State autonomous educational institution of secondary vocational education

Novosibirsk region "Kupinsky Medical College"

PM 04. Performing work by profession junior nurse on nursing

Sterilization

• STERILIZATION is a method that ensures the death of vegetative and spore forms of pathogenic and non-pathogenic microorganisms in the sterilized material.
• All items or certain types of diagnostic equipment that come into contact with wounds, blood, injections, and damaged mucous membranes should be sterilized.

Sterilization steps

Products to be sterilized are processed in several stages:

• Cleaning;
• Disinfection;
• Pre-sterilization cleaning;
• Sterilization.

In modern educational institutions, centralized sterilization departments (CSO) are organized, in which they carry out:

• Pre-sterilization processing of medical instruments;
• Sterilization:

A) medical products;

B) linen and dressings.

Pre-sterilization treatment

The purpose of pre-sterilization treatment is to remove protein, fatty, medicinal, mechanical contaminants (including blood, mucus) from medical devices, which ensures the effectiveness of subsequent sterilization and the safe use of sterilized products.

Pre-sterilization treatment methods

Pre-sterilization processing is carried out manual and mechanized ways.

Manual way:

Stage 1 - rinsing after disinfection with running water for 30 seconds until the odor of the disinfectant is completely removed.

Stage 2 - soaking the product in detergent - 15 minutes.

Stage 3 - washing each product in the same solution in which it was soaked using a brush for 30 seconds.

Stage 4 - rinsing with running water.

Stage 5 - rinsing with distilled water for 30 seconds.

Stage 6 - drying with hot air at a temperature of 75-85 o С in drying ovens

Methods, means and modes of sterilization

The following sterilization methods are used:

• Thermal (steam, air);
• Chemical (gas, chemicals);
• Radiation;
• Plasma and ozone (a group of chemicals).

The choice of a particular sterilization method for specific products depends on the characteristics of the product and the method itself - its advantages and disadvantages.

The most common methods in health care facilities are steam and air.

Steam sterilization method

The sterilizing agent is hot steam under pressure. An autoclave is used for this method.

Packaging: bix, kraft bags, laminated paper, coarse calico.

Materials: polymers, glass, latex, fabric, corrosion-resistant metals.

Advantages: high vapor permeability, a large selection of packaging, sterility remains longer, a cheap and easy-to-use method.

Disadvantages: wetting of products, corrosive to metals.

Air sterilization method

Dry heat ovens are used for this method.

The sterilizing agent is dry hot air (160-200 o C).

Packaging: kraft bags, coarse calico.

Materials: metal, textiles.

Advantages: a cheap, simple method, does not cause metal corrosion, does not wet the packaging and products.

Disadvantages: limited choice of packaging, slow and uneven heating of products, the need to use higher temperatures, the inability to use materials from rubber, polymers.

Gas sterilization method

Gas sterilizers are used for this method.

The sterilizing agent is formaldehyde or ethylene oxide.

Packaging: laminated paper, parchment, kraft paper.

Materials: polymers, glass, metal.

Advantages: low temperature, use of any materials.

Disadvantages: toxicity to personnel and explosion hazard if safety precautions are not followed, long sterilization cycle.

Radiation sterilization method

The radiation method is necessary for the sterilization of products made from thermolabile materials.

Sterilizing agent - ionizing γ and β radiation.

Packaging: in addition to paper bags, polyethylene bags are used.

Advantages: sterility in the package remains for a long time.

Disadvantages: high cost of the method.

Radiation is the main method of industrial sterilization. Used by enterprises producing sterile disposable products.

Description of the presentation for individual slides:

1 slide

Slide Description:

Sterilization State Autonomous Educational Institution of Secondary Vocational Education of the Novosibirsk Region "Kupinsky Medical College" PM 04. Performing work by profession junior nurse for nursing

2 slide

Slide Description:

The concept of Sterilization STERILIZATION is a method that ensures the death of vegetative and spore forms of pathogenic and non-pathogenic microorganisms in the sterilized material. All items or certain types of diagnostic equipment that come into contact with wounds, blood, injections, and damaged mucous membranes should be sterilized.

3 slide

Slide Description:

Sterilization stages Products to be sterilized are processed in several stages: Cleaning; Disinfection; Pre-sterilization cleaning; Sterilization.

4 slide

Slide Description:

In modern medical institutions, centralized sterilization departments (CSO) are organized, in which they carry out: Pre-sterilization processing of medical instruments; Sterilization of: A) medical products; B) linen and dressings.

5 slide

Slide Description:

Pre-sterilization treatment The purpose of pre-sterilization treatment is to remove protein, fat, medicinal, mechanical contaminants (including blood, mucus) from medical devices, which ensures the effectiveness of subsequent sterilization and the safe use of sterilized products.

6 slide

Slide Description:

Methods for pre-sterilization treatment Pre-sterilization treatment is carried out manually and mechanically. Manual method: Stage 1 - rinsing after disinfection with running water for 30 seconds until the odor of the disinfectant is completely removed. Stage 2 - soaking the product in detergent - 15 minutes. Stage 3 - washing each product in the same solution in which it was soaked using a brush for 30 seconds. Stage 4 - rinsing with running water. Stage 5 - rinsing with distilled water for 30 seconds. Stage 6 - drying with hot air at a temperature of 75-85oС in drying ovens

7 slide

Slide Description:

Methods, means and modes of sterilization The following sterilization methods are used: Thermal (steam, air); Chemical (gas, chemical); Radiation; Plasma and ozone (a group of chemicals). The choice of a particular sterilization method for specific products depends on the characteristics of the product and the method itself - its advantages and disadvantages. The most common methods in health care facilities are steam and air.

