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1、有弹性锁扣的止血钳等要将其松开 Still waters run deep.流静水深流静水深,人静心深人静心深 Where there is life,there is hope。有生命必有希望。有生命必有希望2.2.灭菌方法灭菌方法高压蒸汽灭菌高压蒸汽灭菌化学浸泡消毒化学浸泡消毒煮沸灭菌法煮沸灭菌法（二）玻璃、瓷、搪瓷类器皿（二）玻璃、瓷、搪瓷类器皿注射器尽可能使用一次性的，注射器尽可能使用一次性的，玻璃注射器应将内栓抽出并与玻璃注射器应将内栓抽出并与外筒对应编号外筒对应编号1.灭菌前准备灭菌前准备洗净洗净易碎品用纱布等包裹易碎品用纱布等包裹2.灭菌方法灭菌方法高压蒸汽灭菌高压蒸汽灭菌化学消
2、毒剂浸泡消毒化学消毒剂浸泡消毒煮沸灭菌煮沸灭菌酒精火焰烧灼灭菌（大方盘等）酒精火焰烧灼灭菌（大方盘等）（三）橡胶、尼龙和塑料类制品（三）橡胶、尼龙和塑料类制品1.1.灭菌前准备灭菌前准备尽可能选用一次性制品尽可能选用一次性制品非一次性制品洗净，纱布等包好非一次性制品洗净，纱布等包好塑料制品不可高压灭菌，橡胶制塑料制品不可高压灭菌，橡胶制品不可反复高压品不可反复高压2.灭菌方法灭菌方法煮沸灭菌煮沸灭菌高压蒸汽灭菌高压蒸汽灭菌化学浸泡消毒化学浸泡消毒环氧乙烷或甲醛熏蒸消毒环氧乙烷或甲醛熏蒸消毒（四）缝合材料（四）缝合材料肠线等可吸收性缝合材料为已肠线等可吸收性缝合材料为已消毒物品。消毒物品。其余缝
3、合材料应准备足够的数其余缝合材料应准备足够的数量，可疏松地缠绕在线板上，量，可疏松地缠绕在线板上，但不可反复高压灭菌。但不可反复高压灭菌。（五）敷料、创巾、手术衣帽、口罩（五）敷料、创巾、手术衣帽、口罩广泛使用一次性制品广泛使用一次性制品止血巾、创布等可自行制作止血巾、创布等可自行制作回收使用时，应充分洗净回收使用时，应充分洗净高压蒸汽灭菌，包裹不宜大、包高压蒸汽灭菌，包裹不宜大、包扎不宜紧、排列不宜密扎不宜紧、排列不宜密FoldingofaGownforSterilizationlHoldthegownsothattheoutsideisfacingawayfromyou.lPlacethe
4、outsiderightandlefttiesintothewhitetab.Foldthegowninhalflengthwisetwicemakingsurethattheinsideofthegownisshowing.Liethegownonatableandfoldinhalflengthwiseagain.Thenfoldendtoendtwice.Thegownisfoldedinsuchawaythatthetopoftheinsideofthegownispresentedwhenthesterilepackisunwrapped.Instruments are loaded
5、 into an ultrasonic cleaner for washing prior to sterilization（六）高压（六）高压蒸汽灭菌蒸汽灭菌The proper arrangement of surgical packs for steam sterilization.All packs are oriented vertically，and a small amount of space separates the packs。0.10.137MPa121.6126.6C30minAllAll instrumentsinstruments mustmust bebe do
6、ubledouble wrappedwrapped ininlinenlinen oror specialspecial paperpaper oror placedplaced inin a a specialspecialmetalmetal boxbox equippedequipped withwith a a filterfilter beforebeforesterilizationsterilizationTheThewhitewhitestripesstripesononthethetapetapechangechangetotoblackblackwhenwhenthethe
7、appropriateappropriateconditionsconditions(temperature)havebeenmet.(temperature)havebeenmet.Color indicators are also included on theoutside and inside of equipment sterilized inpaperpackages.（七）煮沸灭菌法（七）煮沸灭菌法 非非手手术术室室条条件件下下使使用用。清清洁洁常常水水煮煮沸沸3 35min5min，去去除除沉沉淀淀，将将器器械械放放入入，第第二二次次水水沸沸后后15min15min，可可将将一
