Following trends in steam sterilizer performance by quantitative monitoring of non-condensable gases.

Standards require a daily steam penetration test before starting production with a steam sterilizer. In many cases the results of steam penetration tests are not used for improvements or optimization of processes. This study aimed to detect whether trend analysis with an objective and quantifying steam penetration test has added value for the end-user. The databases of an objective quantifying steam penetration test, from the hospital and the manufacturer, are coupled and analysed. In this study, the databases included five steam sterilizers and approximately a four-year period. Based on the analysis, the process of the sterilizers was optimized. The results of the steam penetration tests became more stable over longer periods. This may result in lengthened periods between maintenance and validation. The analysis demonstrates that an objective, quantifying steam penetration test delivers more insights and knowledge of the functioning of the steam sterilization process. This knowledge may be used to optimize the process and reduce costs for the end-user.

[Monitoring steam sterilisation processes in the dental office]. / Het monitoren van stoomsterilisatieprocessen in de mondzorgpraktijk.

In dental offices, steam sterilisation is used to sterilise instruments and in that way to prevent the cross-contamination of patients and the dental team. In order to ensure that the sterilisation process has been executed successfully, every sterilisation process has to be monitored. The monitoring of every load in the steam steriliser is necessary and often even required, either directly (by legislation) or indirectly (by harmonised standards). The complete monitoring protocol consists of controls of the installation, the exposure, the loading, the packaging and, finally, the 'track and trace' of the instruments. For examining the installation, a steam penetration test, such as the Bowie and Dick test, can be carried out.

Case study on the orientation of phaco hand pieces during steam sterilization processes.

BACKGROUND: Steam sterilization is an essential part of infection prevention. The literature shows that sterilization of medical instruments containing channels is not trivial. Phaco hand pieces have a simple configuration: a device contains a channel with a constant radius. No literature was found indicating whether the sterilization conditions on the inner surface of a phaco hand piece are influenced by the orientation of the hand piece. AIM: To determine whether the orientation of a phaco hand piece influences the results of a sterilization process of this device. METHODS: A qualitative case study, including experiments, is performed with a protocolled combination of steam sterilizer, process, phaco hand piece, orientation of the phaco hand piece, and wrapping. FINDINGS: In this specific case, the orientation of the hand piece influenced the result of the steam sterilization process; in vertically (upright) oriented phaco hand pieces with free water drainage, sterilization conditions are reproducibly established. In the same process, in horizontally oriented or vertically oriented hand pieces without free drainage, these conditions are not established in a reproducible way. CONCLUSION: In the investigated combination of sterilizer, process, load, loading pattern and wrapping, phaco hand pieces have to be oriented vertically (upright) with free water drainage to obtain steam sterilization conditions on the inner surface. It is likely that instruments with comparable configuration and dimensions will yield comparable results. It is therefore recommended that this issue is considered during the development of medical instruments and during performance qualifications of such instruments.