Ot equpiment

sterilization specially
autoclaving
Speaker
Zahid Yaseen Mir
Nursing Officer
GMC Anantnag
 Sterilization definition

Sterilization is a process by which all

living microorganisms including
viable spores, are either destroyed
or removed from an article, surface
or medium
METHODS OF STERILIZATION

 Physical Methods  Chemical Methods

1. Sunlight 1. Alcohol
2. Heat 2. Aldehydes
A. Dry Heat 3. Phenols
I. Red Heat 4. Vapour phase disinfectants
II. Flaming
III.Incineration
IV. Hot Air Oven
B. Moist Heat
3. Ozone
5. Radiation
USES OF STERILIZATION
 Sterilization of materials, instruments
used in surgical and diagnostic
procedures.

For media and reagents used in the

microbiology laboratory.

In food and drug manufacturing to

ensure safety from contaminating
organisms
 PHYSICAL METHODS
Sunlight : Active germicidal effect due to its
content of UV rays
Heat : Most reliable and commonly employed
method of sterilization.
TYPES OF HEAT :

Principle :
Dry Heat : Kills the organisms by denaturation of
bacterial protein, oxidative damage and by the
toxic effect of elevated level of electrolytes and
DNA damage
 PHYSICAL METHODS
Continue………
Moist Heat : Moist heat kills the
microorganisms by denaturation
and coagulation of proteins
 METHODS OF DRY HEAT
STERILIZATION
1.RED HEAT 2.FLAMING 3.INCINERATION

Inoculating wires or Glass slides, scalpels , Soiled dressings ,animal

loops , tips of forceps and mouths of culture carcasses ,beddings and
and needles tubes pathological materials
 METHODS OF DRY HEAT STERILIZATION
CONTINUE….
HOT AIR OVEN :-
Most widely used method of sterilization by dry heat

Parts :- Fan, Thermostat

TEMPERATURE AND TIME

TEMPERATURE HOLDING TIME

160 °C 2 Hours

170 °C 1 Hour

180 °C 30 mins
 USES OF HOT AIR OVEN
Glassware like glass syringes, petrideshes,
flasks, pipettes and test tubes

Surgical instruments like scalpels , scissors ,

forceps etc

Chemicals such as liquid paraffin, fats,

sulphonamide powders etc
 Precautions
Should not be overloaded
Material should be arranged in a manner which
allows free circulation of air
Test tubes, flasks etc should be fitted with cotton
plugs
Petrideshes and pipettes should be wrapped in
paper
Rubber material except silicone rubber or any
inflammable material should not be kept inside
the oven
Oven must be allowed to cool for 2 hours before
opening the doors since the glassware may crack
by sudden cooling
 METHODS OF MOIST HEAT
 At Temperature below 100 °C
1. Low temperature steam formaldehyde
Items which cannot withstand the temperature of 100 degree
may be sterilized by a method. In this method at
subatmospheric pressure at the temperature of 75 degree
with formaldehyde vapour is used

 At Temperature of 100 °C
1. Boiling : Boiling for 10 to 30 mins, kills most vegetative forms
but many spores withstand boiling
2. Tyndallisation:Steam at 100 °C for 20 mins on three successive
days is used. Instrument commonly used Koch’s or Arnold’s
steam steriliser
 At Temperature above 100 °C
AUTOCLAVING :-
 AUTOCLAVE AND
AUTOCLAVING

