b. Importance. Aseptic (sterile) technique is essential in an OR.
Sterile technique is of such great importance that it may be abandoned only during an
event such as cardiac arrest in a patient, in which case immediate resuscitative
procedures take precedence since the time element is vital to successful treatment
(refer to para 1-21c(1)). Even when cardiac arrest occurs, the decision to sacrifice
sterile technique is the surgeon's. The enlisted OR specialist should never abandon
sterile technique except upon order by the surgeon. Such strictness in the maintenance
of sterile technique is necessary because freshly cut, living tissue can become infected
easily. Therefore, it is essential that the OR specialist and all other members of the OR
team know the common sources of microorganisms in an OR and the
means by which these organisms reach the sterile field to contaminate it. Team
members must know how to prevent contamination of a sterile field.
c. Responsibility for Maintenance. The maintenance of sterile technique is
the responsibility of everyone having duties or even being in the OR during
an operative procedure.
(NOTE: Sterile technique cannot be maintained unless practiced by all team
Asepsis may be thought of as a chain, which is as strong as its weakest link.
d. Surgical Conscience. (Knowledge and Application of Principles of Aseptic
Technique). A "surgical conscience" is the foundation upon which the skill and
techniques employed by the OR specialist are built. He must know and apply the
principles of sterile technique. Breaks in technique may allow the entrance of infectious
organisms that the tissues cannot destroy. Even a so-called "mild" infection will delay a
patient's recovery, and a "mild" infection may quickly become a severe one. Thus, any
infection is potentially a threat to the life of a patient. The OR specialist should be
acutely aware that antibiotics are no substitute for sterile technique and should follow
the principles of such technique painstakingly. The specialist--and all other teams
members--should never be reluctant to admit a possible break in technique, even if
there is doubt about it. Any part of the sterile field, including the sterile gowns and
gloves of team members, should be replaced with fresh, sterile items if any doubt arises
as to their sterility.
e. Sources of Contamination. In order to control infection, there must be
control over the sources of contamination. Bacteria are present in the air, water, food,
man-made objects, skin, mucous membranes, nose, throat, and soil. In the OR,