STERILIZATION

Dr. P.V. PARIKH

Professor
Department of Veterinary Surgery & Radiology
College of Veterinary Science & Animal Husbandry
Anand Agricultural University
Anand – 388 001
 STERILIZATION
Sterilization is a process by which an
article can be rendered free from all forms of
living microbes including bacteria, fungi and
their spores, and viruses.

• The various materials and equipment are

prepared for sterilization each in a different
manner and in some instances special
techniques are employed in sterilization
procedure.
PACKING AND WRAPPING A TOWEL FOR STERILIZATION.
PACKING AND WRAPPING A LAPROTOMY SHEET FOR STERILIZATION.
PACKING AND WRAPPING A SURGICAL GOWN FOR STERILIZATION.
PACKING AND WRAPPING OF GAUZE SPONGES FOR STERILIZATION.
PACKING AND WRAPPING OF INSTRUMENTS FOR STERILIZATION.
PACKING AND WRAPPING OF SURGICAL GLOVES FOR STERILIZATION.
PACKING AND WRAPPING OF SCRUB
BRUSH FOR STERILIZATION.
METHODS OF STERILIZATION.

1. Steam sterilization -Autoclaving.

2. ETO sterilization.

3. Radiation.

4. Gas plasma.

5. Chemical sterilization.

6. Filter sterilization.
 1. Steam sterilization
-Autoclaving.
How it works ?

- Inactivation of a single molecule.

- Disruption of a single molecule.
- Protein denaturation.
- Destruction of enzymes.
- Destruction of non – covalent bonds.
 Critical parameters

- Moisture
- Temperature
- Contact with surfaces.
- Air elimination.
- Time.
- Pressure / vacuum condition.
Advantages :
- Short cycle times.
- Simplicity of the process.
- Non – toxic.
- Inexpensive.
- Rapidly anti-microbial.
- East penetration of steam.

Disadvantages :
- Limited polymeric device application due to
material effects.
- Great for metal re-usable metal surgical
instrumentation and heat resistant supplies.
e.g. drapes and dressings
 Team sterilization by two types :
1. Dry heat :
Heated filtered air distributed throughout an
oven by convection or radiation.
Temperature : 140 C for 3 hours.
170 C for 1 hours.
Advantages : Large volume , easy of use ,
Disadvantages : Temp. too high , long cycles
(hours/days) , limited packing.
2. Moist heat :
Heat derived under conditions of saturated water.
Temperature : 100 C for 10 to 15 min in autoclave.
 Steam sterilization- Autoclaving.

Autoclave Temperature Pressure

Time (min)
Settings (F) (PSI)
General
Wrapped 250 20 30
Items
Bottled
250 20 30
Solutions
'Flashing' 270 30 4-7

Routinely, materials are autoclaved at 121 C

under 15 lb pressure for 15-20 minute.
Autoclave
 2. Ethylene oxide - sterilization

ETO Gas
• It is a nasty gas (explosive
and toxic).
• Cartridges release 100% pure
ethylene oxide
• Kills all known viruses,
bacteria (including spores),
and fungi.
Mode of action :
- Alkylation of amine group on the nucleic acid.
- Expoxide and alkylating agent reacts with
proteins and DNA , compromises metabolism and
reproduction of the bacterial cell.

Advantages :
- Broadest material compatibility with most medical
materials.
- Very effecting of killing of m.o.

Disadvantages :
- Relatively long cycle times.
- Residues need to be managed.
- Explosion and worker safety issues.
- Potential hazard to patients and staff.
 3. Radiation.
Two type mainly :
1. Non-ionizing radiation.
e.g. from u v lamps
2. Ionizing radiation
e.g. X rays , Gamma rays , E – beam
Process :
- Typical industrial process.
- Electrons are accelerated from 200 eV to energies up to 10
MeV.
- Gamma rays actually produce high energy primary
electrons as they deposit energy.
- Materials effects in both gamma and e beam come from
the secondary electrons generated by the high energy
primary electrons.
- Difference in material effects between gamma and e beam
results from the process cycle times in air and
temperature effects from processing.
Advantages :
- Reasonably short cycle times.
- Single parameter process.
- Dose can be measured directly and easily controlled.
- Simplicity of the sterilization process.
- Material compatibility with large range of materials.

