The principles of asepsis are those procedures or rules applied to the prevention of infection, to ensure that a certain object or space is sterile and free of microorganisms. Aseptic refers to the absence of microorganisms or infection.
The word asepsis comes from the Greek, where the prefix"a"means"without","sepsis"means"putrefaction"and the suffix"ia"indicates quality. Therefore, it is the quality of an object to remain free of putrefaction or decomposition.
The term asepsis should not be confused with the term antisepsis, which although they go hand in hand, the latter refers to the disinfection process of an organism previously infected with living pathogenic microorganisms.
The main objective of asepsis is to reduce the risk of disease transmission in hospital centers, especially in the surgical area.
It provides all health care users with all the necessary objects and materials, in optimal conditions for their use.
How did the asepsis come about?
From the seventeenth to the nineteenth century, deaths due to systemic infections after injuries, surgical interventions or in the immediate postpartum period were very numerous.
The pattern of communication between the interior and exterior of the human body began to be felt, with the onset of fevers that normally culminated in the death of the patient.
Joseph Clarke in 1790, discovered the relationship of puerperal deaths with the poor hygiene of the precincts destined for motherhood, thus ordering the exhaustive cleaning of those enclosures.
Subsequently, Phillipe Ignace Semmelweis, noted that the rate of death from puerperal fever was directly proportional to the number of interventions where the doctor did not wash their hands previously and ordered the installation of sinks at the entrances to the operating rooms for all medical personnel.
In 1857, Pasteur He showed when studying the fermentation, that the presence of bacteria and microorganisms, and their reproduction in number, produced putrefaction.
Pasteur also discovered that the heat killed these microorganisms, and that it was only necessary to prevent new microorganisms from entering after eliminating them to avoid putrefaction. In 1867, Joseph Lister published a paper in which he proposed to clean the wounds with carbolic acid.
Principles of asepsis
The principles of asepsis are more commonly used in operating rooms, delivery rooms or when performing a procedure in the hospital bed that requires the greatest sterility possible, such as the placement of a chest tube, the taking of a central line, placement of a urethral catheter, among others.
In medicine, sterilization techniques and methods are used whenever a procedure requires the loss of the integrity of the skin, forming a gateway for microorganisms to enter the body.
The practice of asepsis, especially in surgery, requires the preoperative sterilization of the operating room and all the surgical equipment and instruments to be used, to avoid transoperative infections and the consequent protection of the wound until its definitive resolution.
To achieve this, the principles of asepsis listed below must be met:
1-All objects that are in a sterile area must be sterile. For this, it must be verified that it is properly sealed and that its sterility expiration date is in order.
2-Any sterile object, becomes a non-sterile object when touched by a non-sterile object.
3-Any sterile object whose location is below the level of the waist, is considered a non-sterile object.
4-Any sterile object or sterile field out of sight, is considered not sterile.
5-Any sterile object can become non-sterile if they are exposed for a long time in a sterile field, because they are exposed to airborne microorganisms.
6-If there is any perforation, tearing or moisture in any sterile barrier, it can no longer be considered sterile.
7-After placing a sterile field, at least 1 inch around the edge is considered non-sterile.
8-If there is any doubt about the sterility of an object, then it is considered non-sterile.
9-People consider sterile and objects considered sterile should only go with the sterile environment. Those considered non-sterile and those considered non-sterile can only pass through the non-sterile environment.
10-The skin can not be completely sterilized, so it is considered non-sterile.
11-Take care not to compromise the sterility of the sterile field, not reach objects by leaning over the field, keep non-sterile objects far from the field, and take care not to sneeze, cough or talk over the sterile field.
Just as these principles help to maintain sterility in medical surgical procedures of any kind, there are specific methods that help maintain sterility in the performance of almost any procedure in medicine, from hand washing, to the placement of gloves, the correct dress, among others.
References
- Kennedy, 2013; Infection Control Today, 2000; ORNAC, 2011; Perry et al., 2014; Rothrock, 2014. Retrieved from: opentextbc.ca
- Thomas Schlich. National Library of Medicine National Institutes of Health. Med Hist. 2012 Jul; 56 (3): 308-334. Published online 2012 Jul. Asepsis and Bacteriology: A Realignment of Surgery and Laboratory Science. Retrieved from: ncbi.nlm.nih.gov
- Alfredio Jacome Roca. National Academy of Medicine. Asepsis and antisepsis Recovered from: encolombia.com
- Francisco Cañestro Márquez, et al. TCAE in the sterilization service. Vertica Editorial. Malaga, Spain. 2007. Pg 3 - 4.
- Quirúgica asepsia. Retrieved from: en.wikipedia.org