8 slide

Slide Description:

Steam method of sterilization The sterilizing agent is hot steam under pressure. An autoclave is used for this method. Packaging: bix, kraft bags, laminated paper, coarse calico. Materials: polymers, glass, latex, fabric, corrosion-resistant metals. Advantages: high vapor permeability, a large selection of packaging, sterility remains longer, a cheap and easy-to-use method. Disadvantages: wetting products, corrosive to metals.

9 slide

Slide Description:

Air sterilization method For this method, dry ovens are used. The sterilizing agent is dry hot air (160-200oС). Packaging: kraft bags, coarse calico. Materials: metal, textiles. Advantages: a cheap, simple method, does not cause metal corrosion, does not wet the packaging and products. Disadvantages: limited choice of packaging, slow and uneven heating of products, the need to use higher temperatures, the inability to use materials from rubber, polymers.

Plan Introduction Sterilization methods permitted for use in healthcare facilities Sterilization steps a) Disinfection b) Pre-sterilization treatment c) Sterilization Products to be sterilized Disinfection methods a) Boiling b) Steam c) Air d) Chemical Pre-sterilization treatment a) Algorithm of actions Types and methods of sterilization 1) Chemical method of sterilization 2) Steam method of sterilization 3) Air method of sterilization Control methods of sterilization Software control is carried out using the following samples References

Introduction One of the most important areas of work of all medical personnel is the provision and control over the implementation of sanitary-hygienic and anti-epidemic measures and the requirements provided for by the relevant orders of the Ministry of Health of the Republic of Kazakhstan. Sterilization is the process of killing all types of microorganisms, as well as spores and bacteria.

Sterilization methods approved for use in health care facilities Physical (thermal) Steam-Water saturated steam under excess pressure Air-Dry hot air Infrared-Infrared radiation Glasperlen-Medium of heated glass beads Chemical, Gas-Ethylene oxide or its mixture with other components Plasma -Vapors hydrogen peroxide in combination with their low-temperature plasma Liquid -Solutions of chemical agents (aldehyde-, oxygen- and chlorine-containing)

Stages of sterilization 1) Disinfection is a set of measures aimed at destroying pathogens of infectious diseases and destroying toxins on environmental objects. Disinfection reduces the number of microorganisms to an acceptable level, but it may not completely destroy them. 2) Pre-sterilization treatment is the cleaning of medical devices before their sterilization, in order to remove protein, fat and mechanical contaminants, as well as drugs. 3) Sterilization is the complete destruction of all forms of microbes and their spores under the influence of high temperatures and other physical factors, chemicals, ionizing radiation.

Products to be sterilized 1) Medical and laboratory instruments of all kinds are subject to disinfection after each use. 2) All medical devices that come into contact with the skin and mucous membranes, organs, wound surfaces, contact with blood and other biological fluids are sterilized. 3) Disposable instruments (syringe, systems, scarifiers, spatulas, gynecological mirrors) are disposed of by burning in special or muffle furnaces at a temperature of at least 6000 C

Disinfection methods 1) Boiling Applied: for glassware, metal, heat-resistant polymer materials, rubber. 2) Steam Applied: for glass, metal, heat-resistant polymer materials, rubber, latex. Note: During disinfection by boiling and steam method, products made of polymeric materials should be packed in gauze 3) Air Applied: for glass and metal products. 4) Chemical Applied: for glass products, corrosion-resistant metals, heat-resistant polymer materials, rubber. Note: After chemical disinfection, products should be rinsed in running water until the odor of the disinfectant is completely removed.

Pre-sterilization treatment Algorithm of actions: 1) Upon completion of disinfection, medical instruments are rinsed with running water for 30 seconds. Then they are soaked with full immersion in a detergent solution at a temperature of 20-250 C for 15 minutes. 2) Washing each product in a detergent solution using a brush or cotton-gauze swab for 30 seconds. 3) Rinsing with running water for 10 minutes. 4) Rinsing with distilled water for 30 seconds 5) Drying with hot air in a drying oven at a temperature of 850 C until moisture completely disappears.

