Which of the following constitutes a break in sterile technique while preparing a sterile field for a dressing change?
A. Using sterile forceps, rather than sterile gloves, to handle a sterile item.
B. Touching the outside wrapper of sterilized material without sterile gloves.
C. Placing a sterile object on the edge of the sterile field.
D. Pouring out a small amount of solution (15 to 30 ml) before pouring the solution into a sterile container.
Correct Answer: C. Placing a sterile object on the edge of the sterile field.
The edges of a sterile field are considered contaminated. When sterile items are allowed to come in contact with the edges of the field, the sterile items also become contaminated. The sterile field should be prepared as close as possible to the time of use.2 The sterility of supplies used during a surgical procedure can be affected by the events taking place within the operating room, and the length of time the items have been exposed to the environment.
Option A: Under no circumstances should sterile and nonsterile items/areas be mixed since one contaminates the other.4 Sterilization provides the highest level of assurance that all instruments, sutures, fluids, supplies, and drapes are void of microorganisms.2 The sterility of a package is determined by events, not by time. To ensure sterility, all sterile items need to be inspected for package integrity and sterilization process indicators, such as indicator tape and internal chemical indicators, prior to introduction onto the sterile field. If a package has been compromised, it should be considered contaminated and not be used.
Option B: When opening wrapped supplies, the nonsterile person should open the top wrapper flap away from them first, then open the flaps to each side. The last wrapper flap is pulled toward the nonsterile person opening the package. This technique of opening a wrapped package ensures that the nonsterile person does not reach over the sterile item inside. All wrapper edges should be secured to prevent flipping the wrapper and contaminating the contents of the sterile package or field.
Option D: Only the top rim of the bottle top and bottle contents are considered sterile once the cap has been removed from the bottle. Therefore, when sterile fluids are dispensed, the entire contents of the bottle must be poured or the fluid remaining in the bottle discarded. When solutions are poured onto the sterile field, they should be poured slowly to prevent contamination and fluid strikethrough from splashing.