a r a v i n d e y e c a r e s y s t e m s sr.alikutty varghese, ot in-charge

A R A V I N D E Y E C A R E S Y S T E M S

Sr.Alikutty Varghese, OT In-charge


Disinfection & Sterilization

Disinfection : The Destruction of all the Pathogenic organisms capable of giving rise to infection

Asepsis:It is a technique to prevent infection by eliminating micro-organisms.

Sterilization : Defined as a process by which an article surface or medium is made free from all micro-organisms including spores.


Parameters for Sterilization

Nature of product associated

Process associated

Nature of product associatedBio-burden – Degree of contaminationBio- Resistance – Heat or moisture sensitivity

and product stability Bio Shielding – Nature f materials used for

packing and their response towards sterilization Density – Factors affecting penetrating


Process associated

Temperature to achieve sterilization

Duration

Concentration of the agent

Capacity of sterilizer

Parameters for Sterilization Contd….


Methods of Sterilization

Physical Agent Chemical Agent

a. Dry Heat Sterilizationb. Moist Heat Sterilization

a. Gas sterilizationb. Activated Glutaraldehydec. Formaline sterilizationd. Alcohol (70% Isopropanol)e. Povidine Iodinef. Dettol


Physical Agent

Dry Heat: A form of hot air is used to sterilize items

that steam or ethylene oxide gas cannot penetrate.

Advantages: 1. Hot air penetrates on certain substances that steam or gas cannot

penetrate

2. Dry heat can be used in laboratories to sterilize glassware

3. Dry heat is protective method to sterilize delicate instruments

4. Instruments that cannot disassembled can be sterilized in hot air

5. Carbon steel does not become corroded or discoloured in dry heat


Physical Agent (Cont..)

Moist Heat : Pasteurization, boiling, steam under normal pressure, steam under pressure (Autoclave)

Boiling : All pathogenic organism are killed within 15 min. of boiling at 100 0C of temperature


SterilizationAutoclave: Moist heat in the form of saturated steam under pressure is a dependable physical agent for the destruction of all form of microbial life

including spores. The death of micro organisms by moist heat is caused by coagulation of the cell protein.

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SterilizationTime for Autoclave

Pressure Temp. Time

Linen & Instruments

15 pound 121 0C 30 min.

Rubber Items 15 pound 121 0C 10 min.

Liquids 15 pound 121 0C 10 min.


Autoclave

Prevaccum High Speed Autoclave

The pre vacuum high temperature autoclave requires the least time to sterilize a single load. Flash autoclave is an example for this. This is commonly used sterilize only instruments in between surgery. All the air is evacuated using a vacuum pump before admitting steam. This cause rapid rise of temperature (1340C). It permit instant steam penetration. The sterilization time is reduced to fifteen minutes. The cycle is timed automatically


Autoclave

Advantages of Steam Sterilization

a.Steam sterilization is the easiest, safest and surest method of sterilization

b.Steam sterilization is a fastest methodc.Less expensive and easily suppliedd.Steam sterilizer have automatic controle.Steam sterilization leaves no harmful residual


Cleaning of Instruments

Ultra sonic Instruments cleaning

Manual cleaning


Bin Packing Method

All the items should be cleaned and dried properly

All the detachable items are disassembled

Oil and lubricants are wiped off well because steam or gas

will not penetrate through it

Rubber items should not be folded and kept separately from

metal instruments to prevent damage

Hinged instruments must be kept open with box locks

unlocked permit steam contact on all surface

Instrument must be kept open with box locks unlocked permit

steam contact on all surface


Instrument must be placed in a perforated tray to allow steam penetrationSharp and delicate instruments placed on top of the trayLoose packing and space between items are very important for easy circulation and penetration of steamIndicator (autoclave tape) should be placed in the bottom, middle and top of the bin to check whether the autoclave is functioning correctly. If the indicator colour remains the same the sterilization cycle is inadequateName of the item, date of sterilization, date of expiry should be mentioned on each package.Close the bin and keep the holes open so that the steam can enter and penetrate easily.

Bin Packing Method Cont…


Bin Packing Cont…Control :

Positive assurance that sterilization condition is achieved by either steam under pressure, gas sterilization or hot air oven can be obtained only through a biological test.One spore strip can be placed at the bottom of the bin and sterilize in a routine cycle.Once the cycle is completed the spore strip is taken out and sent to the laboratory.


Linen Packing

Gowns are folded in such a way the inside part

faces outside so the surgeons and the nurses

wear the gown without touching the outside

portion.

While folding the eye towels the holes of the

towel must be visible.

Avoid packing items too lightly to enable steam

penetration in each and every layer of the liners


Chemical AgentDefinition : They destroy micro-organisms by protein coagulation and breaking the cell membrane

A. Ethylene Oxide Gas sterilization

Advantage Disadvantage

It damages very little materials It is slow and costly method

It can sterilize materials that cannot be sterilized by other methods

It is flammable and toxic in nature

Effective against all organisms It requires special equipment

Achieve good penetration


Activated GlutaraldehydeAdvantage Disadvantage

It is not corrosive and non staining

It is very costly

It is not absorbed by rubber articles or plastic

It has to be discarded after 15 days of activation

It can be reused throughout effective activation period

Glutaraldehyde is effective in room temperature


Operation Room Cleaning

Purpose : To destroy microorganisms as quickly as

possible

To protect operating room personnel from

getting in contact with known or unknown

infectious materials

To prevent cross contamination


Operation Room Cleaning

Procedure :

The floor is swept first Equipment such as electro surgical units should be checked up and cleaned well Ceiling and wall mounted fixtures are cleaned Cabinets and doors are cleaned, especially around the handles or push plate Walls of the scrub sink need special attention Transportation carts and wheels need special attention


Operation Room CleaningProcedure : (contd…)•Waste buckets are cleaned well and disinfected• Furniture’s are thoroughly scrubbed and cleaned with chemical disinfectant •Floor is always mopped up at last. Clean mop isused to mop the floor•Keep two buckets for mopping floor, one with plain

water and the other with chemical disinfectant (e.g..Dettol 1:4 dilution in water)•First dip the mop cloth in dettol, wrung out andagain dip in dettol water, and mop up the floor insame manner


Operation Room CleaningWeekly / Monthly Cleaning :

Remove all the furniture & equipment from Operating room suit

Cleaning and replacement of air conditioner filter

AC filter, clean and the dust away from OT was the filter, dip in antiseptic

solution, dry it and replace

Regular cleaning of all sterilizers must be done as recommended by the

manufacturers.

Floors through out the operating room suit should be machine – Scrubbed

periodically to remove the accumulated deposits

Washing the walls and floors in the operating room, suit once a week is very

important

Clean and arrange all the equipment and furniture in proper place after

washing operating room

Mop the floor as mentioned before


Operation Room FumigationHow:

Equal quantity of distil water is added in the OT care machine as required according to the size of the operating room

The solution is poured into the machine and the fan placed above the machine is operated electrically, and that leads to the evaporation of formalin

Advantages :

Significant reduction of bacteria in the environmentEffective decontamination of exposed surfaceDecreased housekeeping costs


Conclusion A Good surgery can be spoiled by infection Infection prolongs hospital stay for the patients. Increase the cost, both for the patient and the Institution

a r a v i n d e y e c a r e s y s t e m s sr.alikutty varghese, ot in-charge

Documents

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