce the events of infection
• This unit is designed as ‘’self contained block ‘’with
a series of rooms leading of a corridor with close
doors that separates it from the general wards
Cont’d
The efficiency of the operating room
depends much upon its physical
organization and the organization of its
personnel
An intelligent design in the layout of the
operating room facilitates the efficient
movement of patients and staff and the
economical use of space
Corridors of the operation theater
should never be open b/c there is high
traffic and bacterial contamination of the
air
Design of the operating room

• Architects follow two principles in

planning the physical layout of the
OR suite:
• Exclusion of contamination
from outside the suite with
sensible traffic patterns within the
suite
• Separation of clean areas from
contaminated areas within the
suite
 Principles of operation room design
For the operating rooms, there are many different
designs
The basic design principles which are common to
all operating rooms must fulfill the following
criteria:-
The design must always be simple and easy to keep it
clean
The walls and floor of the operation theater room must
be smooth for easy cleaning
Operation rooms are usually bright and face north or
south so that they are not exposed to the sun for a long
period
 Different rooms for various purposes to prevent cross-
contamination
Design…
There should be sufficient space to
ensure the safe transportation of patients
and staff
Any cross traffic for people other than
the workers of the unit is strictly avoided
Special laundry facilities should be
provided in the operating unit
The recovery room should be near the
operating room so that patients can be
transported safely and quickly following
surgery
 Space allocation in OR
The OR suite is divided into three areas that are designated by the
physical activities performed in each area.
A. Unrestricted Area
 Street clothes are permitted
 A corridor on the periphery accommodates traffic from outside,
including patients
 This area is isolated by doors from the main corridor and
other areas of the OR suite
 It serves as an outside–to-inside access area
 Traffic, although not limited, is monitored at a
central location
unrestricted zone: area in the operating room that interfaces
with other departments;
 includes a patient reception area and
 holding area

