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LECTION - Prevention ofLECTION - Prevention ofcontactcontact and endogenousand endogenous
infectioninfection Dr. Zeltikov AndreyDr. Zeltikov Andrey NikolayevichNikolayevich
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STERILIISATION ofSTERILIISATION of
instrumentsinstrumentsStage1 - preparation of theStage1 - preparation of the
instrumentsinstruments
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Washing solutions forWashing solutions for
instrumentsinstruments Solution ASolution A
Perhydrol 20gPerhydrol 20g
washingwashingdetergennt 5gdetergennt 5gwater 975water 975mlml
Solution BSolution B2,5% Hydrogen2,5% Hydrogen
peroxid 200mlperoxid 200ml washingwashingdetergennt 5gdetergennt 5gwater 795 mlwater 795 ml
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preparation of the Injectionpreparation of the Injection
needelsneedels
InIn Warm water and 1% sodiumWarm water and 1% sodiumhydrocarbonatehydrocarbonate
Canal - with 0,5% ammmoiumCanal - with 0,5% ammmoium Boiling in 2% sodium bicarbonateBoiling in 2% sodium bicarbonate
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STAGE 2 - package andSTAGE 2 - package andpreparation of materials forpreparation of materials for
sterilisationsterilisation
Universal package - box contains aUniversal package - box contains a
set of material for typical operatiosset of material for typical operatios/ appenndectomy,/ appenndectomy,
phlebectommy /phlebectommy /
Specific package - box contains aSpecific package - box contains aset of material for specificset of material for specificoperatios /Stomach resection,operatios /Stomach resection,
pneumonectomypneumonectomy
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STAGE 2 - packageSTAGE 2 - package
MetalMetal Containers -Containers -dressing boxes -dressing boxes -
Schimmelbusch`sSchimmelbusch`sSterilliserSterilliser
Cotton / lien/Cotton / lien/bag`sbag`s
Plastics bag'sPlastics bag's
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STAGE 3STAGE 3 -- STERILISATIONSTERILISATION
In dry heatIn dry heatsteriliser T -180 Csteriliser T -180 C
time 60 mintime 60 min
Gamma raysGamma rays
AutoclaveAutoclave 2 atmospheres2 atmospheres
T - 132,9 CT - 132,9 C Time 20 minTime 20 min
1,1 Atmospheres1,1 Atmospheres T - 120 C T - 120 CTime 45 minTime 45 min
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AutoclavingAutoclaving
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Control of sterilityControl of sterility
Direct methodsDirect methods BacteriologicalBacteriological
Indirect methods -Indirect methods -compounds withcompounds with
known meltingknown meltingpoinds: Benzoicpoinds: Benzoicacid - 120;acid - 120;resorciol - 119;resorciol - 119;
antipyrin - 110antipyrin - 110 IndicatorsIndicators
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STAGE 4 - Keeping theSTAGE 4 - Keeping the
sterilised materialssterilised materials In box can stay sterile for 3 daysIn box can stay sterile for 3 days InIn cottoncotton bag - 24 hoursbag - 24 hours
In Plastics bag's - 1 \ 50 monthsIn Plastics bag's - 1 \ 50 months
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Mechanical and physicalMechanical and physical
antisepsisantisepsis Debridement ofDebridement of
woundswounds UltrasoundUltrasound UVUV
LaserLaser drainagedrainage
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Objectives of drainageObjectives of drainage
Outflow wounds secretionsOutflow wounds secretions Control of healing woundsControl of healing wounds Introduction of drugsIntroduction of drugs
Decompression of hollow organsDecompression of hollow organs
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Types of drainageTypes of drainage
PassivePassive with strip of latexwith strip of latex with different tubes with different tubes
Active with vacuum aspirationActive with vacuum aspirationthrough a drainage tubethrough a drainage tube
Flush - ink-jet flushingFlush - ink-jet flushing
- drip flushing- drip flushing
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Principles of drainagePrinciples of drainage
The insertion of drain trough alternativeThe insertion of drain trough alternativeincisionincision
Placement in dependent areas of thePlacement in dependent areas of thedrained cavitydrained cavity
Fixation of drainageFixation of drainage
maintenance of air-tightnessmaintenance of air-tightness It not be in contact with vessels, nervesIt not be in contact with vessels, nerves
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Active Flush drainageActive Flush drainage
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Active Flush drainageActive Flush drainage
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Debridement of woundsDebridement of wounds
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Complications of drainageComplications of drainage
Microbial contamination throughMicrobial contamination throughdrainage tubesdrainage tubes
Compression and damage of theCompression and damage of theorgans and tissuesorgans and tissues
Blockage, falling out of the drainageBlockage, falling out of the drainage
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dressing changdressing changing\ing\ ASEPSISASEPSIS
OF PATIENTOF PATIENT
Hygienic hand desinfectionHygienic hand desinfection protection medical personalprotection medical personal
preparpreparaation of the patienttion of the patient
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Protective measuresProtective measures
Preparing hands before dressingPreparing hands before dressing Using of fresh (disposable) apron,Using of fresh (disposable) apron,
face mask, covering the hair, eyeface mask, covering the hair, eyeprotectionprotection
Latex, sterile glovesLatex, sterile gloves
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Wound inspectionWound inspection Wound size, depthWound size, depth
degree and nature of deposits and necrotic tissue/degree and nature of deposits and necrotic tissue/black, lathery, scab, sloghy/black, lathery, scab, sloghy/
nature of exudate /serous, bloody/ and degree ofnature of exudate /serous, bloody/ and degree ofsecretion / highly secreting, wounsecretion / highly secreting, woundd becamingbecaming
desiccated/desiccated/ Presence and nature of granulation/ noPresence and nature of granulation/ no
granulation, tissue present, pale,spongy/granulation, tissue present, pale,spongy/
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Wound inspectionWound inspection Extent of epithelial formationExtent of epithelial formation
degree of bleeding tendencydegree of bleeding tendency painfulness of woundpainfulness of wound sings of infectionsings of infection
LocalisationLocalisation Age of woundAge of wound
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Functions of the dressingFunctions of the dressing
Protection against mechanical influences,Protection against mechanical influences,contamination, chemical irritationcontamination, chemical irritation
Protection against secondary infectionsProtection against secondary infections
Protection against drying and loss electrolyteProtection against drying and loss electrolyte
Protection against loss of heatProtection against loss of heat
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Concluding tasksConcluding tasks
After dressing change, the patient isAfter dressing change, the patient isreplaced in wardreplaced in ward
The used materials are prepared forThe used materials are prepared forfinal disposal or for reprocessingfinal disposal or for reprocessing
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Frequency of dressingFrequency of dressing
changechange
Depends on the condition of the woundDepends on the condition of the woundand the characteristics of dressingsand the characteristics of dressings
materialmaterialThe dressing should be inspected and,The dressing should be inspected and,if necessary, removed promptly:if necessary, removed promptly:
If the patient complains of painIf the patient complains of pain
If the dressing is pollutedIf the dressing is polluted
If the bleeding is continuedIf the bleeding is continued
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Documentation of dressingDocumentation of dressing
Is necessary:Is necessary: - to document progress, stagnation- to document progress, stagnation
or reversal of wound healingor reversal of wound healing - to adjust to the treatment plan- to adjust to the treatment plan - to transfer information between- to transfer information between
doctors and nursing staffdoctors and nursing staff
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