STERILIZATION AND

ASEPSIS
 DEFINITION

STERILIZATION

The process of freeing an article from

microorganisms including their spores.
DISINFECTION:

Reducing the number of pathogenic

microorganisms to the point where
they no longer cause diseases, but
may not inactivate some viruses and
bacterial spores.
Sepsis: Comes from Greek for decay or putrid. Indicates
bacterial contamination.

Asepsis: Absence of significant contamination.

• Aseptic techniques are used to prevent contamination

of surgical instruments, medical personnel, and the
patient during surgery.

• Aseptic techniques are also used to prevent bacterial

contamination in food industry.
• ANTISEPTIC:
A chemical that is applied to living tissues such as skin or mucous
membrane to prevent infection by inhibiting growth of bacteria

DISINFECTANT
A chemical used on non vital objects to kill surface vegetative
pathogenic organisms, but not spores or viruses.
Sanitizing - process that reduces microbial population
on object to a safe level.

Decontamination - process that removes pathogenic

microorganisms from an object to make it safe to
handle.
Bactericide:
An agent that kills bacteria. Most do not kill Endospores.

Bacteriostatic agent: inhibits the growth of bacteria, does not

kill them

Sporicide:
An agent that kills spores.
INTRUDING BODY’S LINE OF DEFENSE

During any operative procedure, we are breaching body’s line of

defense

Sterilization , Disinfection and Asepsis

becomes important
JOSEPH LISTER
Discovered how to
use chemical
antiseptics to
control surgery
related infections
Used antiseptics to
disinfect surgical
equipment and
supplies
Methods of Sterilisation

Microbial Control
Methods

Mechanical Removal
Physical Agents Chemical Agents
Methods
 Physical Agents

Heat Radiation

Dry Moist Ionizing Non Ionizing

Incineration Steam Under X Ray, Cathode,

Pressure UV
Gamma
Dry Oven Sterilization

Boiling Water/Hot Water Sterilization Disinfection

Pasteurization

Disinfection
 Chemical Agent

Gas Liquids

Sterilization Disinfection Animate Inanimate

Chemotherapy Antiseptics Sterilization Disinfection

 Mechanical Removal
Methods

Filtration

Air Liquids

Disinfection Sterilization
To achieve sterilization of any instrument three
definite stages are to be completed-

 Pre sterilization cleaning

 Sterilization process

 Aseptic storage
 Presterilization cleaning
• Objective-
Removal of the organic matters, blood and
saliva which provide protective barrier for
microorganisms and prevents its destruction.
• There are three methods for cleaning
-Manual
-Ultrasonic
-Mechanical washing
 MANUAL CLEANING

• Simplest and the cheapest method, but time

consuming and difficult to achieve.
• Heavy duty gloves and glasses must be worn
to protect needle stick injury and to protect
eye.
• Material used for manual cleaning
-Soaps
-Detergents
ULTRASONIC CLEANING

Principle- conversion of
electrical energy into vibratory
sound waves which pass
through a soap solution
containing the instrument.

Used mainly for burs, bone

files, bone cutter, artery
forceps, saw etc.
MECHANICAL WASHING

Principle- High-pressure
jets of water with or
without a detergent which
removes debris from
instrument.
Small instrument like
burs, blade are not
suitable for this type of
cleaning.
 Physical Methods of Sterilisation
Sterilisation By Dry Heat: • Kills by oxidation effects
•The oven utilizes dry heat to
sterilize articles
• Operated between 50oC to
250/300oC.
•A holding period of 160oC for
1 hr is desirable.
• There is a thermostat
controlling the temperature.
•Double walled insulation
keeps the heat in and conserves
Hot Air Oven energy
Uses:

• To sterilise Forceps, Scissors, Scalpels, Swabs.

• Pharmaceuticals products like Liquid paraffin, dusting

powder, fats and grease.
 MOIST HEAT STERILIZATION

Kills microorganisms by coagulating their proteins.

 TEMPERATURE AT O
100 C

Boiling:
Kills vegetative forms of bacterial pathogens.
• Hepatitis virus: Can survive up to 30 minutes of
boiling.
Endospores: Can survive up to 20 hours or more of
boiling
STEAM UNDER PRESSURE - AUTOCLAVE

• Works on the principle of Steam under pressure

• Invented by Charles Chamberland in 1879.

