Methods of Sterilization

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sleeves. Only the front of the gown is con- sidered sterile. l Sterile surgical gloves are considered asep- tic. If they are torn, punctured, or have touched an unsterile surface or item, they are considered contaminated. l The safest, most practical method of sterilization for most articles is steam under pressure. . Label all prepared, packaged, and steri- lized items with an expiration date. . Use articles packaged and sterilized in cot- ton muslin wrappers within 28 calendar days. l Use articles sterilized in cotton muslin wrappers and sealed in plastic within 180 calendar days. l Unsterile articles must not come in contact with sterile articles. . Make sure the patient’s skin is as clean as possible before a surgical procedure. . Take every precaution to prevent con- tamination of sterile areas or supplies by airborne organisms. Methods of Sterilization Sterilization refers to the complete destruction of all living organisms, including bacterial spores and viruses. The word sterile means free from or the absence of all living organisms. Any item to be sterilized must be thoroughly cleaned mechanically or by hand, using soap or detergent and water. When cleaning by hand, apply fric- tion to the item by using a brush. After cleaning, thoroughly rinse the items with clean, running water before sterilization. The appropriate sterilization method is determined according to how the item will be used, the material of which the item is made, and the sterilization methods available. Physical methods of sterilization com- prise moist heat and dry heat. Chemical methods include gas and liquid solutions. PHYSICAL METHODS.— Steam under pressure (autoclave) is the most dependable and economical method of sterilization. It is the method of choice for metalware, glassware, most rubber goods, and dry goods. All articles must be correctly wrapped or packaged so that the steam will come in contact with all surfaces of the article. Similar items should be sterilized together, especially those requiring the same time and temperature exposure. Articles that will collect water must be placed so the water will drain out of the article during the sterilization cycle. A sterilizer should be loaded in a manner that will allow the free flow of steam in and around all ar- ticles. Each item sterilized must be dated with the expiration of sterility. Sterilization indicators must be used in each load that is put through the sterilization process. This verifies proper steam and temperature penetration. The operating instructions for a steam sterilizer will vary according to the type and manufacturer. There are a number of manufac- turers, but there are only two types of steam under pressure sterilizers. They are the downward displacement and the prevacuum, high-tempera- ture autoclave. In the downward (gravity) displacement autoclave, air in the chamber is forced downward and out of the bottom discharge outlet as pressurized steam enters from the top of the chamber. The temperature in the sterilizer gradually increases as the steam heats the chamber and its contents. The actual timing does not begin until the temperature is above 245°F (118°C). The prevacuum, high-temperature autoclave is the most modern and economical to operate and requires the least time to sterilize a single load. By use of a vacuum pump, air is extracted from the chamber before admitting steam. This prevacuum process permits instant steam penetra- tion to all articles and through all cotton or linen dry goods. The sterilization time is reduced to 4 minutes. The temperature in the chamber is ra- pidly raised and held at 274°F (134°C). Timing the cycle is done automatically. If the temperature is increased, the steriliza- tion time may be decreased. The following are some practical sterilization time periods: @ 3 minutes at 270°F (132°C) . 8 minutes at 257°F (125°C) Q 18 minutes at 245°F (118°C) All operating rooms are equipped with high- speed (flash) sterilizers. Wrapped, uncovered, opened instruments placed in perforated trays are 5-18


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