Various types of sterilizers and sterilization techniques

used in hospitals

Most medical and surgical devices used in healthcare facilities are made of
materials that are heat stable and therefore undergo heat, primarily steam,
sterilization. However, since 1950, there has been an increase in medical
devices and instruments made of materials (e.g., plastics) that require low-
temperature sterilization. Ethylene oxide gas has been used since the 1950s for
heat- and moisture-sensitive medical devices. Within the past 15 years, a
number of new, low-temperature sterilization systems (e.g., hydrogen peroxide
gas plasma, peracetic acid immersion, ozone) have been developed and are
being used to sterilize medical devices. This section reviews sterilization
technologies used in healthcare and makes recommendations for their optimum
performance in the processing of medical devices.

Sterilization destroys all microorganisms on the surface of an article or in a

fluid to prevent disease transmission associated with the use of that item. While
the use of inadequately sterilized critical items represents a high risk of
transmitting pathogens, documented transmission of pathogens associated with
an inadequately sterilized critical item is exceedingly rare. This is likely due to
the wide margin of safety associated with the sterilization processes used in
healthcare facilities. The concept of what constitutes “sterile” is measured as a
probability of sterility for each item to be sterilized. This probability is
commonly referred to as the sterility assurance level (SAL) of the product and is
defined as the probability of a single viable microorganism occurring on a
product after sterilization. SAL is normally expressed a 10−n. For example, if
the probability of a spore surviving were one in one million, the SAL would be
10−6.In short, a SAL is an estimate of lethality of the entire sterilization process
and is a conservative calculation. Dual SALs (e.g., 10−3SAL for blood culture
tubes, drainage bags; 10−6 SAL for scalpels, implants) have been used in the
United States for many years and the choice of a 10−6SAL was strictly arbitrary
and not associated with any adverse outcomes (e.g., patient infections)

The Sterilization is conveyed out by the methods according to requirement. The

methods are: 1. Moist Heat Sterilization 2. Dry Heat Sterilization 3. Gas
Sterilization and Others.
1.Moist Heat Sterilization: Moderate pressure is utilized in steam sterilization.
Steam is utilized under pressure as a means of accomplishing an elevated
temperature. It is dominant to confirm the accurate quality of steam is utilized in
order to keep away the problems which follow, superheating of the steam,
failure of steam penetration into porous loads, incorrect removal of air, etc.
2.Dry Heat Sterilization: Dry heat sterilization is utilized for heat-stable non-
aqueous preparations, powders and definite impregnated dressings. It may also
be utilized for sterilization of some types of container. Sterilization by dry heat
is generally carried out in a hot-air oven. Heat is carried from its source to load
by radiation, convention and to a small extent by conduction.
This process can eliminate heat-resistant endotoxin. In each cycle it is
predominant to make sure that the entire content of each container is maintained
for a successful blend of time and temperature for most part to allow
temperature variations in hot-air ovens, which may be considerable. Dry heat is
utilized to sterilize glassware, porcelain and metal equipment, oils and fats and
powders i.e., talc, etc.
Gas Sterilization: Gaseous sterilizing agents are of two main types, oxidizing
and alkylating agents. Vapour phase hydrogen peroxide is an example of the
former. Ethylene oxide and formaldehyde are instance of the alkylating agents.
However, the BP states that gaseous sterilization is used when there is no
acceptable replacement. The main advantage of ethylene oxide is that many
types of materials, including thermolabile materials, can be sterilized without
damage.
Low temperature steam with formaldehyde has been utilized as an option for
sterilizing thermolabile substances. Both ethylene oxide and formaldehyde have
health risks and strict monitoring of personnel revealed to the gases required to
make sure protection from harmful effects.

Sterilization by Radiation: Radiations can be split up into two groups:

electromagnetic waves and streams of particulate matter. The former group
consists infrared radiation, ultraviolet light, X-rays and gamma rays. The latter
group includes alpha and beta radiations. More frequently infrared radiation,
ultraviolet light, gamma radiation and high-velocity electrons are utilized for
sterilization.
(i) Ultraviolet Light:
A narrow range of UV wavelength is successful in eliminating the
microorganism. The wavelength is powerfully absorbed by the nucleoproteins.
The most important disadvantage of UV radiation as a sterilizing agent is its
poor penetrating power. This is the result of powerful absorption by many
substances. The application of UV radiation is limited.
(ii) Ionizing Radiations:

Ionizing radiations are satisfactory for commercial sterilization processes. It

must have good penetrating power, high sterilizing efficiency, little or no
damage result on irradiated materials and are capable of being produced
efficiently. The radiations that satisfy these four measures are best high-speed
electrons from machines and gamma rays from radioactive isotopes.

Sterilization by Filtration: Membrane filters are built from cellulose derives or

other polymers. There are no loose fibres or molecules in membrane filters.
They keep molecules bigger than the pore size on the filter surface hence filters
particularly useful in noticing of small numbers of bacteria.
Passage through a filter of suitable pore size can remove bacteria and moulds.
Viruses and mycoplasma may not be maintained. After filtration the liquid is
aseptically dispensed into formerly sterilized containers which are later sealed.

Other than this, it is tough to make universal statements about the various
methods of sterilization because there can be huge non-identical in these
considerations depending on the size and location of the sterilizer, as well as the
methods waged for product release. All of these circumstances will influence
selection of the sterilization process and the coherence with which it controls.