1. بسم الله الرحمن الرحيم

2. Dr.OSAMA AL-MUSHHADANY MRCS(ENGLAND) IRAQI BAORD PEDIATRIC SURGERY
Nineva medical college

3. Sterilizations and disinfection
Disinfection: is a process that kills or remove pathogenic M.O except spores.
Disinfectant: A chemical agent used to achieve disinfection.
The efficiency of disinfection depends on:
1- Nature and load of MO.
2- Duration of exposure to the chemical material
3- Temperature of the environment.

4. Methods of disinfection
1- Low temperature steam: dry steam at 73C° for 20 minutes at sub atmospheric pressure
2- Boiling water exposure to 100C° for 5 minutes at normal pressure.
3-Formaldehyde gas exposure in specialized cabinet at 50C°.
3-Glutaraldehyde 2% effective for heat sensitive material like flexible endoscopes, but its toxic and cause allergic reaction.

5. Sterilization: A process that destroy all form of microbial life including bacteria, virus, fungus and spores.
Methods of sterilization:
1- autoclave: specialized container supply moist steam under pressure with high temperature. Used for metal ware, glassware, rubber and dry goods. The temp and time needed are:
3  minutes  at (132°C) 8  minutes  at (125°C), 15  minutes  at (118°C).
2-Ethylene oxide: A penetrative non corrosive gas used to sterilizes heat and moist sensitive substance. 3-Irradiation:Using gamma ray to sterilize syringes, catheters, cannulas and other plastic tubes and heat sensitive objects. 4- peracitec acid: chemical agent cause protein denaturation suitable for endoscopes.

6. Some chemical solutions used for skin preparation and wound cleaning
1- Povidone iodine: Can be used to disinfect skin before operation and to clean infected wounds and ulcers. Side effect: allergy, metabolic acidosis, interfere with thyroid function test, not recommended in pregnancy, not used inside abdominal cavities.
2- Chlorhixidine: Effective against gram positive MO. Can be used to disinfect skin before operation and to clean infected wounds und ulcers.
3- Alcohol: 70% used as disinfectant to prepare skin for operation, not used for wound or ulcer.
4- Hydrogen peroxide: Week disinfectant help to flush out depress from cavities by mechanical action

7. Prevention of wound infection at patient level
1- Avoid prolonged preoperative hospital stay.
2- Control any source of infection if possible.
3- Control DM, uremia, anemia, malnutrition, electrolyte disturbance.
4-Preoperative bathing.
5-Stop smocking
5- Avoid shaving the area of operation, if this is mandatory it should be on the table.
6- Prophylactic antibiotic.
7-Early post operative mobilization and exercise.

8. Prevention of wound infection at staff level
1-Staff with focus of infection should not deal with patients.
2-Decrease number of staff in the operative theatre with less movement as possible.
3-Warring of special clothes and gowns.
4- Using the head caps , face mask and boot.
5- Hand washing
6- Warring sterile gloves during surgical procedure and usual gloves when dealing with infective focus.

9. Prevention of wound infection at operative theatre level
1- The operative theatre design and building
2- The ventilation system
3- The table, light source,
4-Anesthetic machines and equipments,
5-Suckers and electro-cauterization devices.
6- Surgical instruments.

10. Prevention of wound infection at surgical word and medical devices level
1- Surgical word devices including: beds, mattresses, pillows, urinals, surgical truly,
2-Reception and examination rooms.
3- CanulLa, IV set line, drains, tubes, blood transfusion sets.
4- The visitors.

11. thanks