13
B. semi restricted area
• Traffic is limited to properly attired (dressed)
personnel Body and head covering are required
this area includes peripheral support areas and
access corridors to the operating rooms
• The patient may be transferred to a clean inside
stretcher on entry to this area
• The patient‘s hair must be covered
• Semi-restricted zone: area in the operating room
where scrub attire is required; may include areas
where surgical instruments are processed
 C. Restricted Area
• Masks are required to supplement surgical
attire Sterile procedures are carried out in
this area
• The area includes the operation rooms, scrub
sink areas, and sub-sterile rooms or clean
core areas where unwrapped supplies are
sterilized
• restricted zone: area in the operating room
where scrub attire and surgical masks are
required; includes operating room and
sterile core areas
 The operating room areas
A. The Supervisor’s office: has direct access to the outside
of the operating room.
The supervisor may need to receive visitors and significant
others who are not dressed in scrub attire
B. Dressing room operating room personnel have a door to
the outside corridors so that personnel may enter there,
change into scrub attire, and go directly into the operating
room.
C. The Holding Area:-this is the area where the health care
givers properly identify the patient and make sure that all
preoperative cares are carried out and other important
data are in the patient’s chart
The operating room areas
• D. Scrub areas are located in several places close to
the operating suites. Hot and cold water pipeline
supplies, Scrub brushes, caps, soaps, and masks are
located at each scrub station.
• E. Sterilization Room:-it is adjacent to the operating
room. The room is usually equipped with boilers
(autoclaves ) for providing sterile water for solutions
and also water for the surgeon ‘s hand and to clean
instruments during surgery.
• The room should be wide enough for lying trolleys
comfortably, to reduce humidity, heat, and risk of
infection and it must be well-ventilated.
 The operating room areas
• F. Utility room a room where equipment is cleaned and
stored. Here a packing room is attached to it and if not
available the utility room must be wide enough for a dual
purpose that is to prevent contamination and humidity.
• G. The sterile supply room:-serves as a supply depot for
wrapped sterile articles. this area should be dusted
frequently with a damp cloth and have storage
cabinets with doors to minimize exposure of the supplies
to room air and dust .
• H. Supply and Storage Areas :-is a room where sterile
equipment is stored and supplied, here un sterile
equipment must not be mixed and stored .
• for extra equipment and supplies are used to store these
extra instruments and supplies are used to stores these
extra instruments and supplies for each unit .
The operating room areas
• I. The recovery room is an intensively monitored setting that
allows observation, therapeutic intervention, and observation
of the patients as they more fully recover from the effect of
the surgical procedure and anesthetics
• -It has access to the outside of the operating room for
transporting patients back to their rooms
• J. The operating suites; are rooms where surgery is performed.
• These rooms are wide enough to allow scrub personnel to
move around nonsterile equipment without their
contamination.
• Green line:- this line is a line where you can not pass before
changing the OR clothes In short, the operating room block is a
self-contained unit of the hospital of the staff and functioning.
• The operation room technique describes the methods of
routine function of this unit.
OR team members
 OR team members
• As the physical design, there is a logical division of
duties among the operating room staff
• Operating room team operating room and its
function (relationship)
• The sterile team consists of :
• -Surgeon
• -Assistant Surgeon
• - Scrub nurse
• The unsterile team includes :
• anesthesia provider (anesthetist) and its assistant
• circulatory/runner nurse
• others, such as students, cleaners, and those who may be
needed to set up and operate specialized equipment or
monitoring devices
 Responsibility of each member
Sterile team members :
wash (scrub) their hands and arms, and put
on a sterile gown and gloves the sterile field
is the area of the operating room that
immediately surrounds and is specially
prepared for the patient
To establish a sterile field, all items needed
for the surgical procedure are sterilized.
After this process, the scrubbed and sterile
team members function within this limited
area and handle only sterile items.
Responsibility of each member
• Unsterile team members; on the other hand, don’t
enter the sterile field;
• They function outside and around it.
• They assume responsibility for maintaining sterile
technique during the surgical procedure, but they
handle supplies and equipment that are not
considered sterile.
• Following the principles of aseptic technique, they
keep the sterile team supplied, provide direct
patient care, handle other requirements that may
arise during patient care, and handle other
requirements that may arise during the surgical
procedure.
Responsibilities of the surgeon

• The surgeon must have the knowledge,

skill, and judgment required to
successfully perform the intended
surgical procedure.
• The surgeon‘s responsibilities include
but are not limited to, the following
• Preoperative diagnosis and care
• Selection and performance of the
surgical procedure
• Post-operative management of care
Responsibilities of the Assistant Surgeons
Under the direction of the
operating surgeon, one or two
assistants help to :
Maintain visibility of the
surgical site
Control bleeding
Close wounds and apply
dressings
Responsibilities of the scrub nurse
• The ‘’scrubbed ‘’nurses learn how best
to work with each surgeon and other
team members as a smooth working
team.
• He/she is guided and directed
constantly by what the surgeon is doing
• This means that the scrubbed nurse
must have constant attention to the
operation field
 Roles of Scrub Nurse Before the operation
Enquire from the surgeon about the type of
incision and instruments required
Check the cleanliness of the OR
Prepare and check material for operations
Scrub, gown, and glove before surgeon
Prepare tables with adequate instruments
Help the surgeon drape the patient
Check electrical apparatus and equipment
Count swabs, and needles, together with the
circulating nurse before operating begins
Respect aseptic roles at all times
Roles of Scrub Nurse During operation

Anticipate requests from

surgeons
Handle instruments in the
correct way
Maintain order around the
surgical field and instruments
table
Roles of Scrub Nurse Between Operations:
Decontaminate, clean, and dry soiled material
Reset and repack clean equipment
Prepare drapes and towels for sterilization
Check the cleanliness and order of the operating
room between operations
Other tasks
Order, check, and restock the material
Check that the material is in sufficient quantities
and is functional
Ensure full cleaning of OR at least every month
The circulatory nurse’s duties

