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Sterilization PPdesign Final
Sterilization PPdesign Final
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Sterilization
Asepsis
It is keeping medical instruments free from microorganisms This is accomplished by:
I. II. Sterilization Disinfection
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I. Sterilization
It is one of the basic steps in surface asepsis. Definition: Sterilization refers to the use of different procedures to destroy all forms of microorganisms including bacterial spores.
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What to sterilize?
It is mandatory to sterilize :
all instruments that penetrate soft tissues and bone. Instruments that are not intended to penetrate the tissues, but that may come into contact with oral tissues.
If the sterilization procedure may damage the instruments, then, sterilization can be replaced by Disinfection procedure
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II. Disinfection
It a is less lethal process than sterilization. Definition: It is a procedure intended to reduce microorganisms as far as possible (but not bacterial spores). Thus, disinfection can never replace sterilization
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Semi-critical
Non-critical
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I. Sterilization - Process
Sterilization Principles
There are 3 different sterilization principles:
1. Heat sterilization 2. Chemical sterilization 3. Radiation sterilization
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1. HEAT STERILIZATION
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1. Heat Sterilization
Advantages: It is the simplest, most effective and inexpensive method. There are 2 procedures depending on the tolerance of the material used:
a) Steam sterilization (Autoclaving) b) Dry heat sterilization
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sterilization
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Steam Sterilization
Advantages & Disadvantages Advantages:
good penetration maintains integrity of liquids (e.g. Lubricants) due to the 100% humidity within the chamber.
Disadvantages:
Non stainless steel metal items corrode may damage plastic and rubber items sharp instruments get dulled.
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Dry-Heat Sterilization
Disadvantages Disadvantages:
Less reliable than autoclaving Large temp difference may arise within device. sharp instruments get dulled Many materials do nottolerate dry heat
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2. CHEMICAL STERILIZATION
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Generally, chemical sterilization procedures have the disadvantages of presenting health hazards to users (e.g. poisonous, flammable, )
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Formalin gas autoclaves have been developed for sterilizing endoscopes and ansthetic apparatus.
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3. RADIATION STERILIZATION
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3. Radiation Sterilization
Provides effective way of sterilization when used in high doses. Gamma radiation (from 60Co). Procedure:
Objects on belt conveyer Expose objects to 25 to 30 kGy for about 24 hrs.
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Radiation Sterilization
Advantages and Disadvantages Advantages:
Clean process Dry process Ensures full exposure of object from all directions
Disadvantages:
Posses threat to humans (radiation) Lengthy process Requires very qualified personnel
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II. DISINFECTION
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Disinfection - Types
As mentioned before, disinfection can not kill all microorganisms but only reduce its number. Disinfection can be accomplished with:
1. Heat disinfection 2. Chemical disinfection
Object that can be disinfected are bedpans, patient skin before operation and surgeon hands before putting gloves.
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1. Heat Disinfection
It is accomplished by boiling water at atmospheric pressure for at least 5 mins
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2. Chemical disinfection
Number of different agents are used according to tolerance of objects and infectious agents.
Using phenol with cleaning component destroy the membrane of microorganisms. Using 70% alcohol for skin which denatures proteins of microorganisms. Use soap containing hexachlorophene for hands. In case of hepatitis use 5% solution of chloramines or heat disinfection
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Asepsis Summary
Asepsis Sterilization Disinfection
Heat
Chemical
Radiation
Heat
Chemical
Steam
Gas
Gamma
Boiling water
Phenol
Dry heat
Ethylene oxide
70% Alcohol
Formalin
Hexachlorophene
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Conclusion
In summary:
Sterilization and disinfection are costly and time consuming process However, it is an essential in all health care facilities to avoid spread of diseases. It depends on the ehtics of the instrument users. Users should keep in mind that contaminated instrument present risk to patient as well as the user himself.
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Agent
Ortho-phthalaldehyde (Cidex FDA cleared, October 1999 OPA) Antimicrobial coating (Surfacine) Superoxidized water (Sterilox) Not FDA/EPA cleared Not FDA/EPA cleared
Rapid readout ethylene oxide Not FDA cleared biological indicator (Attest) New plasma sterilizer (Sterrad 50)
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1. Ortho-Phth-alaldehyde (OPA)
Chemical Sterilizaer Adventages:
not eye and nasal passages irritant has excellent stability over a wide range of pH (3 to 9) has a barely perceptible odor Like glutaric aldehyde, it has excellent material compatibility
Disadvantage:
It stains proteins gray (including unprotected skin)
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Time for 6-log10 reductiona 28-36 minutes 14-18 minutes 4.8-6.3 minutes
2. Surfacine
Surface disinfectants such as phenols Advantages
Effective in significantly reducing microbial contamination Cost-effective Have long-term residual activity
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3. Superoxidized Water
Based on the concept of electrolyzing saline. Advantages:
Cheap The end product (water) is not damaging to the environment
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4. Endoclens
A New rapid automated liquid Chemical Sterilization System. The sterilant is produced, as needed, by automatic mixing of solutions of hydrogen peroxide and formic acid. Advantages:
automatic cleaning process
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capability to process two flexible scopes at same time automated channel blockage and leak detection filter water rinsing and scope drying after sterilization hard-copy documentation of key process parameters user-friendly machine interface total cycle time less than 30 minutes
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6. low-temperature plasma
Technique for decontaminating thermolabile products without the severe drawbacks of gas sterilization methods. Advantages:
Alternative to steam sterilization for sterilizing easily corroding products or electronic instruments Takes less time.
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