Types and methods of sterilization 1) Chemical method of sterilization This method is recommended for products made of polymer materials, rubber, glass, corrosion-resistant metals. It is carried out when the product is completely immersed in the solution, after which the product is rinsed with sterile water. The shelf life of a sterile product in a sterile container lined with a sterile sheet is 3 days. For immersion of products in des. the solution should be used in containers made of glass, plastic or enamelled 1) 6% hydrogen peroxide solution t = Not less than 18 0 С for 360 min 2) 10% gigasept solution for 300 min 3) 2, 5% solution of lysoformin-3000 t = 40 -50 0 С for 60 min 4) Sidex activated 2% solution of glutaraldehyde with p. H = 8, 2 -9, 2 t = 20 -25 0 С for 240 min 5) Glutaraldehyde 2, 5% p. H = 7, 0 -8, 5 t = Not less than 20 0 С during 360 min

2) Steam sterilization method Sterilization is carried out in sterilization boxes without filters or in sterilization boxes with a filter or in double soft packaging made of coarse calico or parchment, sack paper, non-impregnated wet-strength sack paper, paper for packaging products on machines of E grade, paper creped in a steam sterilizer ... The shelf life of products sterilized in boxes with a filter is 20 days, in the rest of the packaging - 3 days Sterilization mode Steam pressure, kg / cm 2 0, 11 Working temperature, 0 С 132 120 Holding time, min Applicability 20 Recommended for products made of corrosion-resistant metals, glass, rubber products 45 Recommended for products made of rubber, latex and certain polymeric materials (high density polyethylene, PVC

3) Air sterilization method Sterilization is applied to dry products, and it is carried out in packaging made of non-impregnated sack paper, wet-strength sack paper, paper for packaging products on machines of E grade, high-strength packaging paper, crepe paper, double-layer crepe paper or without packaging in an open container in air sterilizer Unpacked sterilized products are used immediately after sterilization, packaged - within 3 days. Sterilization mode Applicability Operating temperature, 0 С Holding time, min 180 60 150 Recommended for metal, glass and silicone rubber products

Sterilization control methods 1) Physical and chemical The parameters of the operating mode of sterilizers are monitored chemical methods are based on the color change of indicators upon reaching a certain temperature 2) Bacteriological Sterilization efficiency is assessed

Software control is carried out using the following tests: 1) Azopyram test is carried out for the presence of hemoglobin, oxidants, chlorine-containing substances, washing powder, rust. Prepare 1, 0 -1, 5% solution of hydrochloric acid aniline in 95% alcohol. It is stored in the refrigerator for up to 2 months, outside it - no more than a month. Before setting the sample, mix equal volumes of azopyram and 3% hydrogen peroxide. Use the mixture within 1-2 hours. Do not check hot tools, do not keep solution near heating devices and in bright light. When a blood stain is contacted with reagent, a violet color appears within one minute.

2) Amidopyrine test is performed for the presence of blood. Mix equal amounts of 5% alcohol solution of amidopyrine, 505 acetic acid and 3% hydrogen peroxide solution (2-3 ml each). Apply 2-3 drops of the reagent to the controlled item. In the presence of blood contamination, a blue-green color appears (exposure 3 minutes 3) Phenolphthalein test is carried out to check the quality of washing the active substances of the washing instrument from the surface of the instrument. Apply 1% phenolphthalein solution. If present, a pink coloration occurs.

References 1) San. Pi. N № 8. 013. 03 of 31. 01. 2003 "Sanitary and epidemiological requirements for the quality of sterilization and disinfection of medical devices" 2) http: // ru. wikipedia. org

Normative document

OST 42-21-2-85
Sterilization and disinfection
medical products
destination.
Methods, means and modes.

Sterilization

- complete destruction of all
types of microorganisms and their
dispute on the surface and inside
various subjects as well
in liquids and air.

All should be sterilized.
objects in contact with the wound
surface in contact with blood
or injectables, and
certain types of diagnostic
apparatus in progress
operation come into contact with mucous membranes
shells and may damage them.

Sterilization of medical products
appointments in MO - difficult
multi-step process consisting
from several stages, each of which
determines the quality of sterilization:
preliminary disinfection and
on-site processing of products
use (in procedural,
operating rooms, dressing rooms, etc.)
pre-sterilization
cleaning products
CSO
sterilization packaging
sterilization

The structure of the centralized sterilization department (CSO)

Sterile bix

Modern medical organizations organize
centralized sterilization
departments (CSO), which carry out:
Pre-sterilization processing
medical instruments
Sterilization:
medical products
linen and dressings

CSO tasks

provision of medical departments
(Mo) sterile
medical devices
implementation into practice
modern effective
methods of pre-sterilization
processing and sterilization

The CSO should have two zones:
non-sterile and sterile.
The non-sterile area includes the "dirty"
and "clean".
The "dirty" zone includes:
reception and disassembly rooms
medical devices
washing room - the room is intended for
carrying out PSO products
auxiliary premises - wardrobe,
staff rest and meal room,
showers

A "clean" area is an area where
produced:
drying
quality control of cleaning
parsing, sorting, composing
sets
packaging and preparation for sterilization
products

Sterile area

includes:
unloading side of steam,
dry air and other
sterilizers
warehouse of sterile materials

When planning premises
it is advisable to envisage
organization of two processing streams:
1st stream - processing and sterilization
tools, rubber products.
2nd stream - preparation and sterilization
linen and dressings.
CSO is equipped with supply and exhaust
ventilation and bactericidal
lamps.

Pre-sterilization cleaning (PSO) of medical devices Second stage of instrument processing

PSO is used for cleaning products
medical supplies from
protein, fat, blood,
medicinal and other
pollution.
The quality of the USAR team directly affects
quality of sterilization.