In this apparatus ,material for sterilization is

exposed to 121 degree for 15-20 minutes at 15
IB pressure per sq. Inch.
Saturated steam heats the articles to be
sterilized rapidly by release of latent heat.
Air is poor conductor of heat and
must be removed from chamber. The
contents must be so packed that free
circulation of steam occurs.
 COMPONENTS OF AUTOCLAVE
1. Lid/ door
2. Pressure Chamber
3. Power Switch
4. Control Panel
5. Water Level Indicator
6. Pressure Gauge
7. Whistle
8. Safety Valve
9. Electrical Heater
10. Water Releasing valve
11. Thermometer
12. Stand
 PROCEDURE
a. Place the material to be sterilized inside the
pressure chamber and fill the cylinder with
sufficient water.
b. Close the lid tightly.
c. Put on the electrical heater.
d. Adjust the safety valve to the required pressure.
e. After the water boils, allow the steam and air
mixture to escape through the discharge tap till
all air has been displaced.
f. Close the discharge tap.
g. Count the holding period from this time point of
time, which is about 15 minutes in most cases.
h. After the holding time period, stop the electric
heater and allow the auto clave to cool un till the
pressure gauge indicates that the pressure inside
is equal to the atmospheric pressure
 PROCEDURE Continue....

i. Open the discharge tap slowly and

allow the air to enter the auto clave.
ii. Open the lid of the auto clave and
remove the sterilized material
 USES OF AUTOCLAVE
It is method of choice for sterilizing the
following:-
1. Surgical instruments.
2. Dressing.
3. Culture Media.
4. Auto Cleavable plastic material .
5. Plastic tubes and pipette tips .
6. Solution and water
7. Bio hazardous waste
8. Glass ware (Auto clave resistible)
 Precautions
1. Auto Clave should not be used for
sterilizing water proof materials
such as oil and crease or dry
materials such as gloves powder.
2. Materials are loaded in such a way
that it allows efficient steam
penetration (do not over fill the
chamber.
3. It is more efficient and safer to run
two separate, un crowded loads
than one crowded one.
Precautions Continue...
4. Wrapping objects in aluminium foils is
not recommended, because it may
interfere with steam penetration. Articles
should be wrapped in materials that allow
steam penetration.
5. Material should not touch the sides or
top of the chamber.
6. The clean items and the wastes should
be auto claves separately.
7. Polyethylene trays should not be used as
they may melt and cause damage to the
auto clave.
 OZONE
Low Temperature Sterilization by ozone :
Ozone sterilizer uses oxygen, water and electricity to
produce ozone within the sterilizer and provide
sterilization without producing toxic chemicals at
temperature 25 °C to 35 °C.

In this device, oxygen molecule (O2) are separated

into atomic oxygen (O) in the presence of intense
electrical field. This atomic oxygen (O) combine
with other oxygen molecule (O2) to form ozone
(O3) which provides sterility in approximately 4
hours.
 RADIATIONS
Ionising radiations : Includes gamma rays, X-Rays,
and Cosmic rays . They are highly penetrating, they
damage DNA.
Usually used for sterilization of Plastic syringes, swabs,
culture plates, cannulas, catheters etc

Non-ionising radiations : Includes infrared and UV

radiations
Infrared Radiations :- Syringes and catheters
UV Radiations :- Denaturation of bacterial protein and
interference with DNA replication . Used for
disinfecting enclosed areas bacteriological laboratory,
inoculation hoods, laminar flows, OT .
 CHEMICAL METHODS
A variety of chemical agents are used as antiseptics
and disinfectants. An ideal antiseptic or
disinfectant should :
I. Have wide spectrum of activity and be effective
against all microorganisms including bacteria
( both vegetative and spore forms), viruses,
protozoa, and fungi
II. Act in the presence of organic matters
III. Have high penetration power and quick action
IV. Be stable and effective in acidic as well as in
alkaline
V. Not corrode metals
VI. Be compatible with other disinfectants
 CONTINUE PROPERTIES
 Not cause local irritation
 Not be toxic if absorbed into circulation
 Be safe and easy to use
 Be easily available and cheap
 TYPES OF DISINFECTANTS
1. High Level Disinfectants (HLD) : Kills bacterial
spores

2. Intermediate Level Disinfectants (ILD) : destroy all

microorganisms but not bacterial spores.

