OR Basics: The sterile field

July 20, 2010 by Lisa McCallister

Or, "How to Stay Out of Trouble in the Operating Room.”

OR Basics: The sterile field

Joseph Lister, a British surgeon, established the founding principles of aseptic technique in the journal Lancet in 1867. Before then, surgeons did not wash their hands before operating or disinfect their surgical instruments. (Shudder.) In case you’ve ever sat up late at night pondering the origins of the word “Listerine,” you'll be glad to learn it's named after this important surgeon.

Fast forward to today. Surgeons now scrupulously defend against infections by strict adherence to modern aseptic technique. Although we know much more about how to prevent infections, the battle against microbes is ongoing. The Centers for Disease Control estimate that hospital-acquired infections occur in about 1 percent of the 27 million surgical procedures performed each year. Annually, about 8,000 patient deaths result from such surgical site infections.

If you become a sales representative in the operating room, you will have to undergoing training in OR protocol, so that you will not create havoc in the operating room by contaminating the sterile field.

Here are a few basics:

  1. The sterile field is the designated area which is "free of bugs that can infect people"
  2. The sterile field can include can include surfaces, instruments, even people. Once a surgeon, tech or nurse is “scrubbed in” (hands washed, adorned in sterile garb), then he or she is part of the sterile field. This means if you touch them, you compromise sterility
  3. The sterile field has a vertical dimension that is important to be aware of, as is illustrated so nicely in this picture. This means the “air space” above the sterile areas should not be violated. Doing so, for example by reaching over a tray of sterile instruments, could ignite World War III — or at a minimum make everyone in the operating room very grumpy with you.

One thing should be abundantly clear by now: Contaminating the sterile field is a sure way to get on the wrong side of surgeons and surgical staff.

Some advice for staying out of trouble: