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As a patient you should have the complete right to know what goes into maintaining a strict standard of asepsis to protect from any potential biohazard.

Sterilization can be broadly divided into two
Physical methods and
Chemical methods.

Physical methods are mostly used in the form of Autoclaves.
In addition to the above physical methods certain chemicals are also used as a precursor to Autoclaving in order to achieve a thorough sterilization.

An overview of the sterilization guidelines is mentioned in a stepwise manner :

Traffic Control
Controlled   access   to   the   sterilization   areas minimizes   the   potential   for transfer   of   micro- organisms between contaminated items,  patients,  and staff. These areas must be off limits to anyone not involved in the sterilization process.

Instrument Cleaning
You should take contaminated instruments from the  receiving  area  wearing  heavy duty  puncture- resistant   gloves   while   handling   all   potentially contaminated items. Break down all packs and place disposable  items  and  contaminated  linens in appropriate containers. All contaminated, reusable items must be decontaminated by immersion in an Enviormental Protection Agency (EPA) registered disinfectant before further handling. This step can be eliminated if these items are cleaned in an ultrasonic cleaner (bath) with an EPA-registered disinfectant that also  is  approved  as an  ultrasonic  cleaning  solution. Process  instruments  using  one  of  the  following methods.

All inspecting,  sorting,  wrapping,  and  packaging  of contaminated materials occur here.

The  space  requirements  for  the  sterilization process should be determined by the available size, the degree  of  sufficient  access  for  the  loading  and unloading, and the ability to service the sterilizer. In case of chemical sterilization the solution should lie with the instruments undisturbed for the time mentioned by the manufacturer.

Sterile Storage and Issue
To  protect  and  maintain  all  sterile  items,  the storage and issue areas should not be in the immediate vicinity of the contaminated processing areas.


Presterilization Processing

Inspection and Sorting of Instruments
After drying, you must inspect items closely for wear, breakage, and cleanliness. Sort instruments according to sets or packs. This is the area where your instruments are sorted before wrapping and packaging.

Wrapping and Packaging
Wrapping and packaging is the last step just before the sterilization process Before terminal  (final) sterilization, wrap or package all critical and semi critical items individually or in sets. Ensure you place consumable supplies that are required by your command in each particular pack before wrapping such items as needles, cotton rolls and pellets, gauze, aluminum foil for dental light handles, internal indicators, and towels. Dental instruments are usually placed in packs, on trays  or  cassettes,  before placing  them  into  the sterilizer.

The most common wrapping materials and containers are paper, paper/plastic, nylon tubing, and cloth.   Aluminum   foil,   closed metal   trays,   and perforated cassettes may also be used. The packaging or wrapping materials that you select depends on the compatibility of what type of sterilization method you are  using.   shows  various  sterilization packaging materials and their suitability to withstand steam or dry heat sterilization.

Always refer to the sterilizer manufacturer's instructions for suitability. Paper materials are available in the form of bags or flat  disposable  wraps. Both types are sealed with adhesive  indicator  tape. Thecombination  paper/ plastic peel packs are available in varied sizes of preformed bags or rolls of varied widths that can be cut to the desired length. Either type can be sealed with the adhesive indicator tape or self-sealed. Heat sealed plastic or nylon tubing should only be used as an overwrap after the pack has been sterilized. Heat sealed overwrapping will extend a 30 day shelf life to 180 days.

Protocol : Use of Autoclaves
To sterilise solutions or equipment it is necessary to autoclave them to 15 Psi for 20 minutes. Apparatus to be autoclaved should be placed in sterilising bags or wrapped in tinfoil and autoclave tape placed on the packet (autoclave tape has the barely visible strips. The items may then be placed in the autoclave and sterilised under the operation instructions for the machine.

Autoclaves should be used as the preferred route of sterilisation wherever possible, with the exception of radioactive samples.