Disinfection, sterilization and operation theater guidelines for dermatosurgical practitioners in India

Abstract

Modern day dermatologists conduct different esthetic and surgical procedures, with risk of infective complications. Hence, infection control practices need to be established in dermatological practice to minimize the risk of exogenous infections. These practices include hand washing, cleaning, sterilization, disinfection, operation theater sterilization and specifications. Proper hand washing after examination of each patient and prior to any surgery with a formulation containing alcohol alone or as a combination with other agents reduces the chances of transferring infections to and from patients. Sterilization and disinfection constitute the most important aspect of infection control. Disinfectants and disinfecting procedures vary according to the environment and equipment. Proper knowledge of different processes/agents for sterilization and disinfection is essential. Disinfectants for use in hospitals should always be freshly prepared and should be of adequate strength. Sterilization is carried out most commonly using steam sterilizers or ethylene dioxide sterilizers. The waste generated during practice is a potential source of nosocomial infections and should be treated as per the proper protocol and guidelines. Trained staff to carry out these practices is essential.

Assessment of the Various Sterilization Parameters in Ophthalmic Operating Rooms: A Microbiological Study

“…1 The sterilization of operation theatres is a topic of long term worry ever since the concept of aseptic room was put forward by Lister in 1866. 2 Among the patients undergoing various surgical procedures in operation theatres, post-surgical infection and sepsis remains one of the leading causes of morbidity.…”

How to practice dermatosurgery safely?

“…Aseptic conditions must be ensured. [9] Following universal precautions, use of protective gloves, gown, mask and glasses is important. Safe handling and disposal of biomedical waste is mandatory.…”

Is fumigation enough for air conditioning units in operation theatres and Intensive care units?

“…The OT temperature is maintained at about 20-30 0C and humidity maintained at about 60% for effective fumigation. 13 Water was sprinkled in the OT floor in order to maintain the necessary humid condition. The fumigation procedure is carried out after properly sealing the OT rooms and allowing a contact time of about 12 hours for routine cases, and of 24 hours if any gross contamination occurs during the procedure or operation of septic cases.…”

“…Detection of even a single colony of S.aureus or P. aeruginosa is considered a risk for infection. 13 The swabs collected from representative areas in the operation theatre, like the operating table at the head end, floor beneath the operating table, the overhead shadow less lamps, anesthesia trolley and the instrument trolley were inoculated in Robertson's cooked meat (RCM) media and incubated at 37°C for 5 days for detection of anaerobic organisms. After incubation, if turbidity, foul smell or blackening of meat particles was noticed in the RCM, anaerobic cultures were subsequently done on blood agar plates.…”