Before operation
Receive patient on arrival to OR
Check the patient’s card, name, consent,
type, and side of the operation
Enquire from the surgeon about any
special preparation
check and remove jewels
Check the patient’s clothes
Take the patient to the operating room
and place him or her on the table
The circulatory nurse’s duties
check electrical apparatus and
equipment
help the scrub team to gown and glove
Perform the first count together with
the scrub nurse
Count swabs, and needles together
with the scrub nurse before operating
begins
Observe asepsis rules at all times
Assist anesthetist if necessary
 The circulatory nurse’s duties During operation
Anticipate requests from the surgeon
Insert urinary catheters if necessary (with
assistant
Keep track and count swabs together with the
scrub nurse
Adjust light, diathermy apparatus, suction
machine
Promptly address requests from the scrub team
Detect and report aseptic mistakes
Help apply dressing
 The circulatory nurse’s duties After operation

participate in the safe transfer of patients

onto stretchers
Collect instruments for decontamination,
and place needles and blades in the safety
box
Clean instruments table
Participate in cleaning and re-
arrangement of the operating room
Be present from the beginning until the
end of the operation
The circulatory nurse’s duties Between operations
Decontaminate, clean, and dry soiled material
Reset and repack clean equipment
Prepare drapes and towels for sterilization
Sterilize sets and packs
Check the cleanliness and order of the operating
room
Other tasks
Order, check, and restock the material
Check that material is in quantities and is functional
Ensure full cleaning of OR at least every month
Co-operation and economical use of
hospital supplies, equipment, and time
• The team approach to care should be a coordinated
effort that is performed with the cooperation of all
caregivers
• Team members should communicate and should
have a shared division of duties to perform
specified tasks as a united body
• The failure of any one member to perform his or
her role can seriously impact the success of the
entire team
economical use….
Performing as a team requires that
each member exert an effort to
attain the common goals
competently and safely.
A. economical use of supplies and
hospital equipment Most of the
hospital equipment is being
imported from abroad and it is
costly and, therefore economical and
proper usage of it is mandatory
economical use….
As the cost of supplies and equipment
increases, the OR team members
should be conscious of ways to
eliminate wasteful practices
For example, through away disposable
items only avoid throwing away
reusable items.
The operation room is one of the most
expensive departments of the hospital
 economical use…
The following procedures should be
observed
Pour just enough antiseptic solution
Follow the procedures for draping
Do not open another packet of sutures
for the last stitch unless necessary
Supplies should be opened only as
needed, not routinely ‘’just in case ‘’
they may be needed
Turn off lights when they are not needed
 Qualities of the Operating Room Team
Prerequisites to join the operation
team
• Stamina
• Emotional stability
• Respect
• Stable health
• Good Humor
• Team spirit
 Infection prevention (IP) practices
Infection prevention (IP) practices are intended
for use in all types of healthcare facilities –from
large urban hospitals to small rural clinics
The recommended infection prevention
practices are based on the following principles :
• consider every person potentially infectious
and susceptible to infection
• washing hands before and after any procedure
is the most practical procedure for preventing
cross–contamination
Infection prevention (IP) practices
wearing gloves before touching anything
potentially infectious and wet such as broken skin,
mucous membranes, body fluids, body secretions
and execrations, or soiled instruments and other
items –or before performing invasive procedures
Using antiseptic agents for cleansing the skin or
mucous membrane before surgery, cleaning
wounds, or doing hand rubs or surgical hand scrub
Process instruments and other items that come in
contact with blood, body fluids, secretions and
excretions
Disposing of contaminated materials and
contaminated waste properly
 General preparation
Hand Hygiene
Is a general term referring to any action of
hand cleansing to maintain an infection-free
environment
Appropriate hand /washing/hygiene must be
carried out: before coming in direct contact
with patients
• Before putting on sterile surgical gloves or
examination gloves
• After any situation in which hands may be
contaminated
• After removing gloves
 Clothing
In restricted areas, staff are required to wear
hospital–laundered OR clothing (scrubs) made of
woven reusable fabric (trousers, shirt)
Fresh OR cloth attire should be worn each day
Surgical attire should be changed or removed
when it becomes soiled or wet or after a high
septic procedure
OR uniforms should be removed and deposited in a
designated container before leaving the OR
Surgical attire must be removed when leaving the
operating room (outside )and fresh ones worn on
reentry
 CAPS
Hair (including facial hair) must be
completely covered by a cap that
can be laundered by the hospital
Hair is an important contaminant
and a major source of bacteria. caps
should be removed before leaving
the OR.
 Shoes
Only OR shoes should be worn: they
must protect from liquid and sharp
items are preferred to normal shoes
OR shoes should be removed and
deposited in a designated receptacle
before leaving the operating room
Removal of shoes can transfer
microorganisms from shoes to hands;
hands should be washed after shoe
removal
 MASKS:
Masks are worn in the restricted area in the presence of open
sterile items or equipment or where contact with scrubbed
personnel is possible
Mask should cover the nose and mouth completely and
securely
Masks contain droplets expelled from the mouth and the
throat when talking, sneezing, and coughing
Masks also protect from exposure to pathogenic organisms
spread in the environment
Masks should be tied securely at the back of the head
Masks that have been worn are contaminated with droplets.
They should be removed and discarded by handling only the
ties
Handling of the mask after use can transfer microorganisms
from mask to hands: staff should wash their hands after
handling and discarding a used mask
 Jewelry
All jewelers and watches should be
removed or completely confined with scrub
attire.
These items can harbor germs that are not
removed during hand washing and can
contaminate the sterile field by
unintentional contact
It is recommended that earrings be
removed, but they can be worn if
completely confined under the hair
covering
 Fingernails and polish

