STERILIZATION

Click to NURULIHDA BINTIstyle BY SN edit Master subtitle SAHADI JURURAWAT U29 DEWAN BEDAH KARDIOTORASIK, HSAJB.

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INTRODUCTION OBJECTIVE DEFINITION METHODS PACKAGING STERILIZATION MONITOR STORAGE OF STERILE ITEMS CONCLUSION REFERENCES
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INTRODUCTION

Decontamination/ cleaning is universally recommended as a key component of disinfection and sterilization process. All sterilization processes must be approvec by the U.S Food and Drug Administration(FDA). Sterilizer microbiocidal performance must be tested under stimulated use 4/22/12 condition.

OBJECTIVE

To compromising the sterility of the contents To make sure the instruments are packed (individually or in sets) with correct packaging. To ensure that instruments and supplies are sterile when use.

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DEFINITION

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METHODS OF
STERILIZATION

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THERMAL STERILIZATION

Heat is a dependable physical agent for the destruction of all form of microbial life, including spores. Types of:

Thermal(physical)

Steam under pressure/ moist heat Hot air/ dry heat

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CHEMICAL STERILIZATION

Use in either a gaseous, plasma or liquid state. Changes in colour Such as:

Ethylene oxide gas Formaldehyde gas and solution Hydrogen peroxide plasma/ vapor Ozone gas Acetic acid solution

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RADIATION STERILIZATION

Radiation (physical)

Micromave (nonionizing) X-ray (ionizing)

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STEAM UNDER PRESSURE/ AUTOCLAVE

T = 121C132C Used for linen pack, set,

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STEAM UNDER PRESSURE/ AUTOCLAVE

Long Cycle

Short Cycle

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HYDROGEN PEROXIDE PLASMA/ STERRAD

H2O2. (hydrogen
peroxide)

Low temperature.

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FLASH STERILIZATION

Sterille water 121C- 122C For urgent, unplanned or emerg. Situation (eg dropped/ forgotten).

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HIGH LEVEL DISINFECTANT

Used to all laparascopic instruments, endoscopes(OG DS), colonoscope, choledoscope, cystoscope. Cidex OPA ( ) Reusable item

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PACKAGING

The sterillizing agent must come in direct contact with all surface of every instruments. Must allow adequate exposure to the sterilant, to prevent air from being retained during the sterilization process. Requirement for packaging system:

Be lint-free/ low-linting

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Have a taperproof closure or seal Allow for adequate air removal Allow for penetration, release and removal of the sterilizing agent Be economical Withstand the physical conditions of the sterilizing process Protect the contents from physical damage

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Guess?......

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TEXTILES AND FABRICS

2 types:1.

Woven fabrics Nonwoven fabrics

2.

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Woven fabrics

Commonly reffered as muslin or linen

Reusable should be freshly laundered before use and maintain a protective barrier through multiple laundering and 4/22/12 sterilization

Nonwoven fabrics Combination of cellulose and rayon with strands of nylon randomly oriented through it/ combination of other natural and synthetic fibers bonded by 4/22/12

WRAPPING

Sequentially in two layers Items are enclosed with all corners of the wrapper folded in Types:

Square fold/ parcel Envelope fold Peel packs/ pouches Rigid container

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Square/ parcel fold

Lipatan pertama

Lipatan kedua

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ENVELOPE FOLD

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Peel packs/ pouches Removed as

much air as possible before sealing.

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Rigid container

Have locking mechanism and external handles.

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STERILIZATION MONITORS

In order to ensure effectiveness of sterilization process. Types:-

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Physical/ mechanical indicators

To monitor functions of each sterilizer Such as chamber and jacket pressure and temperature gauges and charts recorded Data obtained from electronic sensors and displays, air leak test and process indicators (biological and chemical)
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Chemical indicators and air removal test

Under going a colour change based on temperature and time

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Autoclave tape Chemical indicator strip

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2. Brownes tube

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3. Bowie-Dick test

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Biological indicator

Shall be used to measure the microbial killing power of the sterilizing process by using a population of calibrates bacterial spores on. When:

Every cycle (3 times/week) After maintanence

After major repair (3 times +ve 4/22/12 biological test)

Hot air Steam sterilization/ sterilization sterrad Bacillus Bacillus subtilis stearothermophil us

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Send for culture and sensitivity of attest-3 time/week

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Storage of sterile item

CSSDssterile COTs sterile room store

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STORAGE OF STERILE ITEMS

Limited access to the storage area or closed cabinets. Clean, dry, dust-free, lint-free area. T (18C-22C) and H (35%-50%)

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Follow the FIFO(1st in 1st out) system. From the floor(8-10) From ceiling(18-20)-to allow for functioning of sprinkler system. From an outside wall(6-8)- to avoid condensation and subsequent contamination.

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CONCLUSION

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REFERENCES

Kementerian Kesihatan Malaysia Mangum G:Infection Prevention in Surgical Setting,181-219,2001. http://www.cramster.com/sterilization

http:// www.maexamhelp.com/instru_sterilizatio http://www.scribd.com/doc/377253/St erilization

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