PSO stages (manual method):

Soaking medical instruments
appointments in detergent solution 15 minutes
Mechanical processing with a brush,
cotton swab (30 seconds each)
removing from the solution, clean the needles
mandrin
Rinsing under running water at
using SMS "Biolot" - 5 min., others
7-10 minutes ("Astra", "Progress")
Rinsing in distilled water 30
seconds
Drying in a dry heat oven (85 0) to
complete disappearance of moisture
PSO control

The quality of the pre-sterilization
cleaning is carried out by samples:
for blood residues, disinfectants, SMS,
rust
- azopyramic - universal
- phenolphthaleic - for presence
leftover SMS
- amidopyrine - for blood residues
- Sudan 3 - for the presence of fatty and
protein residues

Result evaluation

2-3 drops of the reagent are applied to the controlled item and
rub it with a swab. With a positive azopyram test
a purple color appears, quickly, within a few
seconds, turning into pink-lilac and brownish. Coloring,
occurring later than 1 minute is not taken into account. Brownish
staining appears in the presence of rust and
chlorine-containing oxidants, otherwise staining
pink and lilac.
Phenolphthalein test in the presence of unwashed components
synthetic detergents gives a pink coloration.
With a positive amidopyrine test, a blue-green color occurs.
With positive samples, the entire batch of controlled
products must be re-processed before receiving
negative results.
The control results are reflected in the form No. 366 / U, approved by
by order of the Ministry of Health of the USSR on 04.10.1980. No. 1030 "Journal of quality accounting
pre-sterilization treatment ".

Subject to control: in the CSO - 1% of
of each product name, but not
less than 3-5 units.
In case of a positive sample
(reagent color change) all
a batch of products is subjected to
re-cleaning. results
control is recorded in the log.

As a sterilization
packaging by the Ministry of Health
allowed to use
certain types
materials.

Tasks of packaging containing medical
product:
Ensuring passage
sterilization process
Protection from physical
impacts and
mechanical
damage
sterilized object
Keeping sterility
before use
Open packaging
necessary given
rules of asepsis,
antiseptics

sterilization boxes
(bixes) without filter - embedded in
practical health care at the beginning
last century. This type has
short term of preservation of sterility -
72 hours

sterilization boxes
(bix) with antibacterial
filter, sterility in which
lasts up to 20 days

disposable packaging bags
(CRAFT-packages) - paper (flat
and with folds), combined paper-laminate (film).

Kraft - package
Kraft - sealed package - deadline
sterility 30 days;
Kraft - sealed package - deadline
shelf life 3 days

Transparent rolls and bags are designed and
are produced both for packaging individual
small tools and kits, and
for large heavy tools,
sets of underwear. Sterility period 1 year

Self-adhesive combined
paper-laminate -
the period of sterility is 6 months.

Double soft packing made of coarse calico

Sterility period 3 days

Paper and non-woven
wrapping sheets

Paper and non-woven wrapping sheets

Sterilizing
non-woven packaging
material or paper
are the most
suitable for
large in volume
trays with tools
for linen. Non-woven
materials with
increased
durability, ideal
fit for
wraps heavy and
sharp products.

Pulse
heat sealing
apparatus
Use packaging
combined
paper-laminated
(film) - term
sterility 1 year

Pulse heat sealer

Choosing an adequate method
sterilization depends on the physicochemical and biological
features of the sterilized
object.
In the practice of medical
organizations most widely
physical
sterilization methods.

Sterilization methods

Physical
Steam
Air
Glasperlen
Infrared
Chemical
Application
solutions
chemical
funds
Gas
sterilization
Cold
sterilization
(industrial)
Radiation
Plasma
Ozone

Sterilization methods approved for use in MO

Method type
Method
Sterilizing agent
Steam
Overpressure saturated water vapor
Air
Dry hot air
Infrared
Infrared radiation

Glasperlen
Medium of heated glass beads

Gas

Ethylene oxide or its mixture with other components

Ethylene oxide or its mixture with other components

Physical
(thermal)
Chemical
Plasma
Hydrogen peroxide vapors combined with their
low temperature plasma
Liquid
Solutions of chemicals (aldehyde-, oxygen- and
chlorine)

Physical methods

Steam method

Compact
portable
autoclave
To reach temperatures above
boiling points of water enjoy
autoclave. Autoclave presents
a sterilization unit
steam under pressure. Temperature
saturated steam depends on
pressure.
Autoclave operating modes:
132 ° C - 2 atmospheres - 20 minutes -
main mode. Sterilize everything
products (glass, metal, textiles,
EXCEPT RUBBER).
120 ° C - 1.1 atmospheres - 45 minutes -
sparing regime. (glass, metal,
rubber products, polymer
products - according to the passport)
110 ° C - 0.5 atmospheres - 180 min -
especially gentle mode (unstable
preparations, nutrient media)

Steam sterilization method

Sterilizing agent - hot steam
under
pressure.
For
of this
method
use an autoclave.
Packaging: bix, kraft bags, paper laminate, coarse calico.
Materials: polymers, glass, latex,
the cloth,
corrosion resistant
metals,
textile.
Advantages: high permeability
pair, large selection of packaging, longer
sterility is maintained, cheap and
easy to use method.
Disadvantages:
humidification
products,
corrosive to metals.
Steam sterilization method

Stationary autoclave (new generation)

