PREPARATION OF THE SURGICAL TEAM
Surgical personnel are a major cause of microbial contamination during surgery. Careful preparation of the surgical team and nonsterile personnel reduces the number of bacteria in the surgical suite but does not eliminate them.
Since there is correlation between the number of people, their movement and the number of airborne bacteria in a surgical suite, if it is possible, surgical room personnel should be reduced to only those essential for anesthesia and surgical support.
Everybody who is entering the operating room suite should be appropriately clothed, regardless of whether surgery is in progress. To minimize microbial contamination from operating room personnel, should wear scrub clothes rather than street clothes (picture 1).
Picture 1. Scrub clothe
Nonscrubbed personnel should wear long-sleeved jackets over their scrub clothes.
Any footwear that is comfortable can be worn in the surgery area. Shoe covers should be donned when first entering the surgical area and should be worn when leaving it to keep shoes clean.
Picture 2. Shoe covers
Hair is significantly carrier of bacteria so it should be completely covered with surgical cap. Masks should cover the mouth and nostrils (picture 3). Major function of mask is to filter and contain droplets of microorganisms expelled from the mouth and nasopharynx during talking, sneezing and coughing.
Picture 3. Wearing cap and mask
The surgical scrub is a procedure for cleaning the hands and forearms to reduce the number of bacteria that come in contact with the wound through scrubbed personnel during surgery.
All sterile surgical team members perform a hand and arm scrub before entering the surgical suite.
Of the commonly used surgical hand scrub solution, chlorhexidine gluconate has the greatest residual activity and persistence. Combining an alchocol preparation with chlorhexidine gluconate is the most effective means of reducing microbial counts.
Once the scrubbing has been started, nonsterile items cannot be handled. When the scrub has been completed, the hands and arms should be dried with a sterile towel.
Total scrub time is 2 3 minutes per hand and arm.
Gowns serve as a barrier between the skin of the surgical team member and the patient. They are available as disposable (single use) or reusable.
Gowns are folded so that the inside of the gown faces outward. Once you take gown, do not shake it because this increases the risk of contamination.
When you wear gown keep your hands within the cuffs. Have an assistant pull the gown up over your shoulders and secure it by tying neck ties and tying the inside waist tie. If a sterile-back gown is used, do not secure front tie until you have sterile gloves on hands (picture 4).
Picture 4. Securing front tie
Glowing can be preformed:
b) open method
Picture 4. Assisted gloving
Maintaining sterility during surgery
Once gowned, the surgical team members should always face the sterile field and should not touch or lean over a non-sterile area. Also should avoid changing the position level. The arms and hands should remain above waist and below shoulders levels. The arms should be clasped in front of the body, above waist.