To prepare medical instruments for use, various methods are used. Sterilization is one of them. This procedure can be carried out using various means that can provide the desired effect. But first, it’s worth understanding the purpose and features of this process.
Sterilization
The disinfection and sterilization of medical devices is necessary in order to destroy or neutralize various types of microorganisms. Such procedures are of great importance, and if they are neglected, there will be a risk of infectious diseases, including purulent-septic ones. Moreover, both sick and medical workers fall into the risk group.
For this reason, it is important to use various sterilization methods for medical devices. As for the quality of disinfection, it can be checked by swabs to determine Staphylococcus aureus, as well as bacteria belonging to the group of Escherichia coli and Pseudomonas aeruginosa.
The process of disinfecting the instruments as a whole involves disinfection, followed by cleaning and sterilization. The rules of these procedures are approved by the Ministry of Health of the Russian Federation. Before considering the methods of sterilization of instruments that are used in modern medicine, it is worth familiarizing yourself with the general concept of disinfection.
What is disinfection
This term is used to define a procedure that allows for the destruction of opportunistic and pathogenic microorganisms on any surface of the room, including on the floor, walls, switches, medical devices, utensils, etc.
Similar methods should be used in any institution with a medical and prophylactic profile. The key task of disinfection can be called elimination, as well as the prevention of the process of accumulation, reproduction, and also the spread of pathogens.
Disinfection can have both a focal and prophylactic form. Various methods may be used as part of this procedure. Sterilization in this case is aimed at protecting people from the possibility of infection. This process involves wet daily and spring cleaning, which is carried out every week. But focal disinfection is carried out only when there is a suspicion of the occurrence and spread of infection in health facilities.
What is used for effective disinfection
Speaking about a specific drug that is used to neutralize microorganisms, it is worth noting that its choice is carried out depending on which infectious disease you have to deal with.
The type of medical device also affects the degree of disinfection. Based on this, this process can have a high, intermediate and low level.
Instruments and medical devices themselves can be divided into several categories:
1. Critical. Used to penetrate into blood vessels, sterile tissues of the body, due to which they come into contact with injection solutions or blood.
2. Semicritical. During their operation, contact is made with damaged skin or mucous membranes.
3. Non-critical. They are needed for contact with intact skin.
Sterilization methods for medical devices
This procedure can be defined as part of disinfection measures. It should be noted that it is carried out using several key techniques:
1. The steam method. In order to obtain the desired result, water vapor under pressure is used. This approach to sterilization can be implemented using special equipment - an autoclave.
2. The chemical method of sterilization. In this case, special chemical solutions are used. Disinfectants such as hydrogen peroxide or alaminol may be used.
3. Air cleaning. Dry hot air is used here, which is generated using an oven.
4. Physical. Its essence boils down to processing instruments by boiling in distilled water, to which sodium can be added.
5. Biological. It is based on the use of the antagonism of various microorganisms. Through the action of bacteriophages, destruction of Pseudomonas aeruginosa, typhoid bacteria, staphylococci, and others is achieved.
6. Radiation. Instruments are exposed to gamma rays.
7. The use of plasma.
The most widespread is steam sterilization. Its main advantages are reduced to ease of use, small time costs and versatility (any tools can be processed).
But it is important to understand that all methods and modes of sterilization find their application in institutions of medical and prophylactic profile, and the matter is not limited to steam technology alone. Therefore, the main ones should be paid more attention.
Using steam
Paying attention to the steam sterilization method, it should be noted that it remains the most affordable and reliable way of processing heat-resistant medical devices in hospitals.
Tools are placed in special packaging or boxes, which can be with or without a filter. As a sterilizing agent, saturated steam is used under pressure. As for those instruments that are made of brass or stainless steel, they are practically not exposed to autoclaving. Changes, if they occur, are insignificant.
The steam sterilization method is mainly used for the disinfection of special and general surgical instruments, parts of apparatus and instruments made of corrosion-resistant metals, syringes (200 ° C mark), glass, latex and rubber products, some types of plastics, suture and dressings as well as surgical underwear.
In addition, the steam method can be used to sterilize ligature suture material. We are talking about surgical twisted silk and nylon threads, polyester cords, etc.
Air method
The use of dry hot air can be defined as the oldest technique. Moreover, throughout the past century, it has been the most common way to combat the risk of infection. But at the moment, modern medicine uses the air sterilization method less and less, preferring steam.
In order to have the desired effect on the instruments, air sterilizers are used as part of this process, the temperature at which reaches 160-180 ° C. In this case, dry heat is never used to sterilize injection solutions. This can be explained by the fact that due to the low thermal conductivity of air, the temperature of the solutions does not have time to reach the desired level. But talc, heat-resistant powders, auxiliary materials and glass containers can be successfully processed.
The quality of the sterilization process largely depends on how evenly the hot dry air is distributed in the chamber. At the same time, those sterilizers that make it possible to obtain a laminar air flow heated to the desired temperature are considered to be the best.
Chemistry use
The chemical method of sterilization cannot be called the main one, but it performs the function of the auxiliary process with dignity. This procedure is used to process tools that cannot withstand high temperatures.
The process itself takes place in sealed chambers filled with ethylene oxide. It usually takes from 15 to 16 hours to fully sterilize. In this case, the temperature inside remains at 18 ° C.
Also, to achieve complete disinfection of instruments, potent special solutions (formalin, povidone-iodine, pervomur, etc.) can be used.
Plasma technique
If possible, in the health care facility it replaces the chemical effect. The bottom line is that after processing with solutions or ethylene oxide, you can’t use the tools for some time - due to toxic effects in the sterilization process. When using plasma, such problems are eliminated.
The essence of the method is relatively simple: for the disinfection of instruments, pairs of hydrogen peroxide and its plasma are supplied, the temperature of which is at 36 ° C. Further, due to the influence of an electromagnetic field, the formation of free radicals occurs, which neutralize pathogens. To achieve the desired result, it will take 30-40 minutes of a similar effect on medical instruments and materials.
Other methods may be used. Ozone sterilization, for example, also shows good results when processing products that do not fall into the category of heat-resistant.
Radiation method
In this case, the processing of instruments is carried out using exposure to gamma rays. This method of disinfection is used to prepare those instruments that are sensitive to the effects of chemical compounds and high temperature. With this approach to disinfection, microorganisms are destroyed due to the release of ionizing energy.
It is worth noting that this method has recently become no less popular than other methods. This type of sterilization attracts attention due to several tangible advantages:
- tools and materials can be used immediately after the disinfection process is completed;
- Effective processing is possible even in sealed packages, which can subsequently be stored for a sufficiently long time;
- no toxic substances remain on the instruments.
Quality control
In any healthcare facility, various methods of sterilization control are used during disinfection. These are the following actions:
1. Preparation of tools. The removal of small particles that could remain after the operation is performed.
2. Water is chosen only in high quality and always soft. This avoids damage to the autoclave and directly to the material that is being sterilized. The best option would be distilled or demineralized water.
3. The pressure, temperature and duration of the whole process are constantly monitored.
4. The compliance with the loading standards of the amount of sterilized material is recorded.
Obviously, physical sterilization methods have long been not the only disinfection method in modern medicine. Thanks to the rapid development of technology, the approach to tool preparation in Russian hospitals can be described as flexible and effective.