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Chapter 14 Surgical Room Skills 275

FIGURE 14.39 Surgical caps and masks.

them. Careful movement within the surgery room is
vital. Always face any sterile field or zone. Never walk bet-
ween sterile fields. Keep conversations to a minimum.
When the fields are brought together in the surgical
suite, we create sterile zones. For example, when the
gloved, gowned, masked surgeon steps up to the pre-
pared patient on the surgery table and proceeds to drape
the patient, and pull the surgical pack into reach he/she
has created a sterile zone. The sterile zone is even larger
than just the physical packs, patient, and surgeon, it
extends from the shoulders of the veterinarian down to
the draped patient on the surgery table, and the entire
length of the draped patient to the open surgery pack.
Along with taking care not to touch, reach across, or
brush anything in the sterile zone, now we have to be
careful not to come between the parts of the sterile zone!
If any sterile field or even a part of a sterile zone is
compromised, everything is considered contaminated
and must be discarded or re‐scrubbed. Even if there is a
FIGURE 14.40 Holding a gauze sponge for a surgical scrub. doubt of contamination it is best to consider it contami-
nated and switch it out.
A sterile field is a single area that is prepared asepti- The reason for all of this great care is when the integ-
cally like the surgical prep on a patient and a surgeon’s rity of the skin is compromised, which occurs from the
scrubbed hands. We consider these two fields as being incision. This opens a door for contaminants to enter
“sterile”, but they aren’t really, because that would actu- easily. Nosocomial infections occur during surgical pro-
ally destroy the tissues, but they are very clean! The ster- cedures because of a break in the sterile fields or zones.
ilized packs, gloves, and suture material are devoid of These are often staphylococcus or streptococcus bacte-
organic material and so are truly sterile since they were rial infections that are very difficult to treat and can seri-
autoclaved. Each of these items are also considered ously jeopardize the health and well‐being of the patient.
sterile fields. So, we avoid reaching across, brushing At this point the surgeon is notified there is a patient
against, or touching these fields with bare hands, scrub on the table, and she/he will start their scrub. If there
tops, sleeves, and so on, in order to avoid contaminating was time, laying out their cap, mask, and booties as well