Air method Dry heat -

Air method
Dry heat sterilization is carried out in special
devices - dry-oven sterilizers. Sterilization in dry heat
the cabinet takes place by means of circulation
hot air inside it.
Autoclave operating modes:
180 ° C - 60 minutes - basic mode.
All products (glass, metal,
EXCEPT RUBBER).
160 ° C - 150 minutes - gentle mode. (glass,
metal, rubber products, polymer
products - according to the passport)

Air sterilization method

Sterilizing agent - dry hot
air (160-200oС).
Packing: kraft bags, open
way.
Materials: metal, glass, polymer,
rubber, latex.
Advantages: cheap, simple method, no
corrosive to metal, does not occur
moisturizing packaging and products.
Disadvantages: limited choice
packaging, slow and uneven
warming up products, the need
using higher temperatures,
inability to use materials from
textiles.
Air sterilization method

Air method

Note:
Dry products are sterilized;
Products sterilized in kraft bags, packaging from
wet-strength bag paper, stored for 3 days, in a 2-layer packaging made of crepe paper for medical
goals - up to 20 days;
Products sterilized without packaging must be
used directly after sterilization for
working shift (6 hours) under aseptic conditions.
During air sterilization, metal
instruments without packaging, they are positioned so that they do not
touched each other. Detachable products
sterilized disassembled.

Air sterilizer (dry oven)

Glasperlen method

The principle of operation of glassperlen
sterilizer is based on a cast
sterilizable surgical instruments
in contact with small glass
spheres with a temperature of 250C.
Sterilization of the instrument is carried out in
for a very short time - no more
20 seconds. Thanks to such a short
period and non-destructive effect
sterilization (glassperlen)
balls on the tool, negative impact
high temperature practically
absent.
Sterilizes in just 5 seconds: forceps,
pliers, scalpel holders, probes,
spatulas, chisels, chisels, diamonds, files,
burs, root elevators, reamers,
contra-angle handpieces, needle holders,
tweezers, gingival scissors, etc.

Infrared method

Small-sized
sterilizer
created for
sterilization
dental and
microsurgical
metal tools
in hospitals,
clinics, hospitals and
other medical and
cosmetology
institutions.
Sterilization
carried out
infrared powerful
short-term
heat exposure.

UFO chamber for storing sterile instruments

Chemical methods

Chemical sterilization

This method uses chemicals
in a gaseous state or objects to be sterilized
immersed in solutions of chemicals.
Sterilization with solutions - auxiliary
method used when impossible
use others ..
Sterilization solutions - sterilants
Mainly used for sterilization
Hydrogen peroxide 6%
Sterilization mode:
Temperature 18 ° С - exposure 360 ​​min
Temperature 50 ° С - exposure 180 min
The solution is used once.

Chemical sterilization

Deoxone-1
Sterilization mode:
Temperature 18 ° С - exposure 45 min
Sidex
Temperature 21 ° С - exposure 240 min
Virkon 2%
Temperature 18 ° С - exposure 10 min

Chemical sterilization

Sterilization with solutions -
helper method used
if it is impossible to use others.
Advantages: availability, ease of use
performance and reliability
Disadvantages: products are sterilized without
packaging, washed after sterilization, which
can lead to recontamination.
Used only with decentralized
system.

Chemical sterilization

Sterilizable products freely
laid out in containers with solutions. At
long, they fit
spirals, channels and cavities are filled
solution.
After the end of sterilization of the product
three times twice immersed for 5 minutes in
sterile water, changing it each time, then
with a sterile forceps, they are transferred to
sterile container (sterilization
box) lined with sterile
a sheet. Shelf life is 3 days.

Chemical sterilization

For gas sterilization, a mixture of OB (oxide
ethylene with ethyl bromide) and its mixture,
formaldehyde.
Sterilize: Optics, pacemakers, products from
polymeric materials, glass, metals.
Carrying out conditions:
Instrumentation is packed in two layers
polyethylene film 0.06-0.2 mm thick, paper:
packing high-strength two-layer. Term
preservation of sterilized products in packaging from
plastic film - 5 years, in parchment

Chemical sterilization

Advantages: In a gaseous state
ethylene oxide does not corrode metals,
does not spoil products made of leather, wool, paper,
plastics. He is strong
bactericidal, sporicidal and virucidal
means. His couples have a high
penetration. carried out at
low temperatures (18-80 ° С) and products
sterilized in packaging.
Disadvantages: toxicity to personnel and
explosion hazard in case of non-observance of the technique
security.

Gas sterilization

Cold sterilization method

Radiation method
The sterilizing agent is ionizing
gamma and beta radiation. Object temperature at
sterilization rises slightly, therefore
this method is called cold sterilization.
For individual packaging in addition to paper,
use polyethylene bags. Sterility in
such packaging lasts for years. Shelf life
indicated on the packaging. This way is widely
used in industrial plants,
manufacturing medical devices
single use (systems for
blood transfusions, obstetric kits).

Cold sterilization method

With plasma sterilization method
use high-frequency plasma in
domestic devices "Plaster", "Feruso".
For processing products from heat-sensitive
materials (endoscopes, pacemakers,
optical devices, endoprostheses, etc.)
the Sterrad 100-8 sterilizer is used.
This method is used for sterilization
small-sized medical devices
(dental burs, needles for
acupuncture, etc.).

