Sterilization Secrets: Sterilizing Surgical Instruments

In the vast galaxy of surgery, complete sterility is a top priority. The threat of infection, old foe, can be completely eliminated by stringent and effective sterilization methods. "Sterilization Secrets" reveals no secrets, only basic facts and good habits assuring patient safety and successful surgery.

What Could Possibly Be Hiding Itself: Microbial Contamination

Surgical instruments, when not sterilized, can harbor a number of microorganisms such as bacteria, viruses, and fungi. Contamination of a surgical wound by the disease agents would prove lethal, slow in healing, costly, and, in the worst case, eventually be detrimental to patient lives.

The Sterilization Arsenal: Techniques and Methods

Sterilization that is effective is the killing of all microbial life. The following is a succinct description of techniques in common usage:

Steam Sterilization (Autoclaving):

The gold standard, with high-pressure steam to kill microorganisms.

It's effective, reliable, and highly useful for heat-resistant items.

Ethylene Oxide (EtO) Gas Sterilization:

Applied to heat-sensitive items, with EtO gas killing microorganisms.

Needs to be done with good ventilation and air flow to dissipate leftover gas.

Hydrogen Peroxide Gas Plasma Sterilization:

Low-Temperature Process employing hydrogen peroxide vapor to create a plasma that kills microorganisms.

Faster than EtO and more appropriate for all types of material.

Chemical Sterilization (Liquid Chemicals):

Soak in liquid chemical sterilants.

For those materials other processes are too hot for.

Critical Practices for Sterilization Success:

Effective Cleaning:

Sterilization will be ineffective on dirty instruments. Bioburden (organic matter) can insulate microorganisms from sterilants.

Pre-cleaning and gentle scrubbing is necessary.

Proper Packaging

Equipment will have wrapping materials that allow penetration by sterilizing agents but are not sterile after processing.

Sterile barrier systems are most critical to instrument sterility during storage and transport.

Validation and Monitoring:

The sterilization procedures need to be validated in order to prove their suitability.

Biological and chemical indicators are used for monitoring sterilization parameters and confirmation of microbial inactivation.

Storage and Handling

Sterile instruments need to be handled and stored carefully to prevent contamination.

Aseptic storage and method are required.

Sterile Processing Department (SPD) Role:

SPD is the central point of instrument sterilization. The department staff, who undergo the process training, carry out the following:

Cleaning, testing, and packaging instruments.

Maintenance and operation of equipment for sterilization.

Sterilization cycle monitoring and quality control.

Maintenance of accurate records.

The Ever-Continuing Search for Safety

Sterilization is not an event but a process that requires ongoing vigilance and compliance with the best practice. Through appropriate cleaning, utilization of validated process of sterilization, and culture of safety, infection risks might be minimized in hospitals during the provision of best results to the patient.