Official Course Description: MCCCD Approval: 04/25/95
SGT254 19956-99999	LEC	2 Credit(s)	2 Period(s)
Surgical Microbiology and Bioscience
Principles of asepsis and the microbial environment related to the surgical patient. Also, handling of surgical specimens, thermoregulatory devices and the multiple, simultaneous events that establish the integrity of surgical wounds. Prerequisites: Admission to the program or permission of instructor.

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MCCCD Official Course Competencies:
SGT254   19956-99999	Surgical Microbiology and Bioscience

1.	Define specific terminology related to identification of microorganisms. (I)
2.	List the major flora from the different anatomic regions of the human body. (II)
3.	Describe the clinical signs of infected or contaminated wounds. (III)
4.	List methods of preventing endogenous contamination of surgical wounds. (IV)
5.	Describe antibiotic propylaxis related to target organism, antibiotic selection and duration of therapy. (V)
6.	Define principles of wound or cavity irrigation. (VI)
7.	Define universal precautions and describe the principles. (VII)
8.	Identify situations requiring special sterility confirmation. (VIII)
9.	Describe the immunocompromised patient. (IX)
10.	Describe the multiple, simultaneous events that reestablish the physical and physiologic integrity of surgical wounds. (X)
11.	Explain the relationship between laboratory tests and the management of the surgical patient. (XI)
12.	Describe the care and handling of surgical specimens and the surgical first assistant's role. (XII)
13.	Describe the intraoperative care of patients with single or multiple organ failure. (XIII)
14.	Explain the principles of fluid, electrolyte, acid-base, and nutritional balances in the surgical patient and the therapies that may be needed during the perioperative period. (XV)
15.	Describe the indications for and complications of thermoregulatory devices. (XIV)
16.	Describe reportable preoperative, intraoperative, and postoperative conditions of the skin. (XVI)

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MCCCD Official Course Outline:
SGT254   19956-99999	Surgical Microbiology and Bioscience

I. Terminology A. Gram's stain B. Acid-fast stain C. Dark-field microscopy D. Culture and sensitivity E. Other II. Normal flora A. Skin B. Oral cavity C. Respiratory passages D. Gastrointestinal tract E. Urinary tract F. Genitalia G. Other III. Recognition of wound sepsis A. Signs of inflammation 1. Erythema 2. Heat 3. Edema 4. Pain B. Cellulities C. Abscess D. Contamination with foreign debris E. Perforated viscus F. Sudden, massive wound contamination IV. Preventing endogenous wound contamination A. Skin 1. Plastic adherent drape 2. Skin towels 3. "No touch" technique 4. Care of penetrating wounds B. Gastrointestinal 1. Owel technique 2. Closed anastomosis V. Antibiotic prophylaxis A. Indications B. Target organisms C. Antibiotic selection D. Route of administration E. Duration of therapy F. Growth of resistant organisms VI. Wound/cavity irrigation A. Rationale for irrigation B. Types of irrigants C. Methods of irrigation D. Side effects E. Contraindications VII. Universal precautions A. Indications and rationale B. Methodology C. Hepatitis B immunization D. Other VIII. Special sterility confirmation A. Implants B. Transplants C. Other IX. Immunocompromised patients A. Altered immune response and susceptibility to sepsis B. Opportunistic pathogens C. Special precautions D. Implications for prophylaxis E. Other antimicrobial therapy X. Wound healing A. Methods and materials B. Tensile strength C. Cosmetic scar D. Types of wound healing 1. First intention 2. Second intention 3. Third intention E. Surgical techniques F. Necrosis G. Systemic patient factors H. Wound disruption XI. Tests and patient management A. Diagnosis of surgical diseases B. Preparation of patient 1. General tests 2. Specific tests C. Assessment of operative mortality and morbidity risk D. Intra operative testing E. Diagnostic tests for follow-up F. Lab reliability XII. Care and handling of surgical specimens A. Types B. Care factors C. Surgical first assistant's role XIII. Management of the critically ill patient - organ failure A. Special needs of the critically ill 1. Factors 2. Expectations B. Assessment of the patient's clinical status 1. Acute crisis 2. Intraoperative care problems XIV. Thermoregulatory devices A. Patient conditions requiring hypo/hyperthermia B. Procedures for hypo/hyperthermia C. Complications XV. Fluid, electrolyte, acid-base and nutritional balances A. Normal and pathologic balances B. Assessing status in a perioperative patient 1. Hydration 2. Electrolyte 3. Acid-base C. IV replacement therapies D. Methods of blood replacement E. Methods of reducing fluid overload XVI. Skin Assessment A. Preexisting skin conditions B. Skin reactions 1. Prepping agents 2. Pressure 3. Stretching 4. Heat 5. Cold C. Body's reaction to hematoma D. Reporting and documenting skin changes

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