Low-temperature plasma sterilizer STERRAD 100NX

Ozone sterilization is designed for
processing small-sized products simple
configurations made of corrosion-resistant steels and
alloys.
Ozone is synthesized from air in a gas discharge
reactor sterilizer.
Sterilization holding time 50 minutes,
ozone deactivation time 10 minutes.
Ozone sterilizer (СО-01-С or СО-5)
refers to low-temperature (temperature
40 ° C), used for sterilizing dry
scalpels, tweezers, mirrors, probes, spatulas,
dental burs in unpackaged form,
placed in 1 layer in a cuvette.

Ozone sterilizer

Chemical sterilization

Performed in closed containers,
covered with intact enamel, and
also made of glass or
plastics.
The objects to be sterilized are immersed in
solution at a temperature of 18 ± 2 °.
For sterilization, the instruments are completely
immersed in open (or disassembled)
form in one of these solutions.
When soaked in alcohol and triple
mortar tools are considered
sterile after 2-3 hours, in peroxide
hydrogen - after 6 hours.

Gas method

When sterilizing food
products, medicines
and various kinds of devices, as well as in
laboratory practice justified
the application of ethylene oxide ourselves,
which kills and vegetative
cells, and spores, but only acts in
if the subject
sterilization materials contain
some amount (5-15%) of water.
Ethylene oxide is used in the form
gas mixture (with N2 or CO2), in
which its share ranges from 2 to 50%.
The ethylene oxide method provides
the most gentle temperature
sterilization mode.

Gas sterilization method

Sterilizing agent -
formaldehyde or ethylene oxide.
Packaging: laminated paper,
parchment, kraft paper.
Materials: polymers, glass,
metal.
Advantages: low
temperature, use of any
materials.
Disadvantages: toxicity for
personnel and explosion hazard when
non-observance of safety precautions,
long lasting
sterilization cycle.
Gas sterilization method

Cold sterilization methods

Plasma method

allows you to create a biocidal
environment based on water
hydrogen peroxide solution,
as well as low-temperature
plasma (ionized
gas generated by
low pressure).
This is the most modern method
sterilization known at
present day. He
allows sterilization
any medical products,
from hollow instruments to
cables, electrical appliances, to
which in some cases
fails to apply at all
none of the known
sterilization methods.

Plasma sterilizers

Radiation method

Antimicrobial treatment can be carried out with
using ionizing radiation (y-rays),
ultraviolet rays and ultrasound. The greatest
application in our time has received sterilization uchas.
Radiation method or gamma ray sterilization,
used in special installations in industrial
sterilization of single use - polymeric
syringes, blood transfusion systems, Petri dishes,
pipettes and other fragile and heat-sensitive products.
The isotopes Co60 and Cs137 are used. Penetrating dose
radiation should be very significant - up to 20-25
μGy, which requires compliance with particularly stringent measures
security. In this regard, radiation sterilization
held in special rooms and is
factory sterilization method (directly in
it is not produced in hospitals).

Radiation sterilization method

The radiation method is necessary for sterilizing products
from thermolabile materials.
Sterilizing agent - ionizing γ and β radiation.
Packaging: in addition to paper, bags made of
polyethylene.
Advantages: sterility is maintained for a long time
packaging.
Disadvantages: high cost of the method.
Radiation
–
basic
method
industrial
sterilization.
Used by
enterprises,
issuing
sterile
products
one-time
application.
Radiation sterilization method

Radiation method

Sterilization of instruments and others
materials is carried out in sealed
packages and with the integrity of the latter
lasts up to 5 years. Hermetically sealed packaging
makes storage and use convenient
tools (you just need to open
packaging).

Ozone sterilization

Designed for processing
small items simple
configurations made of corrosion-resistant
steels and alloys

Sterility assurance principles:

Only touch a sterile item with others
a sterile item to avoid contamination.
Always keep sterile items above your waist.
The sterile field must always be within sight.
Try not to talk, cough, sneeze, or
bend over a sterile surface as
the resulting air flows contain
microorganisms.
The border zone around the sterile field with a width of about
2.5 cm is considered potentially infested.
Do not allow wipes to get wet over sterile
surface, since any liquid penetrates through
tissue, and with it microorganisms.
If a sterile object touches a non-sterile one, everything
the sterile field is considered contaminated and prepared
new sterile field.
Consider an item as contaminated if you are unsure about it
sterility.

