STERILIZATION OF OPERATION THEATRES – TIME TO STOP FUMIGATION

Dr.T.V.Rao MD
Sterilisation means eradicating germs completely, which is not 100% possible in an operation
theatre. The sources of bacterial (germ) contamination are from air and the environment, infected
body fluids, patients, articles, equipment etc. Many times we are practising the old tradition of
sterilization of operation theatres and sick rooms with the use of formaldehyde for sterilization, Try
to give up blind use of formaldehyde which is hazardous and has several unknown health related
uses Inhaling those fumes usually has instant side-effects like coughing, nausea, vomiting, secretion
of more saliva than usual, sweating, red eyes, itchy skin, laboured breathing and a running stomach,
Fumigation is an age old process of sterilisation, of the environment, may be a sick room or
operation theatres. It is usually done with formalin fumes, which are very pungent and harmful. So
when a room is fumigated, it is tightly closed and sealed before fumigation. The room is opened
after fumigation (12 - 24 hours). The room can be used once all fumes are out.

OSHA indicated that formaldehyde should be handled in the workplace as potential carcinogen and
set an employee exposure standard for formaldehyde that limits an 8-hour time- weighted average
exposure concentration of 0.75ppm. Formaldehyde is the commonly used agent. Formaldehyde gas
is generated from liquid formalin utilizing potassium permanganate crystals. 40% formalin liquid is
added to potassium permanganate crystals to generate gas. Alternately, formalin liquid can be
dispersed by a sprayer like device in the theatre environment. After a contact time of at least 6-8
hours, the formaldehyde needs to be neutralized by using ammonia, allowing at least 2 hours
contact time for ammonia to neutralize the formaldehyde prior to the use of theatre.

Emerging Compounds in use for Sterilization of Operation theatres:
Bacillocidrasant:
A newer and effective compound in environmental decontamination with very good cost/benefit
ratio, good material compatibility, excellent cleaning properties and virtually no residues. It has the
advantage of being a Formaldehyde-free disinfectant cleaner with low use concentration.
Advantages
- Provides complete asepsis within 30 to 60 minutes.
- Cleaning with detergent or carbolic acid not required.
- Formalin fumigation not required.
- Shutdown of O.T. for 24 hrs. Not required.
Other Newer and Non Toxic compounds:
A Chemical compound - VIRKON is gaining importance as non-Aldehyde compound. Virkon is proved
to be a safe virucidal, bactericidal, and fungicidal, mycobactericidal and non-toxic compound. It
contains oxone (potassium peroxymonosulphate), sodium dodecylbenzenesulfonate, sulphamic acid;
and inorganic buffers. It is typically used for cleaning up hazardous spills, disinfecting surfaces and
soaking equipment. Though Virkon is shown to have wide spectrum of activity against viruses, some
fungi, and bacteria, it however is less effective against spores and fungi than some alternative
disinfectants. Several other compounds are emerging in the Market for safer use, may need better
resources for utility and implementation.
Do not underestimate the power of simple measures the inanimate surfaces in the operation
theatre need proper periodic cleaning and disinfection. Grossly contaminated surfaces are the
potential sources of hospital acquired infections. The operation theatre should be thoroughly
washed with water and detergent mixture so as to get rid of all spills and proteinaceous materials
before a disinfectant is used for mopping the surfaces. Many scientific studies prove simple cleaning
measures and human behaviour can make a change in up keeping the human and patient safety It
has been observed that there is a general relationship between the aerobic bacterial count and the
risk of infection. There is a significant risk of infection when there are more health care workers and
permitting many medical students in the theatre the counts certainly reduce when the staff follow
the principle of lesser talking and more scientific behaviour for human safety , My experience with
renowned surgeons, they encountered few infection WHEN there is an optimal human discipline as
dedicated hand washing and care of mask and head gear when operating and above all a respect for
the tissue, they are operating, AND the chemicals alone are no solutions.
The above mentioned chemicals are only examples do not carry any conflict of interest
Dr.T.V.Rao MD Professor of Microbiology Freelance writer

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