Disadvantages :
- Radiation shielding and safety issues.
- Capital costs for facility , infrastructure and source
replenishment.
-Complexity of sterilization equipments.
 4. Gas plasma.
• Based on a patented process involving
the generation of a low-temperature
hydrogen-peroxide gas plasma.
• Requires only a 74 minute cycle time
and leaves no toxic residues or
emissions.
• Effectively sterilizes most heat- and
moisture-sensitive medical devices and
surgical instruments.
Advantages :
- Safe for environment and health care.
- Simple to operate , install and monitor.
- Compatible with most medical devices.

Disadvantages :
- Sterilization chamber is small , about 3.5 ft to 7.3
ft.
- Endoscope or medical devices restrictions based
on lumen intemal diameter and length.
- Requires synthetic packing and special container
tray.
 5. Chemical sterilization
• It is also known as cold sterilization.
• Certain chemicals use in sterilization:
1. Ethyl alcohol
2. sodium nitrite (4 gm/l )
3.Cidex and sterisol
4. 1% formaldehyde
5. Ethyl alcohol and isopropyl alcohol
6. Formalin (38 % ) and 10 g sodium hydroxide
 Hypochlorites (household bleach) &
chlorine

• Advantages • Practical Uses

– 0.1% hypochlorite used as
– active against viruses, general disinfectant
spores, fungi – Strong hypochlorite (0.25%)
used in lab & on wounds
• Disadvantages – Extra strong (1%) used on HBV
blood spills
– inactivated by organic – Chlorine used to treat drinking
matter, freshness & pH water and control Legionella
critical (go off if
diluted), corrosive to
metals
• Iodophors & Iodine

• Advantages
– Some activity against viruses, spores, fungi
• Disadvantages
– inactivated by organic matter, can stain skin, irritant,
expensive
• Practical Uses
– Pre-op skin disinfection
– Povidone iodine used as surgical scrub, as powder on
ulcers
 Alcohols
• Isopropanol & ethanol
• Advantages
– kill vegetative bacteria on clean surfaces in 30
seconds
• Disadvantages
– inactive against spores, fungi
– Inflammable
– Need to be at correct %age with water (65-80%)
• Practical uses
– Skin antisepsis before venepuncture
– Hand rubs
– Disinfection of e.g. trolley tops
 Alkylating agents
• Glutaraldehyde and Formaldehyde
• Advantages
– Good activity against spores, viruses, fungi
• Disadvantages
– Glutaraldehyde only moderately active against TB
– Need long exposure time for full effect (3 hours)
– freshness & pH critical
– TOXIC!
• Practical uses
– Disinfection of endoscopes
– Blood spills
– Fumigation
 Cold (chemical) sterilization.

• Instruments must be dry before

immersion.

• Glutaraldehyde (Cidex) is the most

common disinfectant.

• 3 hours exposure time is needed to

destroy spores.

• Glutaraldehyde is bactericidal,
fungicidal, viricidal, and sporicidal.
 MATERIALS
&
EQUIPMENTS

COTTON INSTRUMENT SURGICAL SCRUB

MATERIALS PACKS GLOVES BRUSHES

ALL SUTURE NEEDLES, SCALPEL BLADES,

SCISSORS AND OTHER SHARP INSTRUMENTS
Towels STERILIZED BY MEANS OF CHEMICALS MUST
Drapes BE THOROUGHLY CLEANED PRIOR TO
Laparo. sheets TREATMENT WITH CHEMICALS.
Gowns
Swabs
INSTRUMENT TRAYS FOR
CHEMICAL STERILIZATION OF
CUTTING INSTRUMENTS.
LABELLED ‘ODD’ & ‘EVEN’ FOR USE
ON RESPECTIVE DAYS OF THE
MONTH.

SCISSORS, SUTURE NEEDLES &

SCALPEL BLADES BEING
CHEMICALLY STERILIZED.
 6.Filter sterilization.
• Filters are used for removal of
microorganisms in fluids and gases.
• They come in a wide variety of types
and sizes.
• 0.2 micron filter is required to
remove bacteria from fluids.
• The filter is placed in the IV line or
on a syringe, so that the contaminated
solution is sterilized before reaching
the patient.