The indicators are a rectangular strip of
inert paper base coated on one
side with two colored marks (Fig. 1) - indicator 4 and
comparison standard 5, and labeling. For gluing
the indicator is necessary from its back side under the inscription
"Date", separate the left part of the security paper 1 (Fig. 1) by
notch line 2 glue the left side of the indicator to the line
perforation 3 to the package. In this case, the right side of the indicator
does not stick.
To remove the indicator from the packaging after sterilization
it is necessary, without separating the protective paper 1, to tear off
indicator along the perforation line from the glued left
parts. Glued left side of the indicator with service
inscriptions are not removed from the packaging and reaches
consumer, which allows you to control the multiplicity
using paper packaging material

Sterilization PROVISION FOR DEATH / in medical devices microorganisms of all kinds which are at all stages of development, including spore forms STERILIZATION FOR PROVIDING DEATH / in medical devices microorganisms of all kinds which are at all stages of development, including spore forms

SPECIFIC GENERAL REQUIREMENTS chemicals for sterilization of medical products quickly and completely Solubility in water overnight and complete water solubility Stability Stable Easy and quick removal from the PRODUCT BALANCES TO SAFE PATIENT LEVEL Easy and quick removal from the PRODUCT BALANCES TO SAFE FOR PATIENTS LEVEL NO STRONG AND IRRITANT ODOR NO STRONG AND IRRITANT ODOR

SPECIAL REQUIREMENTS FOR DRUGS STERILIZATION antimicrobial broad spectrum activity, including obligatory in terms of resistance to certain agents spore forms of bacteria with the antimicrobial broad spectrum activity, including obligatory in terms of resistance to certain agents spore forms of bacteria good penetration of sterilant, INCLUDING THROUGH STERILIZATION PACKAGING MATERIALS GOOD PENETRATION CAPACITY OF THE STERILIZING AGENT, INCLUDING THROUGH STERILIZATION PACKAGING MATERIALS

IN MODERN STERILIZERS SHOULD BE PROVIDED: EFFECTIVE OPERATING MODES EFFECTIVE OPERATING MODES (due to the presence of functional systems that ensure the achievement and maintenance of the specified values ​​of the mode parameters in the chamber loaded with sterilized products) (due to the presence of functional systems that ensure the achievement and maintenance of the specified values ​​of the parameters the loaded sterilizable articles apparatus chamber) AUTOMATIC METHOD OF AUTOMATIC CONTROL METHOD LIGHT AND DIGITAL DISPLAY OF LIGHT AND DIGITAL DISPLAY OF SOUND SIGNALS SOUND ALARM SYSTEM LOCKOUT PROCESS iN COMPLIANCE claimant SYSTEM LOCKOUT PROCESS iN COMPLIANCE claimant possible to print INFORMATION committed CYCLE POSSIBILITY OF PRINT DATA ABOUT THE PERFECT CYCLE

SPECIAL REQUIREMENTS TO STEAM sterilizer drying OPPORTUNITY PRODUCTS IN STERILIZATSION- NOY NOY CAMERA CAMERA AIRCRAFT - to circulate the air during the sterilization cycle Sterilization - Forced cooling the gas to sterilize PRODUCTS OPPORTUNITY degassing degassing sterilized products probably sterilize the article to the liquid - Can be sterilized CONTAINERS - THE POSSIBILITY OF WASHING OF PRODUCTS FROM RESIDUES OF THE PRODUCT WITH STERILE WATER STERILE WATER

EFFICIENCY OF MEANS OF STERILIZATION OF PRODUCTS FOR MEDICAL PURPOSE The agent is considered effective in reducing the contamination of test products contaminated with test microorganisms (based on 10 6 microbial cells per test product), by 100%. The tool is considered effective in reducing the contamination of test products contaminated with test microorganisms (based on 10 6 microbial cells per test product) by 100%.

ACHIEVEMENTS IN THE FIELD OF STERILIZATION develop and introduce new chemicals on the basis of various active substances allows for sterilization of articles of dissimilar materials and has the effect of sterilization in an acceptable period of time developing and implementing new chemicals on the basis of various active substances allows for sterilization of articles of dissimilar materials and PROVIDING EFFECT OF STERILIZATION IN ACCEPTABLE TIME

ACHIEVEMENTS IN THE FIELD OF STERILIZATION introduction of a new sterilization equipment and materials: introduction of a new sterilization equipment and materials: - Portable equipment for sterilization INFRARED METHOD - Portable equipment for sterilization INFRARED METHOD - packaging materials intended for use in a steam, air, gas and plasma sterilization method in health facilities - packaging materials intended for use in a steam, air, gas and plasma sterilization method in health care facilities - chemical indicators of different classes used in the sterilizer DIFFERENT TYPES OF OPERATIONS external and internal control of sterilization - chemical indicators of different classes used in the sterilizer DIFFERENT TYPES OPERATIONAL EXTERNAL AND INTERNAL CONTROL OF STERILIZATION

ACHIEVEMENTS IN THE FIELD OF STERILIZATION INTRODUCTION OF NEW Sterilization Technologies: Introduction of new sterilization TECHNOLOGY - PLASMA TECHNOLOGY OF FOREIGN MODELS plasma sterilizer - PLASMA TECHNOLOGY OF FOREIGN MODELS plasma sterilizer - TECHNOLOGY OF PLANTS, produce electrochemically activated solutions - TECHNOLOGY OF PLANTS, produces ELECTROCHEMICALLY ACTIVATED SOLUTIONS

METHODS OF STERILIZATION METHOD sterilant STEAM WATER SATURATED STEAM pressurized HOT AIR AIR DRY INFRAKRASNYYIK RADIATION GLASPERLENOVY Wednesday HEATED GLASS BEADS OF ETHYLENE OXIDE GAS FORMALDEHYDE OZONE PLASMA PAIR OF HYDROGEN PEROXIDE IN COMBINATION WITH THEIR low-temperature PLASMA CHEMICAL MEANS LIQUID SOLUTIONS

GOST R “STEAM STEAM STERILIZERS, LARGE. General technical requirements and test methods "General technical requirements and test methods"

State sanitary and epidemiological regulation of the Russian Federation 4.2. CONTROL METHODS. BIOLOGICAL AND MICROBIOLOGICAL FACTS Control of air removal Control of air removal in steam in steam sterilization chambers.

