Surgical asepsis, or aseptic technique, is designed to get rid of pathogenic microorganisms from areas or objects. It is also used to keep areas and objects free of microorganisms. Surgical asepsis demands more precautions than medical asepsis. Aseptic technique is commonly used in surgery, labor and delivery, in procedures that involve puncturing the skin, when the skin's layers are penetrated by surgical incisions or burns, and during procedures that involve putting objects into normally sterile body cavities. There are nine principles that must be followed to prevent microorganisms from infecting a wound during surgery.
Sterile Fields
The first principle of surgical asepsis states that all materials in a sterile field must be sterile. All objects added to your sterile field must also be sterile. If you put your hands into the sterile field, they must be covered using sterile gloving technique and the gloves should also begin in sterile packaging.
The second principle states that a sterile barrier that has been compromised by punctures, tears or moisture has to be considered contaminated. If a sterile field has been set up and it is accidentally torn, the openings can allow microorganisms to invade and contaminate.
Sterile Borders
The third principle states that once a package is opened, a 2.5 cm (1 inch) border around the edge is considered unsterile. For example, many procedures contain setup of sterile packaging that is opened before sterile gloves are applied. During this time the 1 inch unsterile border is the only section that can be touched.
The fourth principle states that tables draped as part of a sterile field are considered sterile only at the table level. Therefore the table legs, underside of the table, or any shelves below the table level are to be considered unsterile.
Sterility Questions
The fifth principle examines questions or doubts. It states that if there are any questions or doubts about an object's sterility, the object should be considered unsterile.
The sixth principle states that sterile people and objects should only come into contact with sterile fields, and unsterile people and objects should only come into contact with unsterile areas, such as the 2.5 cm border.
Movement and Range of Vision
The seventh principle states that movement around or in the sterile field must not compromise or contaminate the sterile field. While performing procedures requiring a sterile field, it is important to remember that correct sterile technique must always be followed.
The eighth principle says that anything out of your range of vision or below waist level is considered contaminated and unsterile. For instance, if an object is dropped below the waist, it is no longer sterile. The backside of the body, which is out of your range of vision, is also considered unsterile. Therefore, you should never turn your back on your sterile field and bring all tables needed in procedures up to your waist level.
Air Exposure
The ninth and last principle of surgical asepsis states that a sterile object or field can become contaminated by lingering exposure to air. While performing a sterile procedure, one should stay organized and finish the procedure as quickly as possible.
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