8、一般般细细菌菌杀杀死死，细细菌菌芽芽孢孢则则需需60min60min。2%NaHCO2%NaHCO3 3液液可可使使水水的的沸沸点点提提高高到到102102105C105C，并并可可防防止止金金属属生生锈锈，但但对橡胶制品有损害。对橡胶制品有损害。（八）化学药品消毒（八）化学药品消毒新洁尔灭新洁尔灭 0.1%0.1%皮肤、粘膜，浸泡器械。皮肤、粘膜，浸泡器械。0.1%0.1%新新洁洁尔尔灭灭1000ml1000ml，5g5g医医用用亚亚硝硝酸酸钠钠，用用于于长长期期浸浸泡泡器器械械。物物品品上上不不可可有有有有机机物物存存在在，不不可可与与肥肥皂皂、碘碘酊酊、高锰酸钾和碱类药物混用。高锰酸钾和
9、碱类药物混用。酒精酒精 707075%75%，浸泡器械，特别是有刃浸泡器械，特别是有刃器械，器械，30min30min以上。以上。煤酚皂煤酚皂 常用于环境消毒常用于环境消毒甲醛甲醛10%10%，金属器械、塑料薄膜、橡胶制金属器械、塑料薄膜、橡胶制 品、各种导管，浸泡，品、各种导管，浸泡，30min30min以上以上40%40%，用于熏蒸消毒。用于熏蒸消毒。聚乙烯酮碘聚乙烯酮碘0.75%0.75%，皮肤、粘膜消毒。皮肤、粘膜消毒。0.1%0.1%，口腔消毒。口腔消毒。1%1%，阴道消毒。阴道消毒。0.5%0.5%，鼻腔、咽、阴道的喷雾鼻腔、咽、阴道的喷雾 消毒。消毒。IsopropylAlcoh
10、ol(70%)ADVANTAGES:ADVANTAGES:CausesproteinCausesproteindenaturation,celllysis,anddenaturation,celllysis,andmetabolicinterruption.metabolicinterruption.Degreasestheskin.Degreasestheskin.DISADVANTAGES:DISADVANTAGES:IneffectiveagainstIneffectiveagainstbacterialsporesandpoorlybacterialsporesandpoorlyeff
11、ectiveagainstvirusesandeffectiveagainstvirusesandfungi.fungi.ChlorhexidineGluconateChlorhexidineGluconateADVANTAGES:ADVANTAGES:l lRapidactionRapidactionl lResidualResidual activityactivity isis enhancedenhancedbyrepeatedusebyrepeatedusel lLessLess susceptiblesusceptible toto organicorganicinactivati
12、oninactivationthanthanprovidoneprovidoneiodineiodineDISADVANTAGES:DISADVANTAGES:Occasionalskinsensitivity.Occasionalskinsensitivity.InactiveagainstbacterialInactiveagainstbacterialsporessporesActivityagainstvirusesandActivityagainstvirusesandfungiisvariableandfungiisvariableandinconsistentinconsiste
13、ntPovidoneIodineADVANTAGES:ADVANTAGES:l lBactericidal,Bactericidal,viricidal,viricidal,andfungicidalandfungicidalDISADVANTAGES:DISADVANTAGES:l lOccasionalskinOccasionalskinsensitivitysensitivityl lPartiallyinactivatedPartiallyinactivatedbyorganicdebrisbyorganicdebrisl lLessresidualactivityLessresidu
14、alactivitythanchlorhexidinethanchlorhexidinel lPoorsporicidalPoorsporicidalactivityactivityUSES:DuraPrepDuraPrepSuppliesafilm-formingSuppliesafilm-formingsolutionofiodophorandsolutionofiodophorandisopropylalcoholforafinalisopropylalcoholforafinalskinprepskinprepSolutioniscontainedwithinSolutioniscontainedwithinanapplicatorwhichspeedsupanapplicatorwhichspeedsuptheprepprocesstheprepprocessSolutionprovideslong-Solutionprovideslong-lasting,fast,broad-spectrumlasting,fast,broad-spectrumantimicrobialactivityantimicrobialactivity