Sterilization and disinfection

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The terms sterilization, disinfection, asepsis and antisepsis are often used interchangeably and frequently incorrectly. Sterilization is the process of destruction of all forms of microbial life. This includes bacteria, viruses, fungi, algae and protozoans. The term also implies the complete elimination of dormant bacterial spores, which are highly resistant to environmental changes and can survive within the environment for many years. This chapter looks at Disinfection; Methods of sterilization; and Preparation and handling of surgical packs.

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2.2 Regular disinfection is mandatory in operating theatres and kennel areas to minimize the risk of infection.
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2.4 Pre-vacuum autoclaves. medium-sized tabletop unit. Larger autoclaves are required for hospitals with a high surgical caseload.
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2.6 Micro-dose ethylene oxide sterilization machines use small doses of gas and are much safer to use than the earlier machines, where the entire sterilization chamber was flooded with EtO. A sterilizer liner bag is used.
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2.8 Cold sterilization of arthroscopic equipment.
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2.9 Chemical indicators. Steam sterilization: the upper strip shows the appearance prior to sterilization; the lower strip shows the obvious colour change following the sterilization process. Irradiation sterilization: appearance of the red dot shows that the package has been subjected to effective sterilization by gamma irradiation. Ethylene oxide sterilization: the yellow stripes turn blue when exposed to ethylene oxide.
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2.14 Plastic pouch used for sterilization of small items of equipment. These pouches are sealed by means of an adhesive strip once the item to be sterilized has been placed inside. Chemical indicator incorporated into the packing of a plastic pouch.
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2.16 Surgical packs should be wrapped with each corner folded away from the centre of the pack. Small flaps should be incorporated into the wrap so that they can be grasped and the packaging removed without contaminating the inner layer. Once folded, the pack is sealed with autoclave tape.
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2.17 A small plastic protective covering has been placed over the tips of these sharp-pointed scissors. The covering must be compatible with the sterilization process being used.
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2.18 Sterile items should be stored in closed cabinets, which are labelled so that items can be found easily when required.
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2.19 Transferring a small sterile item. The item is passed to the surgeon whilst being held in the outer packaging. This transfer should not be performed over the sterile field.
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2.20 Unwrapping a sterile item. The outer packaging is unwrapped one corner at a time and the free ends collected and held with the non-free hand. The package is then offered whilst being held within the wrapping.
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