Sterilization modes in an infrared sterilizer Instruments Temperature, C Duration, min of the cycle holding stage All-metal small 200 ± 3 115 Larger (with locks, channels and without them) 620 Massive (dental forceps) 1025

CHARACTERISTICS OF THE MEANS USED IN STERILIZERS STERRAD 100C AND KhMTS-80 CHARACTERISTICS OF THE MEANS USED IN STERILIZERS STERRAD 100C AND CHMTS-80 CHARACTERISTICS LYSSENTY STERRAD 100C AND HMTS-80 STERILIZERS HYDROGEN CONCENTRATES 9 months HYDROGEN CONCENTRATORS,% HYDROGEN CONCENTRATORS Vials

CHARACTERISTICS OF STERILIZATION CYCLES IN STERILIZERS STERRAD 100C and XMTS-80 , min Short Long - 72

ACCESSORIES for plasma sterilization STERILIZER STERILIZER special trays with lids or basket (for placing the product) SPECIAL conduits with a lid or basket (for placing the article) Special packing with a chemical agent based on hydrogen peroxide special packaging with a chemical agent based on hydrogen peroxide SPECIAL PACKING MATERIALS SPECIAL PACKAGING MATERIALS CHEMICAL INDICATORS CHEMICAL INDICATORS BIOLOGICAL INDICATORS BIOLOGICAL INDICATORS

3 Without booster 0.4 3 With booster POLYMER D 1 Without b "title =" (! LANG: POSSIBILITY OF STERILIZATION OF PRODUCTS WITH CHANNELS IN A "SHORT CYCLE" CHANNEL MATERIAL CHANNEL LENGTH (D), M INTERNAL DIAMETER) CHANNEL D 3 Without booster 0.4 3 With booster POLYMER D 1 Without b" class="link_thumb"> 23 !} POSSIBILITY OF STERILIZATION OF PRODUCTS WITH CHANNELS IN A "SHORT CYCLE" CHANNEL MATERIAL CHANNEL LENGTH (D), M INNER CHANNEL DIAMETER (ID), MM METAL D 3 Without booster 0.4 3 With booster POLYMER D 1 Bezier 1.0 booster (long cycle) With booster (long cycle) 3 Without booster 0.4 3 With booster POLYMER D 1 Without b "> 3 Without booster 0.4 3 With booster POLYMER D 1 Without booster Without booster 1.0 1 With booster (long cycle) With booster (long cycle)"> 3 Without booster 0.4 3 With booster POLYMER D 1 Without b "title =" (! LANG: POSSIBILITY OF STERILIZATION OF PRODUCTS WITH CHANNELS IN A "SHORT CYCLE" CHANNEL MATERIAL CHANNEL LENGTH (D), M INNER DIAMETER) CHANNEL D 3 Without booster 0.4 3 With booster POLYMER D 1 Without b"> title="POSSIBILITY OF STERILIZATION OF PRODUCTS WITH CHANNELS IN A “SHORT CYCLE” CHANNEL MATERIAL CHANNEL LENGTH (D), M INNER CHANNEL DIAMETER (ID), MM METAL D 3 Without booster 0.4 3 With booster POLYMER D 1"> !}

RESTRICTIONS FOR STERILIZATION BY PLASMA METHOD Not subject to plasma sterilization: products made of materials that absorb moisture products made of materials that absorb moisture products made of materials containing cellulose products made of materials containing cellulose products made of natural rubber products made of natural rubber

A full range of accessories for safe sterilization STERILIZER MODERN sterilizer model modern models CARTRIDGE WITH sterilant (for chemical sterilization methods) CARTRIDGE WITH sterilant (for chemical sterilization methods) STERILIZATION PACKAGING MATERIALS STERILIZATION PACKAGING MATERIALS BIOLOGICAL INDICATOR BIOLOGICAL INDICATOR chemical indicator various classes of chemical indicators VARIOUS CLASSES

Means suitable for sterilization of articles (according NIID) CONTAINING aldehyde - based on glutaraldehyde glutaraldehyde ortho-phthalaldehyde ortho-phthalaldehyde ALDEHYDE ALDEHYDE succinic acid succinic acid oxygen-containing - based on hydrogen peroxide peracid active oxygen chloro-SODERZHASCHIEANOLITY

Problems in implementing the sterilization of solutions of chemical means are necessary using a sterile container for placing the product in the solution of step: - sterilization exposures or TLD - RINSING product from residual chemical means are necessary presence of a large amount of sterile rinse water product from the balance of funds is necessary to have a large number of sterile water FOR RINSING PRODUCTS FROM RESIDUES OF THE REMOVAL, THE NEED FOR A STERILE 70% ETHYL ALCOHOL IN THE CASE OF ITS USE TO ACCELERATE THE DRYING OF THE ENDOSCOPE CHANNELS NO POSSIBILITY OF STERIELE