(2) The cap worn on the head of team members should completely cover
the hair to prevent particles of dandruff or hair from falling on the sterile field or in the
(3) Infected areas are grossly contaminated. All team members should
(4) The air is usually contaminated by dust and droplets.
(a) Team members are required to wear a mask covering the nose
and mouth during an operative procedure. The mask must cover the mouth and nose
entirely and be tied securely to prevent venting. The strings should not be crossed
when tied because the sides of the mask will gap. A pliable metal strip is inserted in the
top hem of most masks to provide a firm contour fit over the bridge of the nose. This
strip also helps prevent fogging of eyeglasses. Air should pass only through the filtering
system of the mask. Masks should be either on or off. They should not be saved from
one operation to the next by allowing them to hang around the neck or by tucking them
into a pocket. Bacteria that have been filtered by the mask will become dry and
airborne if the mask is worn necklace fashion. By touching only the strings when
removing the mask, contamination of the hands will be reduced. Masks should be
changed between procedures and sometimes during a procedure, depending on the
length of the operation and the amount of talking done by the surgical team.
(b) When possible, the respiratory tract of the patient should be
isolated from the incision. In some cases, isolation is achieved by using the anesthesia
screen. This serves as a barrier between the incision and the respiratory tract.
(c) Team members should not talk except when essential. Silence is
even better than masking to reduce the number of organisms spread from nose and
(d) Team members should avoid sneezing and coughing.
(e) Persons who have colds or any active infection should be
excluded from the operating room.
(f) Main corridors are considered to be contaminated areas;
therefore, doors from corridors into the operating rooms should be kept closed. Also,
sterile items without wrappers should not be carried through corridors.
(g) Walking through and around the operating room should be kept to
the necessary minimum.
(h) All dusting should be damp-dusting with a germicide solution.
Floors should be wet-vacuumed between cases as well as at the end of the day. Dry-