Finger nails should be kept clean

and short at less than 3mm and
nail polish avoided
Other personnel protective
equipment
Eye wear provides solid side
shields (‘’OR goggles ‘’)
hands should be washed after
glove removal
 Procedure of hand washing /scrubbing
 Before entering the OR, the patient must take off
his/her clothes in the receiving area and wear a
patient gown, a cap, foot covers, and a clean bed
sheet.
Hand washing and surgical hand scrub
 Hand hygiene:- refers to hand washing, antiseptic
hand washing,
 Surgical hand antisepsis =surgical hand scrub
= Scrubbing up: mechanical hand wash with a
broad spectrum antimicrobial agents and a sterile
brush performed before surgery by the surgical
team to eliminate as many transient
microorganisms as possible
 Surgical hand scrub
 The goal of the surgical hand scrub is to
remove as much debris and bacteria as
possible from the hands and arms. the
concept of clean and dirty areas is
important to anyone attempting a surgical
scrub
 The scrub begins at the fingertips
(considered a clean area after the scrub)
and progresses in one direction to the
elbows (considered dirty)
The procedure of hand washing /scrubbing
 The surgical scrub brush is only used on nails
and not on skin to avoid some abrasion of the
skin
 Hands and arms should be held away from the
body (dirty )during the surgical scrub to
prevent contact with scrub attire (dirty)
 Hands should be held higher than the elbows
to prevent fluid from running from the elbows
(dirty )to the hands (clean) during the scrub
and drying
 This position also keeps the hands and
arms in prominent view and helps to
prevent accidental contamination by contact
with surrounding areas
 Cont’d
 Avoid splashing water
 Theoretically as a surgical scrub time,
it is suggested for two hands that
 one minute be spent on the nails
two minutes on the fingers,
 30 seconds on the palms
 30 seconds on the backs of the
hands and
 a final one minute spent on the
area of the forearm and elbow.
 That makes at minimum 5 minutes
 Equipment
Scrub sink with running water tap Sterile and reusable
nail brushes
soap (the best scrubbing agents are antimicrobial
scrub agents )
Preparation jewelry should be removed
Nails should be short, clean, and healthy
The skin of the scrubbed person should be free from
cuts and abrasions
Hair should be contained within an appropriate hair-
covering
Mask should be in place
Additional personnel protective equipment such as an
apron should be in place
 Scrubbing
i. Allow the water to run and cover the nail pick and
brush with soap, using your elbows on the soap
dispenser
ii. Clean your nails and remove any gross debris from
your hands
iii. Start by scrubbing your hands and forearms, down
to your elbows, using the WHO hand washing
procedure for the hands and a rotational action for
your forearms; this should last for at least one
minute
iv. Wash the soap from your hands and forearms by
holding up your arms with your hands elevated
under the tap, such that the water runs off into the
sink from your elbows
Scrubbing…….

