Principles of asepsis in healing, medicine and the operating room

The principles of asepsis are the aspects that generally must be considered in the medical or nursing context to maintain asepsis, which is defined as the absence of infectious organisms such as bacteria, fungi, viruses and any other type of microorganism that can cause disease.

The knowledge and management of these principles is of utmost importance for professionals in the human and animal health sciences, since they have to do with the preservation of the life of patients, especially those who are subjected to surgical interventions of any kind. nature.

The skin is the largest organ in the human body and the same can be said to be true for most vertebrate animals. This covers the skeleton, muscles and other organic systems of the body, therefore it represents an important barrier against different types of potential infections.

Article index

• 1 Why are the principles of asepsis so important?
• 2 Objectives
• 3 Principles of asepsis to heal a wound
• 4 Principles of medical aseptic cleaning
• 5 Principles of asepsis in surgery
• 6 How to maintain or achieve asepsis?
• 7 Asepsis vs. antisepsis
• 8 References

Why are the principles of asepsis so important??

During surgery, childbirth or wound healing, incisions are usually made in the skin that expose the innermost layers of the skin and, in many cases, also other internal organs of the body, which become more vulnerable to contamination. and infectionssepsis), which could have serious implications for the patient's health.

The good practices of the qualified personnel who participate in these procedures can greatly prevent the development of infectious conditions that represent important risks for those who undergo surgery, and it is for this reason that the principles of asepsis are so important.

goals

The main objectives of these principles are:

• Prevent the introduction of potentially pathogenic microorganisms into body cavities and other susceptible places in the body
• Prevent the transmission of potentially pathogenic microorganisms from the medical / veterinary staff to the patient or vice versa

Principles of asepsis to heal a wound

The following are the principles that a nurse or doctor should follow when caring for a wound:

• From the center to the periphery.
• From top to bottom.
• From head to toe.
• From distal to proximal.
• From clean to dirty.
• Inside out.

Cleaning principles of medical asepsis

The following 5 principles are defined by many professionals such as principles of medical asepsis or the principles of cleaning technique, that seek to control, prevent or reduce the transmission of microorganisms from one patient to another or between the treating person and the patient, but not necessarily applied during a surgical intervention.

1. Identify which objects and / or surfaces are dirty
2. Identify which objects and / or surfaces are clean
3. Identify which objects and / or surfaces are sterile
4. Keep dirty, clean and sterile things separate
5. Remedy any contamination immediately

Here it is important to clarify that "clean" is not the same as "sterile". Cleaning consists of reducing part of the microorganisms that may be on an object or any surface, whether in the clinical field or not. So something "clean" has few microorganisms.

Sterility refers, on the other hand, to the removal of any type of microorganism that may be on an object and / or surface. In theory, something “sterile” has been subjected to different processes to completely eliminate all microorganisms from it..

Principles of asepsis in surgery

In the surgical context, however, only 4 principles of asepsis are handled, also known as the principles of sterile technique, because special care is taken to know:

1. Identify which objects and / or surfaces are sterile
2. Identify which objects and / or surfaces are not sterile
3. Keep sterile and non-sterile objects and / or surfaces separate
4. Remedy any contamination immediately

How to maintain or achieve asepsis?

A large number of patients acquire infections during their stay in some hospital spaces, which is generally due to contamination caused by the misconduct of the personnel in charge of their care..

Some of these infections can be very dangerous, and this is the reason why there are different conditions that must be taken into account when maintaining asepsis in a given space, especially when it is in a surgical context. We can summarize some in the following list:

• Properly sanitize your hands and use gloves at all times (they must be sterile in the case of a surgical context).
• Always try to maintain sterility, identifying what is sterile and separating it from what is not..
• Make sure to use sterile implements when handling any part of a patient's body during surgery, as the operating room staff and the tools they use should be a source of contamination for the patient.
• Constant hygiene, especially when switching between different patients outside the operating room (during consultations, check-ups, wound cleaning, etc.).
• The personnel who care for any patient must use the appropriate protective equipment and under strict conditions of sterility, especially if it is an environment dedicated to a surgical intervention..
• Maintain the environment around the patient in the most sterile conditions possible, making sure to correctly define the limits of the sterile space.
• Recognize and identify what could be the sources of environmental contamination for the patient during the intervention, in order to avoid any opportunity for infection.
• When sterility is lost, for whatever reason, it is important to quickly recognize where the “sterility break” occurred and carry out the necessary procedures to remediate the contamination as soon as possible..

Asepsis vs. antisepsis

It is important to distinguish between two closely related, but at the same time different, concepts: asepsis and antisepsis..

As mentioned above, the asepsis is the condition of the absence of pathogenic or potentially infectious microorganisms, and the principles of asepsis are all the techniques and procedures that must be carried out in order to prevent contamination with these microorganisms.

There is another very similar term, antisepsis, which is related to the removal of transitory microorganisms through disinfection, which means that preventive methods are not used, but rather that these microorganisms are present and must be eliminated in order to maintain the health of the patient or to "recover" asepsis.

Thus, asepsis principles could then be defined as prophylactic or preventive methods, rather than as remediation or decontamination. in situ, Well that's what antisepsis is about.

References

1. Crow, S. (1994, April). Asepsis: a prophylactic technique. In Seminars in perioperative nursing (Vol. 3, No. 2, pp. 93-100).
2. Denton, A., & Hallam, C. (2020). Principles of asepsis 1: the rationale for using aseptic technique. Nursing Times, 116(5), 40-42.
3. Deutschman, C. S., Hellman, J., Roca, R. F., De Backer, D., Coopersmith, C. M., & Research Committee of the Surviving Sepsis Campaign (2020). The surviving sepsis campaign: basic / translational science research priorities. Intensive care medicine experimental, 8 (1), 31.
4. Dockery, G. D. (2012). Aseptic techniques. In Lower Extremity Soft Tissue & Cutaneous Plastic Surgery (pp. 53-68). WB Saunders.
5. Faller, N. A. (1999). Clean versus sterile: a review of the literature. Ostomy / wound management, 45 (5), 56-60.
6. Foster, C. E., & Campbell, J. R. (2019). Basic Principles of Infection Control. In Healthcare-Associated Infections in Children (pp. 3-16). Springer, Cham.
7. Humes, D., & Lobo, D. N. (2005). Asepsis, antisepsis and skin preparation. Surgery (oxford), 23 (8), 297-298.
8. Schlich T. (2012). Asepsis and bacteriology: a realignment of surgery and laboratory science. Medical history, 56 (3), 308-334.