3. Low Level Disinfectants (LLD) : destroy vegetative

bacteria and enveloped viruses; variable action on
non envoloped viruses, & fungi, but no action on
tubercle bacilli spores.
EXAMPLES OF DISINFECTANTS
HLD :- Aldehydes, Peracetic acid, Hydrogen
peroxide

ILD :- Alcohol : Ethyl and Isopropyl alcohol

Phenolics : phenol, cresol, lysol
Halogens : iodine, chlorine

 LLD :- Quaternary ammonium compound

(QAC) , Chlorhexidine
SPAULDING’S CLASSIFICATION OF MEDICAL DEVICES
 CHEMICAL METHODS CONT……
ALCOHOL :Ethyl alcohol and isopropyl alcohol
are the most frequently used. They act by
denaturing bacterial protein, but they have no
sporicidal or virucidal activity. They are used
mainly as skin disinfectant

ALDEHYDE

FORMALDEHYDE
It is markedly bactericidal, sporicidal and virucidal. It
is used both aqueous solution and in gaseous form.
USES OF FORMALDEHYDE
1. Preservation of tissue for histological examination
2. To sterilize bacterial vaccines
3. To prepare toxoid from toxin
4. For killing of bacterial cultures and suspensions
5. For destroying anthrax spores in hair and wool

GLUTARALDEHYDE
This is effective against bacteria, viruses. It also kills
spores
Commercially available as ‘Cidex’
USES OF GLUTARALDEHYDE

1. For sterilization of cystoscopes,

endoscopes and bronchoscopes
2. To sterilise plastic endotracheal
tubes, face masks, corrugated
rubber anaesthetic tubes and
metal instruments
 PHENOLS
Phenols are produced by distillation
of coal tar between temperature of 170
degree to 270 degree .The lethal effect
of phenols is due to cell membrane
damage, thus releasing cell contents
and causing cell lysis.
Certain phenol derivatives like cresol,
chlorhexidine, chloroxylenol and
hexachlorophene are commonly used as
antiseptics
 PHENOLS CONT…..
CRESOL: Lysol (Solution of cresols in
soap)
Commonly used for sterilization of
infected glassware, cleaning floors,
disinfection of excreta
CHLORHEXIDINE: Savlon
(Chlorhexidine and Cetrimide)
Widely used in wounds, pre-operative
disinfection of skin, as bladder irrigant
etc
VAPOUR PHASE DISINFECTANTS
 Formaldehyde Fumigation Commonly
used to sterilize the OT

Requirement :- (For an area of 1000 cubic feet)

1. 500 ml of 40% formaldehyde in 1 litre of water
2. Stove or heat plate for heating formalin
3. 300 ml of 10 % ammonia
PROCEDURE OF FUMIGATION
1. Close all doors and windows airtight and switch off fans
and AC.
2. Heat formalin solution till boiling dry.
3. Leave the OT un entered overnight.
4. Enter OT next day morning with 300 ml of ammonia.
5. Keep ammonia solution for 2 to 3 hours to neutralize
formalin vapours.
6. Open the OT to start surgery.
7. Advised fumigation at weekly intervals.
 DISADVANTAGES
1. Act as a potential carcinogen
2. Toxic
3. Irritant.
Commercially Available Disinfectants
1. Baccilocid rasant: A newer and effective
compound in environmental decontimination
with very good cost benefit ratio, good material,
compatibility, excellent cleaning properties
2. It is a formaldehyde free disinfectant cleaner with
low use concentration
Active Ingredents:
 Glutaral 100mg / gram
 Benzyl-C12-18-alkyldimethyleammonia
Chlorides 60 mg/ gram.
 Didecyldimethylammonia-chloride
60mg/gram
Advantages:-
 Provides complete asepsis within 30-60
minutes
 Cleaning with detergent or carbolic acid
not required.
 Formalin fumigation not required.
 Shutdown of OT for 24 hrs not required.
 ALDEKOL
A new method of fumigation has been
evolved using aldekol; a mixture containing:
6% formaldehyde
6% glutaraldehyde.
5% benzalkonium 120 chloride.
VIDEOS :-
Wrapping of instruments
Autoclaving Process
Fumigation