AUTOCLAVE
• Autoclave consists of a vertical or a horizontal
cylinder.
• One end has an opening which is meant for keeping
materials to be sterilised.
• The lid is provided with a Pressure gauge, to measure
the pressure
• A safety valve is present to permit the escape of
steam from the chamber
• Articles to be sterilised are placed in the basket provided
• Sterilisation is carried out under pressure at 121º for 15 mins.
CHEMICAL AGENTS
Chemical agents act by
• Protein coagulation
• Disruption of the cell membrane
• Removal of Sulphydryl groups
• Substrate competition
ALCOHOLS
• Ethanol /Isopropyl alcohol are frequently used
• No action on spores
• Concentration recommended 60-90% in water
Uses
• Disinfection of clinical thermometer.
• Disinfection of the skin – Venipuncture
ALDEHYDES
• Formaldehyde & Glutaraldehyde are frequently used
• Formaldehyde is bactericidal, sporicidal & has a lethal effect on
viruses.
• Glutaraldehyde is effective against Tubercle bacilli, fungi and viruses
USES
FORMALDEHYDE
• To preserve anatomical specimens
• Destroying Anthrax spores in hair and wool
• 10% Formalin+0.5% Sodium tetra borate is used to
sterilise metal instruments
USES
GLUTARALDEHYDE (Cidex)
• Used to treat corrugated rubber anesthetic tubes, Face masks, Plastic
endotracheal tubes, Metal instruments and polythene tubing
HALOGENS
• Iodine in aqueous and alcoholic solution has been used widely as a
skin disinfectant
• Actively bactericidal with moderate action against spores
• Chlorine and its compounds have been used as disinfectants in water
supplies & swimming pools
PHENOLS
• Obtained by distillation of coal tar
• Phenols are powerful microbicidal substances
• Phenolic derivatives have been widely used as disinfectants for
various purposes in hospitals
• Eg: Lysol, cresol
USES

• Various combinations are used in the control of pyogenic cocci in

surgical & neonatal units in hospitals.

• Aqueous solutions are used in treatment of wounds

GASES
Ethylene Oxide
• Colourless, Highly penetrating gas with a sweet
ethereal smell.
• Effective against all types of microorganisms
including viruses and spores
USES
• Specially used for sterilising heart-lung machines, respirators,
sutures, dental equipments, books and clothing.
• Also used to sterilise glass, metal and paper surfaces, plastics, oil,
some foods and tobacco.
FORMALDEHYDE GAS

• Widely employed for fumigation of operation theatres and other

rooms
BETA PROPIOLACTONE
• Used in fumigation

• For sterilisation 0.2% BPL is used

• Has a rapid biocidal activity

• Very effective against viruses

SURFACE ACTIVE AGENTS AND METALLIC SALTS

Substances which reduce the surface tension

• Cations are widely used in the form of quaternary
ammonium compounds.

• Markedly bactericidal, active against Gram positive

organisms.

• No action on spores, tubercle bacilli, viruses

METALLIC SALTS

• The salts of silver, copper and mercury are used as

disinfectants.

• Act by coagulating proteins

• Marked bacteriostatic, weak bactericidal and limited

fungicidal activity
Non- Ionising radiation:
• Electromagnetic rays with longer wavelength

• Absorbed as heat

• Can be considered as hot air sterilisation

• Used in rapid mass sterilisation of prepacked Syringes

and catheters

Eg: UV rays
IONISING RADIATIONS

• X- rays, gamma rays & cosmic rays.

• High penetrative power

• No appreciable increase in the temperature – COLD

STERILISATION

• Sterilise plastics Syringes, catheters, grease fabrics

metal foils
 Sterilization control.
Thermocouple – it is to record the temperature directly by a
potentiometer.
Bacterial spores:- spores of bacillus sterothermophilus are
used as the test organism. The spores of this organism are
killed in 12 minutes at 1210 C An envelope containing a filter
paper strip impregnated with 106 spores is placed inside the
autoclave during sterilization.
Chemical indicator – browne’s tube contains red solution
which turns green when exposed to temperature of 1210 C for
15 minutes in autoclave
Autoclave tapes.
Resistance of Microorganisms
Sterilization
Spores
bacterial, fungal Bacillus stearothermophilus
Bacillus subtilis
Clostridium sporogenes

High Level Disinfection

Mycobacteria, TB bacilli

Intermediate Disinfection

Hydrophilic viruses Polio, Coxsackie, Rhino

Low Disinfection

Vegetative fungi & bacteria Trichophyton, Cryptococcus,Candida

Lipophilic viruses Pseudomonas, Staphylococcus,Salmonella
HSV, CMV, RSV, HBV, HIV
Dental instruments are classified into three categories
–
critical, semi critical, or non critical depending on
their risk of transmitting infection and the need to
sterilize them between uses.
Spaulding Classification
Item comes in contact with Type
recommended

 Critical Tissue, vascular space Sterilization

 Semicritical Mucous membrane High level

disinfection
Non intact skin High level
disinfection

 Noncritical Intact skin only Intermediate or

not mucous membranes low level
disinfection
Critical Semicritical Noncritical