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Sterilization and Disinfection of Patient-Care Items in Oral Healthcare Settings

Course Number: 474

Sterilizing Wrapped Instruments

The third station of the CPA is the setting where the sterilizers and related supplies are located. There should be adequate space for loading and unloading. The area can also house the incubators essential for spore testing (see Quality Assurance ) and storage space for sterile instrument units and disposable (single-use) items. Manufacturer and building-code specifications will determine placement and room ventilation requirements.

All instrument units to be sterilized should be placed in the sterilizer so that all surfaces will be directly exposed to the sterilizing agent. Loading must allow for free circulation of steam (or another sterilant) around each unit; perforated trays/cassettes should be placed so they are parallel to the shelf; non-perforated containers should be placed on their edge; peel-packs should be placed on edge and small items should be loosely placed in wire baskets.

The sterilization cycle must be monitored by physical, chemical, and biological indicators (see Quality Assurance). Follow manufacturer’s recommendations regarding the physical parameters (e.g., time, temperature, and pressure) of the sterilizer and its compatibility with other indicators. Once the sterilization cycle is complete, allow the packs to cool and dry inside the chamber (Table 2). Hot packs act as wicks; absorbing moisture and bacteria from hands.2,3

Table 2. Minimum cycle times for steam sterilization.3

Type of sterilizerUnitsExposure time at 250˚F (121˚C)Exposure time at 270˚F (132˚C)Drying time
Gravity displacementWrapped30 min.15 min.15-30 min.
Textile packs30 min.25 min.15 min.
High-speed prevacuumWrapped instrumentsN/A4 min.20-30 min.
Textile packsN/A4 min.5-20 min.