iv. Repeat this procedure a further three

times, initially down to the mid-
forearm, then down to the wrists, then
just for the hands, each time lasting for
at least one minute
v. Keeping your arms elevated, dry your
hands and forearms with the sterile
towels in the gowning pack, using a
dabbing motion instead of a wiping
motion; use one towel for each hand,
before throwing them away
The procedure of hand washing /scrubbing

• Action/steps /
Open the drum that contains the sterile hand
brushes and check if the soap is ready
Turn on water tap and wet your hands and
forearms.
• 1. Take soap(1st application )
Wash and rub the lateral side of your left little
finger, then its medial side: then the lateral and
medial of each successive finger, wash the back
and the palm of your left hand the process is
repeated with the opposite hand
Steps…
• Then rub your left wrist and
forearms higher than your elbows
to anion water to drip off the
elbows.
• 2. Take soap ( 2nd application ).
• Brush only your fingernail carefully
for at least 1 minute.
• The nail brush is discarded
3. Take soap (3rd applications)
Wash and rub your left hand and wrist, then the
right side
Thoroughly rinse the suds from your hands while
holding them higher than your elbows
Turn off the water tap with the elbow
If any part of the hands pointed upward and away
from the scrub attire, to the sink, add minutes to
that area of the skin to correct the contamination
With fingers and hands pointed upward and away
from the scrap attire, the scrap person enters the
procedure room pushing the door open with
his/her back
Scrubbing cont’d
The gown and towels are packed with the towel on top
; Approach and pick up the hand – towel without water
dripping on the sterile pack or table. open and take the
sterile hand towel and dry each hand and forearm
separately
Begin drying one of your hands while half the towel
Proceed from the fingertips to above the elbows. Grasp
the unused part of the towel with your dry hand release
the wet half, and repeat the drying process on your other
hand
Try not to bring a wet (unsterile) part of the towel back to
a dry area, drop the towel
Take and put your gown on, and then put the gloves on
left hand first
 Gowning and gloving
The sterile gown is put on immediately after the
surgical scrub
The scrubbing nurse handles the sterile gowns very
carefully without on her body and slips into its
sleeves gently over her theater dress
The circulatory nurse assists by pulling the gown
over the shoulders
The gown is tied at the back by the circulating
nurse
The hands at the wrist are tied by her self so that
the cuffs of the gloves are fitted over them
Kinds of gown
Gowning ….
 iv. Gowning and Gloving
i. Take the sterile gown and gently shake
it out, taking care not to let anything
else touch it
ii. Open it up and place your hands into
the sleeves, keep your hands inside the
sleeves
iii. Ask an assistant to help pull it up over
your shoulders and fasten it up at the
back
iv. Take the right-hand glove and place it,
palm down, fingers facing your body
Gowning and Gloving…..
v. Grasp the bottom of the cuff with the
thumb and index finger of your right hand,
still inside the sleeve; grasp the top of the
cuff with your left hand (also inside the
sleeve) and pull the glove around and over
your right hand
vi. Pull gently on the sleeve of the gown to
help move your hands into the gloves and
straighten out the fingers; the sleeves of
the gown should remain over most of your
palm
vii. Repeat this technique for the left-hand
Gloving
Gloving :
Sterile gloves may be put in two
ways
⚫ closedgloving technique
⚫ open gloving technique

