After disinfection of the skin in the surgical area, the sterilized dressing is applied.General towel method, although can play a certain role in wound isolation, but its disadvantages are: 1.(2) the wound is not closely separated from the surrounding skin.(3) repeated use of towel forceps fixed, so that the surgical towel has many holes.
In order to make up for the above shortcomings, at present, many hospitals adopt the method of adding disposable sterile surgical film (some of which contain iodide) to the incision skin, and the film still adheres to the wound edge after the skin incision, which can prevent the bacteria remaining on the skin from entering the wound during the operation.In order to reduce the contact between sterilized dressing and disinfected skin, the sterilized dressing should be pasted on the skin of the disinfected operation area by the instrumenter wearing sterilized gloves before laying the towel, and then the sterilized dressing should be covered.If the traditional surgical towel is still used, it should be properly fixed and kept dry as far as possible.
Aseptic gown is widely used in domestic hospitals and disposable dressings are widely used in foreign countries.This dressing has been manufactured in China. Due to its high cost, it has not been widely used. Some hospitals only use it for infectious surgery.If a disposable dressing is used to cover the surgical area, the towel method is basically the same.
1. Objective to cover other parts of the surgical patients except the minimal skin area necessary to expose the incision, so as to make the surrounding environment become a large range of sterile area, so as to avoid and minimize the pollution during the operation.
2. Principle of single dressing: when laying a single, it is necessary to avoid too small exposure of the incision and to minimize the exposure of the skin around the incision.Generally, there should be six layers of sterile towels around the operation area, and at least two layers around the operation area.For minor surgery, only one sterile hole towel is required.
3. Lay four pieces of treatment towels first in the single order: usually, lay the opposite of the operator first, or lay the relatively unclean area (such as perineum, lower abdomen and head), and finally lay the side close to the operator (such as abdominal surgery, lay the order of lower, opposite, upper back, this side or lower, upper, opposite and this side first).Then in the top, the bottom of the shop in a single, finally spread a large sterile drape.
4.The head end should be covered over the patient's head and anesthesia frame, both sides and the foot end should be drooping over the edge of the operating table 30cm.
5. Single berth method: take the single berth for abdominal surgery as an example
(1) the single layer (the first assistant) should stand on the right side of the patient. After the incision is confirmed, four sterile therapeutic towels should be laid around the incision (the therapeutic towel on the side near the incision should be folded 1/4, and the folded part should be downwards).
(2) the operator shall pass the therapeutic towel in order, with the first 3 folded edges toward the surgical assistant and the fourth folded edges toward the operator.
(3) the single layer covered the lower part of the surgical field with the first therapeutic towel, and then placed it on the upper part, the opposite side and the same side of the surgical field in order.
(4) four therapeutic towels were laid across the surgical field and fixed with 4 towel forceps.Avoid clamping the skin and upwarping the towel forceps when using them.
(5) the single layer and the instrumentalist stand on both sides of the operation bed respectively, and the middle layer is transferred by the instrumentalist. The middle layer is placed above and below the incision, with the cephalic side exceeding the anesthesia frame and the foot side exceeding the operation table.
(6) after placing the middle drape, the person who applies the single drape shall soak his/her hand with disinfectant for 3 minutes or rub his/her arm with a complexated iodine preparation, and then wear a sterilization operating suit and gloves.
(7) finally, lay a large open abdominal section with holes, aim the opening at the incision site, and extend the short end to the head and the long end to the lower limbs.The upper end of the bed should be expanded to cover the head and anesthesia frame of the patient. The upper end should be pressed down and the lower end of the bed should be expanded. The instrument tray and the foot end of the patient should be covered.
(8) for major surgery, pull a piece of middle drape horizontally at the side of anesthesia table.
(9) if a subcostal incision is needed, a pair of compromise drapes should be placed under the back of the waist before laying 4 therapeutic towels on the affected side.A pair of compromise drapes should be padded on each side when a transverse abdominal incision is needed.
(10) when laying the drape, both hands only touch the edges and corners of the operation drape to avoid contacting the sterile operation drape around the incision.In the shop, when big drape, want to hold a horn to cover the back of the hand inside roll, have bacterium article around in case the hand encounters, wait like anaesthetic wearing, infusion tube and be polluted.
(11) in order to prevent the first assistant from contacting the surgical drape around the incision due to the search for a single Angle when placing the large drape of laparotomy, the first assistant leaves immediately after laying the small operation drape. Generally, the surgery or other assistants wear sterile surgical gowns and gloves before placing the large operation drape
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