PATIENT AND SURGEON PREPARATION
Surgeons must prevent inadvertent injury or transmission of infection to their patients or to themselves. The concept of universal precautions states that all patients must be viewed as having blood-borne diseases that can be transmitted to the surgical team. To prevent this .trans- . mission, surgical gloves, surgical mask, and eye wear with side shields are required. (See Chapter 5 for a detailed discussion of this topic.) Additionally most authorities recommend that the surgical team wear long-sleeved gowns
that can be changed when they become visibly soiled (Fig. 7-17).
If the surgeon has long hair, it is essential that the hair be held in position with barrettes or other holding devices or be covered with a surgical cap. It is a major breach in aseptic technique to allow the surgeon’s hair to hang over the- patient’s face and mouth (Fig. 7-18).
Before the patient undergoes the surgical procedure, a minimal amount of draping is necessary. A sterile drape should be put across the patient’s chest to decrease the risk of contamination (see Fig. 7-17).
Before the extraction, patients should vigorously rinse their mouths with an antiseptic mouth rinse, such as chlorhexidine. This reduces the gross bacterial contamination in the patient’s mouth, which helps to reduce the incidence of postoperative infection.
To prevent teeth or fragments of teeth from falling into the mouth and potentially being swallowed or aspirated into the lungs, many surgeons prefer to place a 4 x 4 inch gauze loosely into the back of the mouth (Fig. 7-19). This oral partition serves as a barrier-so that, should a tooth slip from the forceps or shatter under the pressure of the forceps, it will be caught in the gauze rather than be swallowed or aspirated. The surgeon must take care that the gauze is not positioned so far posteriorly that it makes the patient gag. The surgeon should explain the purpose of the partition to gain the patient’s acceptance and cooperation for allowing the gauze to be placed.