64
 Gloving cont…
closed gloving technique
1. lay the glove palm down over the cuff of the
gown 2.The fingers of the glove face to ward you
3.working through the gown sleeve ,grasp the cuff of the
glove and bring it over the open cuff of the sleeve
4. unroll the glove cuff so that it covers the sleeve cuff
5.proceed with the opposite hand ,using the same
technique
6.never allow the bare hand to contact the gown cuff edge
or outside glove

65
Gloving
cont….
Open gloving technique
1.pick up the glove by its inside cuff with one
hand 2.do not touch the glove wrapper with bare
hand
3. slide the glove onto the opposite hand
4. leave the cuff down
5. using the practically gloved hand ,slide the fingers into
the outer side of the opposite glove cuff
6. slide the hand into the glove and unroll the cuff
7. do not touch the bare arm as the cuff is unrolled
8.with the gloved hand ,slide the fingers under the out side
edge of the opposite cuff and unroll it gently ,using
the same technique
67
Open gloving technique

68
 Sterilization

Sterilization is defined as the process where

all the living microorganisms, including
bacterial spores, are killed.
Sterilization is an absolute condition while
disinfection is not. The two are not
synonymous.
 Heat
Heat is considered to be the most reliable method of sterilization
of articles that can withstand heat. Heat acts by
oxidative effects as well as denaturation and coagulation of
proteins. Those articles that cannot withstand high temperatures
can still be sterilized at lower temperatures by prolonging the
duration of exposure.
The action of heat:
Dry heat acts by protein denaturation, oxidative damage, and
toxic effects of elevated levels of electrolytes. The
moist heat acts by coagulation and denaturation of proteins.
Moist heat is superior to dry heat in action.
 The temperature required to kill microbe by dry heat is more
than the moist heat.
Thermal death time is the minimum time required to kill a
suspension of organisms at a predetermined temperature in a
specified environment.
Factors affecting sterilization by heat are:
Nature of heat: Moist heat is more effective than dry heat
Temperature and time: temperature and time are inversely
proportional. As temperature increases the time taken decreases.
Number of microorganisms: The more the number of
microorganisms, the higher the temperature or longer the
duration required.
Nature of microorganism: Depending on the species and strain of
the microorganism, sensitivity to heat may vary.
Spores are highly resistant to heat.
Type of material: Articles that are heavily contaminated require
higher temperature or prolonged exposure.
Certain heat-sensitive articles must be sterilized at lower
temperatures.
Presence of organic material: Organic materials such as protein,
sugars, oils, and fats increase the time required
 DRY HEAT:

Red heat: Articles such as

bacteriological loops, straight
wires, tips of forceps, and searing
spatulas are sterilized by holding
them in Bunsen flame till they
become red hot.
This is a simple method for
effective sterilization of such
articles but is limited to those
articles that can be heated to
 Flaming:
• This is a method of passing the article over a
Bunsen flame, but not heating it to redness.
• Articles such as scalpels, mouth of test
tubes, flasks, glass slides, and cover slips are
passed through the flame a few times.
• Even though most vegetative cells are killed,
there is no guarantee that spores too would
die on such short exposure.
 Incineration:
This is a method of destroying contaminated
material by burning them in an incinerator.
Articles such as soiled dressings; animal
carcasses, pathological material, bedding, etc
should be subjected to incineration.
This technique results in the loss of the
article, hence is suitable only for those
articles that have to be disposed of.
Burning of polystyrene materials emits
dense smoke, and hence they should not be
incinerated.
 MOIST HEAT:
• Moist heat acts by coagulation and denaturation of
proteins.
At temperature below 100oC:
• Pasteurization: procedure is employed in the food and
dairy industry. This method is suitable for destroying
most milk-borne pathogens like Salmonella,
Mycobacteria, Streptococci, Staphylococci, and Brucella
At temperature 100oC:
• Boiling: Boiling water (100oC) kills most vegetative
bacteria and viruses immediately. Certain bacterial
toxins such as Staphylococcal enterotoxin are also heat
resistant. Some bacterial spores are resistant to boiling
and survive;
At temperatures above 100oC:
• Autoclave: Sterilization can be effectively achieved
at a temperature above 100oC using an autoclave.
Water boils at 100oC at atmospheric pressure, but
if pressure is raised, the temperature at which the
water boils also increases.
 Sterilization
Chemical methods use gaseous or liquid
chemicals
-ethylene oxide gas is used to sterilize items
that are sensitive to heat or moisture. Its
effectiveness depends on four parameters
w/c include :
• Concentration of EO gas
• Temperature
• Humidity, and
• Duration of (gas exposure )
Glutaraldehyde 2% and formaldehyde 8%
can also be used as chemical sterilizers
 Chemical methods

ALCOHOLS:
• Mode of action: Alcohols dehydrate cells, disrupt
membranes, and cause coagulation of protein.
• Examples: Ethyl alcohol, isopropyl alcohol, and
methyl alcohol
ALDEHYDES:
• Mode of action: Acts through alkylation of amino-,
carboxyl- or hydroxyl group, and probably damages
nucleic acids. It kills all microorganisms, including
spores.
• Examples: Formaldehyde, Glutaraldehyde
 Chemical methods

PHENOL:
• Mode of action: Act by disruption of membranes,
precipitation of proteins, and inactivation of enzymes.
• Examples: 5% phenol, 1-5% Cresol, 5% Lysol (saponified
cresol), hexachlorophene, chlorhexidine, chloroxylenol
(Dettol)
HALOGENS:
• Mode of action: They are oxidizing agents and cause
damage by oxidation of essential sulfhydryl groups of
enzymes. Chlorine reacts with water to form
hypochlorous acid, which is microbicidal.
• Examples: Chlorine compounds (chlorine, bleach,
hypochlorite) and iodine compounds (tincture
iodine,iodophores
Monitoring sterilization procedures
Sterilization procedures can be monitored routinely
using a combination of biological, chemical and
mechanical indicators as parameters
Different sterilization processes have different
monitoring requirement
Biological Indicators
Monitoring the sterilization process with reliable
biological indicators at regular intervals is
strongly recommended

81
Biological
…
⚫The biological indicator types and minimum
recommended intervals should be:
steam sterilizers:- A highly resistant but relatively
harmless (nonpathogenic) microorganism called
Bacillus stearothermophilus is used to test steam
sterilizers undertaken weekly
Chemical Indicators
Chemical indicators include indicator tape or labels,
which monitor time, temperature and pressure for
steam sterilization, and time and temperature for dry-
heat sterilization
mechanical Indicators :-Mechanical indicators
for sterilizers providea visible
record of the time, temperature and
pressure for that sterilization cycle
This is usually a printout or graph from the sterilizer,
or it can be a log of time, temperature and pressure
kept by the person responsible for the sterilization
method Effectiveness
(kill or remove EndPoint
Summary microorganisms)

Decontamination Kills HBV and HIV and 10 minute soak

some microorganisms
cleaning(water only) Up to 50% Until visibly clean

cleaning (soap and Up to 80% Until visibly clean

Rinsing with water)

High-pressure steam, dry

sterilization 100% heat or chemical for
recommended time

High-level disinfection 95% (does not inactivate Boiling, steaming or

some endospores) chemical for 20 minutes

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The end