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STERILIZATION OF SURGICAL INSTRUMENTS

Sterilization of surgical instruments is done by two methods:

  1. Autoclaving
  2. Cold Sterilization.

AUTOCLAVING

If surgical instruments are sterilized via autoclaving, then the following steps should be adopted:

  • Each and every one of the instrument which has a strong susceptibility of having metal to metal interaction have to be lubricated. Such surgical instruments include self retaining refractor, needle holder, scissor, hemostat etc.
  • Although a wide range of specified lubricants for surgical instruments are available but the most excellent among them is milk for instruments.
  • Do not ever make use of industrial specified lubricants for lubrication of surgical instruments e.g. oils.
  • Now place all the surgical instruments in the autoclave. There are two methods available for autoclaving i.e. either individually or in the form of a set. Criteria for the selection of method depend upon the nature of surgical instrument to be autoclaved.

The explanations for each method are given below:

Individual Instrument Method:

Important points that should be kept in mind are:

  • As the surgical instruments have to be placed in unwrap and opened position, so we should use those pouches which have a wider capacity i.e. 4 inches or more wide pouch.
  • Pouches that are disposable as well as not reusable paper are considered as the ideal.
  • Pouch should be fabricated with a ratchet lock e.g. hemostat or needle holder for the unlocked positioning of surgical instruments in autoclave. Instrument Set Method

Important points that should be kept in mind are:

  • Sterilize the entire surgical instruments in unwrap and opened position. Those surgical instruments which are comparatively heavier must be placed on the underneath of the set. This is the case when more than one layer is desired.
  • All the surgical instruments should be open so that it will facilitate the entrance and direct contact of steam with instruments that will give a good autoclaving. Otherwise, there will be thermal expansion that will ultimately lead to crack development on the hinged regions of surgical instruments.
  • Overloading of autoclave results in the generation of pockets due to which there will be less or near to no penetration of steam in the chamber. That is why, avoid this consequence.
  • Throughout autoclaving, surplus moisture is formed. So to soak up it, keep a towel at the bottom of chamber.

COLD STERILIZATION

By using this method, surgical instruments are sterilized in a period of approximately 10 hours. For this purpose, surgical instruments are submerged in a cold sterilization solution for the specified period of time. As the time period is too prolong, so it can produce harmful effects on the instruments which are much more intense if compared with autoclaving which takes only 20 minutes. If just disinfection of surgical instruments is required rather than sterilization, then cold sterilization can be adopted as disinfection process requires just 10 minutes for its completion. But overall if we see, then autoclaving is preferred over cold sterilization method.

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