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 operating room and the
means by which these organisms reach the sterile field to contaminate it. Also, 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 operating room during
an operative procedure. Sterile technique cannot be maintained unless practiced by all
team members. Asepsis may be thought of as a chain that is as strong as its weakest
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 the principles of
sterile technique and he must apply them. 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 there is no substitute for sterile technique and he
should, therefore, follow the principles of such technique painstakingly. The specialist,
and all other team 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 operating
room, there are specific sources of possible contamination that are a constant threat to
an open incision. They should be recognized as such and controlled. These sources
(1) Members of the operating room team (their dress, breath, skin, etc.).
(2) The patient.
(3) All items used in the wound and on the sterile setup.
(4) Dust in the air.
(5) Other personnel in the operating room.