Advancement in Sterile Processing Over the Years

---

Sterile processing has always been the invisible backbone of the operating room. For the longest time, steam sterilization was the best-known way to kill germs and even though it had its drawbacks in the beginning, research has proven it is still the best method. Advancement in sterile processing has been slow and gradual, but every one of the motions forward was much needed.

Surgery Advancements: Steam

Steam sterilization is a very simple process. Sterilization destroys all microorganisms on the surface of an article or in a fluid to prevent disease transmission associated with the use of that item.

There has been a need to increase the reliability of the process and documentation of these processes has come a long way. Years ago, the surgical tech or nurse had to make small linen test packs and place a sensitive indicator inside the pack to monitor the ability of the autoclave to reach perimeters that needed to be met. With advances in sterile processing procedures and research, there are now ready-made test packs available and they are extremely reliable for reading perimeters of the autoclave.

With this increase in awareness of the importance of infection control, “biological” have also been introduced. Biological indicators are small vials of active bacteria that are introduced intermittently into the autoclave and placed directly over the drain plug where most of the autoclave activity takes place. When the sterilization process is finished, the biological is placed in a small incubator and watched during 24 to 48 hours incubation time. If there is growth present, this proves that the autoclave did not actually reach desired perimeters or there was some type of breech in the system.

Surgery Advancements: Sterrad/Gas Plasma Technology

Although steam sterilization is a favored method, there are certain polymers that will melt when exposed to extreme temperatures and pressures. Medical equipment with delicate lenses and intricate parts will not withstand steam sterilization. With the new advanced procedure of using gas plasma technology, low temperature and decreased exposure time are both beneficial in processing lightweight medical equipment. This equipment is small and easy to store. The small cassettes of sterilant are also easy to store and are good for at least 5 cycles in the sterilizer. Packaging products are simple and color-coded for easy reading and operation of the entire process.

Surgery Advancements: Closed System Autoclave Flash Pans

In the past, if ante rooms were not available adjacent to the operating room, flash autoclaves might be placed in hallways far away from the operating room itself. For years, instruments were autoclaved in hallways, then carried in the open air and turned onto sterile field. It was just the way it had to be. Now, with improved methods of closed sterilization pans, safe coverage for sterile instruments has reduced the chance of infection by airborne particles and poor handling techniques of flashed instruments. These pans have locked down lids that will not slide and many of them are clear, so the surgical tech can actually visualize the indicator, making sure that item(s) have met sterile perimeters.