Introduction to the Operating Room
LESSON 3: Safety in the Operating Room
3-17
3-17. STERILITY OF MATERIALS
To protect the patient from infection that could prove fatal, measures must be taken to assure the sterility of the materials used. Numerous measures are
employed during the operation to maintain sterile conditions. The OR specialist has many duties in the employment of these measures that include the following:
a. Goods are to be cleaned, wrapped, and loaded in the autoclave (steam pressure sterilizer) in such a way as to facilitate their penetration by steam.
b. Goods are to be processed in the sterilizer at the temperature and for a period appropriate for the item or class of goods and the size of the packages being sterilized.
c. Sterilization indicators are to be placed inside the packs as a check on the sterility of the goods processed. These indicators consist of chemically treated, heat-sensitive paper. If the indicator fails to change color, the specialist will know that the temperature necessary for the sterilization of goods has not been reached inside the autoclave and thus he is to discard the pack as unsterile. If the indicator has changed color, the specialist is to consider the pack safe for use, even though the color change does not provide assurance that the temperature of 250ºF has been maintained long enough for steam to penetrate the depth of the pack. The specialist should be aware of the limitations of sterilization indicators while at the same time realizing their usefulness as a check on the sterility of goods. The method described in g below is used in order to gain absolute assurance of the sterility of autoclave goods.
d. Pressure-sensitive tape is used for sealing and labeling surgical pack wrappers and other items to be processed in the steam pressure autoclave. The paper tape backing changes color when subjected to steam sterilization, giving definite indication that the item has been autoclaved.
e. Upon their removal from the autoclave, packs are to be placed on a perforated surface until they have cooled. This precaution is observed because a condensation of moisture occurs underneath a hot pack when it is placed on a solid metal surface. The pack will absorb this water, thus contaminating the pack since the metal surface is not sterile.
f. The packs are to be dated immediately after they have been processed in the autoclave. This measure prevents confusion as to which packs have been autoclaved.
g. Periodic tests are run to determine whether or whether not autoclaves are actually sterilizing the goods being processed. These tests should be conducted weekly, and in some installations they may be carried out more often. The test is done by placing a bacterial spore test strip (a standard item) inside a large pack.
After the pack has been autoclaved, the test strip is removed under sterile conditions, replaced in its packet, and sent to the laboratory. If no growth of organisms occurs within the designated period, the autoclave is sterilizing the goods. If a growth of organisms does occur, the autoclave in which the test strip was processed is not used until it is checked and repaired by maintenance personnel; and the items "sterilized" in that autoclave during the test period are considered unsterile and must be reprocessed and resterilized.
h. All measures necessary for the maintenance of aseptic technique are carried out while an OR is being prepared for an operation and during surgery.
