Surgical environment and instrumentation
Dental implants can be placed in an operating room (OR) or in a dental practice. It is imperative that practitioners consider all surgical procedures as potentially infectious. In addition, it has been shown that it is especially important to avoid perioperative infection of the wound during surgery, when foreign bodies are implanted (Haanaes, 1990).
In the oral cavity, several sources of infection during surgery have been identified: instruments, the hands of surgeon and assistants, the air of the OR, patients’ nostrils and saliva, and the perioral skin (van Steenberghe et al., 1997).
Thus, the concepts of asepsis and sterility must be adhered to in dental implant surgery, and an OR is by far the most appropriate setting for dental implant surgeries (Fig. 31.1). Leaving aside the requirements for an aseptic environment, from an economic point of view, the transformation of a dental setting to an acceptable “operating room” requires such efforts that the profitability of the surgery is questionable. Consequently, we strongly recommend an aseptic OR being part of the dental setting if the practitioner aims to place implants on a regular basis.
The Surgical Team
- The surgeon
- The operating room nurse, who assists the surgeon during surgery
- The circulating nurse, who connects the people in the sterile field with the non-sterile area
The Operating Room
Outside the OR is a dedicated scrub area used by surgeons and nurses prior to surgery. There is storage space for common surgical supplies.
The OR is a controlled temperature and humidity environment, spacious, easy to clean and without windows. Operating fields should be cleaned before and after each surgical procedure and at the end of each day.
During surgery, the goal is to keep the operating field totally sterile for patient safety. This involves the following points.
- The door of the OR is closed during the operation.
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