Decontamination:

Control of Microbial Growth Sterilization: Killing or removing all forms of microbial life (including endospores) in a material or an object. Purposes of sterilization: To destroy all pathogenic microorganisms including HIV viruses To sterilize instruments and equipments used in the surgical practice To keep the articles in such a condition that they are ready for use at any time. For the safety of the patient Method of Sterilization: 1. Autoclave 2. Dryheat oven 3. Chemical

1. Autoclave: Chamber which is filled with hot steam under pressure. Preferred method of sterilization, unless material is damaged by heat, moisture, or high pressure. Temperature of steam reaches 121oC at twice atmospheric pressure.Most effective when organisms contact steam directly or are contained in a small volume of liquid. All organisms and endospores are killed within 15 minutes. Precaution: Never touch the drainage tap, outlet valve of the autoclave while heating it under pressure Never heat autoclave too quickly to bring up the pressure once the outlet valve is closed Never leave the autoclave unattended while the pressure is rising Never open the lid before the pressure has dropped to normal , as you may scald with steam During sterilization make sure the lid is secured and no steam escapes. if it does neither the pressure nor the temperature will be corrected. Principle: All article must be clean and dry The wrapper and container should allow penetration of steam into the article The drum should not be too full nor the contents be arranged too compactly Can and jar must be opened and turned to their side so that stem can penetrate the contents

The temperature and pressure of steam must be 121 /1.05kg/cm2 degree so that it will Kill all type of microorganism. The distruction of bacteria depends upon the length of the time the articles are exposed to steam under pressure.

While operating autoclave , all the air in the chamber must be driven out and replaced by steam

When autoclave is over ,wait for half an hour to dry the materials. Procedure: Clean thoroughly all instruments using small brush Rinse all instruments with clean water Dry all instruments properly Open all joined parts of the instruments and wrap the sharp edge and needle point in gauze before sterilization Double wrap the instruments in freshly cleaned clothes or paper using envelope or square wrap technique

Fold up cuff of surgical gloves ,place gauze or paper inside the gloves and underfold the cuff and wrap in clean clothes or paper

Place the wrapped gloves thumbs up in a wire basket on their side.

Arrange the equipment packs on an autoclave cart or shelf ,place in the autoclave chamber to allow free circulation and penetration of steam to all surfaces Sterilize the wrapped items for 30 mins and unwrapped items for 20 mins,time with clock at 121 degree centigrade (250f)and 106 kpa(15 Ibs/in2)

Wait until the pressure gauze reads zero before opening lid or door 14-16cm (5-6inch).this may take 20-30 mins

Then,open the lid/door and allow the packs to dry completely before removal.this may take 20-30 mins Place the sterilized packs on a surface padded with paper or fabric to prevent condensation.

 Allow the pack to reach room temperature before storing and record sterilization condition (time ,temperature,pressure)

2.Dry heat oven :

Place objects in an oven. Require 2 hours at 170oC for sterilization. Dry heat is transfers heat less effectively to a cool body, than moist heat Place the metal instruments or glass syringe in a metal container with a close lid Place covered container in oven and heat desired temperature Begin time after desired temperature reached and maintain temperature for the recommended time. After cooling remove container and store 3.Chemicals: The chemical substances known as disinfectants,are used to kill pathogenic organism .the stronger the chemical the lesser the time required for disinfection. Principles: A chemical disinfectant acts by coagulating or changing the composition of the protein so that no longer exist in the same form.

Advantages: This method is used to sterilize instruments which are damaged by heat and metallic objects prone to corrosion. It is an easy method Disadvantages:

 A disinfectant cannot destroy the spores Disinfectants are injurious to skin and the articles Equipments can be disinfected by varieties of chemical solutions. The following chemicals are major types of chemicals for sterilization.
1.

Formaldehyde :

2. Glutaraldehyde:
1

Formaldehyde : Excellent disinfectant. Commonly used as formalin, 8% for 24 hours

2 Glutaraldehyde: Less irritating and more effective than formaldehyde. One of the few chemical disinfectants that is a sterilizing agent. A 2% solution of glutaraldehyde (Cidex) is: Bactericidal, tuberculocidal, and viricidal 8-10 hours. Commonly used to disinfect hospital instruments.

Procedure:

prepare fresh solution of chemical sterilant or check to be sure solution is not out of date

submerge the cleaned and dried items in 2% gluteraldehyde or 8%formaldehyde solution.completely covering all items cover container and soak for appropriate time 8-10 hrs for gluteraldehyde or atleast 24hrs for formaldehyde. Remove the items from the chemical solution using sterile gloves or a sterile forceps. Rinse items thoroughly with sterile water to remove all traces of chemical sterilant. Use the items immediately or place it in a sterile covered container. HLD High Level Disinfection: