|Less than 30 MORE DAYS UNTIL THE CONFERENCE!
ONLINE REGISTRATION CLOSES THIS WEEK!
Our 17th Annual Conference and Exposition will be in
Las Vegas, Nevada on June 17-June 22, 2012.
You need not be an APP member to attend the Conference!*
For brevity, I suggest that you use all sterile disposable single use items, however if you are to reprocess used instruments: Classes Come to the APP or the APT conference for classes on the subject Read the notes from one of the recent APP classes https://brnskll.com/shares/statim/ for a thorough description of some options, including accessible … Read more
Did you read confusing STATIM information in the old APP Procedure Manual? (prior to 2013 edition)
- STATIM in the old APP Procedure Manual
In the current 2013 edition of the APP Procedure Manual, I helped correct the previously confusing references to Statim autoclaves.
The current 2013 version of the guidelines refer to the Statim and the acceptable use of unwrapped sterilization methods.
Quotes from the 2013 APP procedure manual:
- Steam under pressure (saturated steam/steam autoclave): 220-270 kpa pressure at 132° Centigrade (270° Fahrenheit) for 3-40 minutes depending on cycle.
- Steam autoclave process types
- Steam flush-pressure pulse (type S):
“Another design in steam sterilization is a steam flush-pressure pulsing process, which removes air rapidly by repeatedly alternating a steam flush and a pressure pulse above atmospheric pressure. Air is rapidly removed from the load as with the prevacuum sterilizer, but air leaks do not affect this process because the steam in the sterilizing chamber is always above atmospheric pressure. Typical sterilization temperatures and times are 132°C to 135°C with 3 to 4 minutes exposure time for porous loads and instruments.” The Statim is an example of a type S steam flush pressure pulse autoclave, which is acceptable for sterilization.
The actual procedure surface is referred to as an “aseptic field,” and is a sterilized surface that becomes exposed to air contact only at the beginning of the piercing procedure. The aseptic field used by most piercers is the sterile inside surface of a freshly opened large autoclave or sterile glove package, Statim cassette, rigid sterilization container, or sterilized tray. Once the package is opened, sterile tools, needles, jewelry, and disposables can be dropped onto the inside surface for use. The exterior of sterilized packages such as those containing the jewelry should not touch the aseptic field; the contents should be carefully dispensed onto it.
To minimize the risk of cross-contamination and to ensure that piercing room procedures are as clean as possible, many components of the tray setup must be disposable. Unless supplies are purchased presterilized* or will be sterilized in an autoclave immediately prior to the procedure, all disposables must be individually packaged in autoclave bags, sterilized, and remain intact in their pouches stored in enclosed, nonporous drawers or containers until use. Disposable materials that must be sterilized include: marking implements, piercing needles, corks or synthetic stoppers, elastic bands, swabs, and gauze.
* This includes only FDA-cleared items that are commercially sterilized according to accepted medical standards. The supplier must make documentation of appropriate sterilization available.
The following is to clarify the inconsistencies in the previous editions:
Here is a glimpse of a few piercings I performed during an exhibition for colleagues in New England. I enjoy sharing ideas and techniques with my peers. Let me know what you think.
My goal is an atraumatic aseptic technique: Primum non nocere
All of these piercings were performed without clamps using the STATIM 2000 autoclave, sterilized single use equipment, sterile nitrile gloves, and the titanium jewelry was anodized with the Reactive Metals Micro anodizer.
A useful device for arranging your instruments for washing in a Hydrim : Available here Instrument Cradle for Sterilization.
Statim autoclaves are not “flash” sterilizers.
SciCan’s STATIM cassette sterilizers have a biological effectiveness that has been proven in tests for hollow and solid instruments at many internationally recognized institutes in Canada, the United States, and Europe.
…“flash sterilization” is an antiquated term that does not fully describe the various steam sterilization cycles now used to process items not intended to be stored for later use. Read the full ST79 Statement for details here and AAMI Article here
Question: What is flash sterilization?
Flash Sterilization usually means steam sterilization of an unwrapped instrument or device for 3 to 10 minutes in 270° F saturated steam. Flash sterilization is usually accomplished with a gravity displacement cycle, although certain newer sterilizers may employ a vacuum at the beginning or end of the cycle to remove air, steam, or aid in drying.
Question: Why use flash sterilization?
Flash sterilization is used when rapid sterilization of instrument or devices is required. This need may be the result of a limited number of instrument sets, a need for unanticipated instruments, or a contaminated instrument.
Question: What is the main problem with flash sterilization?
The problem is not with the sterilization process, but with the difficulty in maintaining sterility at the end of sterilization. It has been common practice to sterilize items in an open mesh basket. Upon removal from the sterilizer, the basket containing the items is covered or wrapped. The basket is then transported through non sterile areas to the operating site.
Once the sterilizer is opened at the end, of the cycle, the basket and its contents may be exposed to recontamination. Even with subsequent wrapping or covering, it is difficult to ensure the items have remained sterile.
Event Related Sterility I-Introduction Event-Related Sterility Maintenance Policy defines procedures intended to maintain the sterility of packages until they are used. This document focuses on event-related sterility maintenance of hospital-prepared packages containing sterile supplies wrapped in single-use or reusable materials. Since some supplies have expiration dates and degrade over time, this document covers only … Read more
via Basics on Processing & Sterilization – Sterile & Materials Processing Department – University of Rochester Medical Center. URMC / Sterile & Materials Processing Department / Basics on Processing & Sterilization Basics on Processing & Sterilization Table of Contents Introduction Functions The Decontamination Process The Assembly & Packaging Process The Sterilization Process Quality Assurance Introduction The Sterile Processing Department (Central … Read more