1.5 Surgical Asepsis and the Principles of Sterile
Technique
SURGICAL ASEPSIS
When Is Surgical Asepsis Practiced?
Surgical asepsis is practiced in many fields of medicine, but always with the same purpose of
preventing infection. Usually, surgical asepsis is used when a foreign object is being introduced
into a patient's body, thereby opening a possible route of transmission for an infectious agent.
For example, a patient needs to have a urinary catheter. A catheter is inserted into the patient's
bladder using surgical asepsis; otherwise, the patient may develop a urinary tract infection.
Other procedures, such as wound dressing changes or certain IV therapies, also require surgical
asepsis because there is a direct opening between the outside world and the patient's
bloodstream. Lastly, and most obviously, surgical asepsis is used in surgical procedures.
However, this too can range from open heart surgery in an operating room to excision of a skin
cancer in a dermatologist's office.
Components of Surgical Asepsis
In order for surgical asepsis to be achieved, all the components involved in the procedure -
tools, work area, and workers - must be free of all microorganisms. First, equipment to be used
in the procedure must be sterilized. This is accomplished by physical or chemical sterilization.
Equipment is packaged with a date of sterilization. When it is time to open the package, the
healthcare worker must inspect the package to make sure it is intact. Any evidence of moisture
or a break in the seal means the instrument is considered unsterile. It is discarded and another
is used.
, Next, a sterile fi eld must be created, which is a work area that is free of all microorganisms. To
create a sterile field, a sterile drape is placed over a tray, upon which sterile instruments may
be dropped. Also, the patient is covered with a sterile drape to create an aseptic field in which
the healthcare providers may work.
Asepsis refers to the absence of infectious material or
infection. Surgical asepsis is the absence of all microorganisms
within any type of invasive procedure. Sterile technique is a set
of specific practices and procedures performed to make
equipment and areas free from all microorganisms and to
maintain that sterility (BC Centre for Disease Control, 2010). In
the literature, surgical asepsis and sterile technique are
commonly used interchangeably, but they mean different things
(Kennedy, 2013). 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 practised to maintain sterility.
Sterile technique is most commonly practised in operating
rooms, labour and delivery rooms, and special procedures or
diagnostic areas. It is also used when performing a sterile
procedure at the bedside, such as inserting devices into sterile
areas of the body or cavities (e.g., insertion of chest tube, central
venous line, or indwelling urinary catheter). In health care,
sterile technique is always used when the integrity of the skin is
accessed, impaired, or broken (e.g., burns or surgical incisions).
Sterile technique may include the use of sterile equipment,
sterile gowns, and gloves (Perry et al., 2014).
Sterile technique is essential to help prevent surgical site
infections (SSI), an unintended and oftentimes preventable
Technique
SURGICAL ASEPSIS
When Is Surgical Asepsis Practiced?
Surgical asepsis is practiced in many fields of medicine, but always with the same purpose of
preventing infection. Usually, surgical asepsis is used when a foreign object is being introduced
into a patient's body, thereby opening a possible route of transmission for an infectious agent.
For example, a patient needs to have a urinary catheter. A catheter is inserted into the patient's
bladder using surgical asepsis; otherwise, the patient may develop a urinary tract infection.
Other procedures, such as wound dressing changes or certain IV therapies, also require surgical
asepsis because there is a direct opening between the outside world and the patient's
bloodstream. Lastly, and most obviously, surgical asepsis is used in surgical procedures.
However, this too can range from open heart surgery in an operating room to excision of a skin
cancer in a dermatologist's office.
Components of Surgical Asepsis
In order for surgical asepsis to be achieved, all the components involved in the procedure -
tools, work area, and workers - must be free of all microorganisms. First, equipment to be used
in the procedure must be sterilized. This is accomplished by physical or chemical sterilization.
Equipment is packaged with a date of sterilization. When it is time to open the package, the
healthcare worker must inspect the package to make sure it is intact. Any evidence of moisture
or a break in the seal means the instrument is considered unsterile. It is discarded and another
is used.
, Next, a sterile fi eld must be created, which is a work area that is free of all microorganisms. To
create a sterile field, a sterile drape is placed over a tray, upon which sterile instruments may
be dropped. Also, the patient is covered with a sterile drape to create an aseptic field in which
the healthcare providers may work.
Asepsis refers to the absence of infectious material or
infection. Surgical asepsis is the absence of all microorganisms
within any type of invasive procedure. Sterile technique is a set
of specific practices and procedures performed to make
equipment and areas free from all microorganisms and to
maintain that sterility (BC Centre for Disease Control, 2010). In
the literature, surgical asepsis and sterile technique are
commonly used interchangeably, but they mean different things
(Kennedy, 2013). 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 practised to maintain sterility.
Sterile technique is most commonly practised in operating
rooms, labour and delivery rooms, and special procedures or
diagnostic areas. It is also used when performing a sterile
procedure at the bedside, such as inserting devices into sterile
areas of the body or cavities (e.g., insertion of chest tube, central
venous line, or indwelling urinary catheter). In health care,
sterile technique is always used when the integrity of the skin is
accessed, impaired, or broken (e.g., burns or surgical incisions).
Sterile technique may include the use of sterile equipment,
sterile gowns, and gloves (Perry et al., 2014).
Sterile technique is essential to help prevent surgical site
infections (SSI), an unintended and oftentimes preventable
