1. Institute of Surgical Research Surgical Techniques A1 Practical Modul

2. Asepsis and the surgeon 1. Dressing 2. Cap, mask 3. Scrubbing 4. Gowning 5. Gloving

3. It is forbidden to wear: -bracelets -rings -wrist-watch -nail-polish 1. Dressing Change to scrub suit, shoes/clogs worn exclusively in the operating suite or wear shoe covers

4. 2. Cap and mask Positioning the mask rightwrong

5. Correct position of the mask

6. Participation in a surgical intervention requires the implementation of the complete protocol of scrubbing and disinfection. Scrubbing has to be made according to the accepted and generally applied rules of the local surgical suite. Simple scrubbing with soap is not a disinfection! 3. Scrubbing

7. The goal of scrubbing To reduce the number of bacteria of the transient and resident flora and to inhibit their activity.

8. Scrubbing and disinfection Mechanical cleansing (3 min) 1. Cut nails and clean subungual areas. 2. Adjust water flow and temperature. 3. Wash hands and forearms to the elbows with soap. 4. Rinse hands (from fingers to the elbow). 5. Clean nails with a sterile brush and soap. It is forbidden to brush other parts of the hand! 6. Rinse hands (from fingers to the elbow). Chemical disinfection (5 x 1 min)

9. Scrubbing 1. Hand-wash with soap

10. Scrubbing 2. Hand- and arm-wash with soap

11. Scrubbing 3. Steps of rinsing the hands

12. Taking out the brush

13. Scrubbing 4. Cleansing the nails with brush

14. Scrubbing 5. Steps of rinsing the hands

15. Do not touch the basin!

16. Disinfection 1. rightwrong

17. Steps of chemical disinfection 2.

18. 4. Gowning

19. Effective „sterile” area Certain parts of the gown can not be considered sterile: a. the back and the axillaries b. lateral from the axillaries c. under the waistline d. the sleeves from the shoulders to 10 cm distance over the elbows.

20. Taking out the sterile gown right wron g

21. Gowning 2. Grasping the neck of the sterile gown

22. Gowning 3. Unfolding the sterile gown

23. This is forbidden!

24. Gowning 4. Opening the sterile gown

25. Gowning 5. Position of the arms rightwrong

26. Gowning 6. Steps of pulling the gown over the shoulders

27. Pulling the gown rightwrong

28. Fixing the sterile gown

29. Fixing the sterile gown 2. rightwrong

30. Fixing the sterile gown 3.

31. This is (again) forbidden!

32. Gloving of the left hand 1. from inside!

33. Glowing of the right hand 2. from outside!

34. The gloved hands

35. Removing the gloves

36. The operating field before the isolation of the patient

37. The operating field after the isolation of the patient

38. SURGEON 2nd ASSISTANT 1st ASSISTANT ANESTHESIA SCRUB NURSE The position of the surgical team