Sterilization and the Packaging and Storing of Wrapped Instruments

Sterilization and the Packaging and Storing of Wrapped Instruments

Sterilization is a method that eradicates, eliminates, or inactivates all types of life, especially microorganisms like fungi, bacteria, spores, and other biological agents like viruses found on a surface or object. Unlike disinfection or sanitization, which only reduce the presence of these life forms and biological agents, sterilization ensures their complete removal.

 Items used in patient care are classified based on the risks associated with their use and the ability to transmit infection.

• Critical items enter soft tissue or bone and carry the highest infection transmission risk; they must always undergo heat sterilization.
• Semi-critical items contact mucous membranes and pose a lower infection risk than critical These items should generally be heat sterilized. If they cannot withstand heat sterilization, a high-level disinfectant should be used instead.
• Non-critical items, which only touch the skin, present the lowest risk of infection. These items should be cleaned and, if visibly dirty, disinfected with a low-level disinfectant. Dental healthcare workers need to know the proper procedures for cleaning and reprocessing patient care items.

 The idea of using packaging materials, such as paper and plastic peel packages or wrapped perforated cassettes, is to enable the sterilizing agent to penetrate while also preserving the instrument's sterility after processing.

Wrapped sterile instruments and supplies should be kept in cabinets with drawers or doors that can be closed. Avoid places like under a sink or anywhere else that could expose the sterile packaging to water or moisture.

 What is the shelf life of wrapped sterilized instruments?

Storage methods for sterilized instruments may follow a date-based or event-based system. Although some facilities still date each package and adhere to shelf-life protocols like FIFO (First in, first out), most have transitioned to event-based strategies. This method is based on the idea that items remain sterile until a specific event like being opened for use or damaged during storage.

 Other than being opened for use, the duration a device remains sterile is influenced by certain incidents that can compromise its packaging.

•  Damage to the packaging can result from rough or incorrect handling, overcrowding of packages during storage, stacking or crushing of packages during transport by personnel and the condition of storage carts or shelves. Such damage permits the entry of airborne bacteria and dust, endangering the sterility of the contained device.
•  Moisture can serve as a conduit for microorganisms from the air and surfaces to infiltrate packaging materials. Sterile items should not be kept close to moisture sources like sinks, exposed water pipes or against external High humidity levels in the sterile storage area or handling packages shortly after sterilization can likewise jeopardize sterility. Try to avoid placing hot packages on cool surfaces to avoid condensation.
•  Contamination from soil poses another risk to sterility. Any package that appears soiled or stained should be deemed contaminated, with its contents needing reprocessing or Dirt from unclean transport carts, dirty hands, and filthy storage bins or shelves can also endanger sterility.

Source: Infection control guidelines for:

Dentistry - https://www.cdc.gov/oralhealth/infectioncontrol/index.html