Sterilization of dressings is a mandatory measure that guarantees 100% cleanliness and safety. Thanks to special cleaning methods, any pathogens that can cause bacterial, viral and fungal diseases are killed.
What is meant by the term "sterilization"
Today, the most common methods for cleaning dressings and medical devices in the clinical setting are:
- autoclaving;
- air oven sterilization;
- treatment with chemical solutions, gas.
In some cases, they resort to radiation treatment. Moreover, each of these methods consists of three main stages, including disinfection, pre-sterilization cleaning and direct sterilization.
What material is considered dressing
This category includes varieties of fabrics used to treat wounds, including the surgical field (tamponade, dressings, medical wipes, etc.). The material used for dressings has a highthe level of hygroscopicity, therefore, it quickly absorbs liquid discharge from open wounds, dries instantly, but must remain elastic and durable. In addition, when preparing sterile bandages, napkins, turundas and other types of gauze products, their hypoallergenicity is taken into account. An important role is played by the availability and cheapness of the dressing material, since in most cases its significant consumption is required. After sterilization, the dressing should not lose its properties.
Gauze, cotton wool, lignin are mostly common. Bandages, medical wipes, tampons, turundas and other products are made from gauze. Dressing material is not complete without the use of hygroscopic cotton wool. It is sold in any pharmacy, used for various purposes, depending on which non-sterile or sterile cotton wool is purchased. Both types have excellent suction abilities, but in medical practice, sterile cotton wool is more often used. It prevents dust, debris from entering the wound, protects it from shock, exposure to sunlight. At the same time, cotton wool is placed in the wound only on top of a sterile bandage, otherwise its fluffy fibers will get wet and stick to the epithelium.
Instead of cotton wool, you can use lignin (these are the thinnest corrugated paper sheets that are made of wood. To fix the dressings applied to the wound surface, tubular and elastic bandages are used - this is also a dressing material, the sterilization of which allows reuse.
Viewstreatment of medical devices for dressings
Depending on the mode of dressing sterilization, it is important to adhere strictly to the algorithm of actions and exercise control over the course of the processing process. Of fundamental importance in matters of sterilization of products and materials is the period of preservation of sterility. The period of absolute purity of gauze, cotton products and medical biks specified by the manufacturer is also taken into account. Next, we will consider in more detail each of the types of sterilization that are used in modern clinics.
What is autoclaving
This is one of the most common and affordable methods of sterilization, involving exposure to steam. The method is based on simple laws of physics. As you know, when boiling (100 °C), water forms steam, for this there is no need to create additional pressure. But if it is nevertheless increased by 0.5 atmospheres, then steam will begin to be released at a higher temperature. These are ideal conditions for the death of all pathogenic microflora, including those microorganisms that are resistant to high temperatures.
The duration of dressing treatment depends on the temperature at which it will take place:
- at 110°C exposure lasts one hour;
- at 120-126 ° С - about 45 minutes;
- at 127-133 °C half an hour is enough;
- at a temperature of 134 ° C, microbes die in 15 minutes.
It is worth noting that the dressing can be reused after washing only inif he was involved in a non-purulent environment.
Sterilization device
The autoclave is a metal container with double strong walls. Water is poured between them, after which the lid is hermetically closed with screws, and the heating element is turned on from below. As soon as the water boils, steam begins to form, which fills the inside of the autoclave with dressings.
After laying, the bix is closed with a lid, due to which the container becomes completely sealed. Bixes can be stored outside the sterilization device for no more than two days. Inside they are lined with fabric. When filling the autoclave, do not ram the bixes, it is important to leave free space so that steam can penetrate inside. It is more convenient to fill containers for sterilization with homogeneous products.
In some cases, autoclaving involves sterilizing clothes in special bags. The same rules apply here as when laying a bix. The only thing worth noting is the need to use paired bags, dressed one on top of the other. This will keep the bag clean even if you untie the bag with non-sterile hands. The upper bag is shifted down, and the inner one is placed on a sterile surface and its contents are disassembled.
Algorithm of actions when working with an autoclave
The method involves the use of a powerful steam flow, however, for its application, one cannot do without a special apparatus for sterilizing dressings. It's called an autoclave. Forin order to process products properly and not doubt their 100% purity, you need to follow a few simple rules:
- Before the procedure, be sure to treat the inside of the bix with medical alcohol.
- A clean sheet is laid at the bottom, and a container of bed linen, gauze and cotton products is placed on top of it. It is also allowed to sterilize rubber items and medical instruments (they are wrapped in a towel and sent to biks).
- Then, after loading the laundry for sterilization, several indicators are placed. After processing the dressing, they will indicate whether the sterilization has been carried out properly.
Mikulicz sterility test
To make sure the sterilization of the dressing material in the autoclave, one of the simple tests is carried out. The simplest and most common is the Mikulich test. It is performed as follows:
- On a strip of paper, write any word with a pen, lower the indicator into a liquid, more like a paste, consisting of starch and water. After that, the paper is allowed to dry.
- The dry strip is moistened again, but this time in Lugol's solution, so it darkens, turns blue and the written word disappears on it.
- The dried indicator is sent to the autoclave along with the sterilized dressing. If after exposure the paper turns white again, then the processing was successful.
Bacteriological test
This is a direct way to find out if thedressing material pathogenic flora. To ensure the sterility of the products, it is necessary to open the bix directly in the operating room and run gauze flaps moistened with isotonic sodium chloride solution over the treated materials. Then moistened gauze swabs are sent to a test tube. Bacteriological control is carried out several times a month. This method of purity and sterility control is considered the most reliable.
Air treatment of dressings
During air treatment, the sterilizing effect can be achieved due to the powerful supply of dry and hot air. A distinctive feature of the method is the complete absence of moisture on the inner walls of the bix, and therefore the sterility period is increased, and the metal container is not threatened by metal corrosion.
However, the air method of processing dressings has a number of disadvantages. First of all, it is worth noting the protracted and unequal heating of the products placed in the bix. In order to sterilize materials with dry hot air, higher temperatures will be required. The minimum allowable temperature threshold is 160 °C. In this case, the duration of exposure in this mode should be at least 2 hours. To process the dressing in half an hour, you need an air flow within 200 ° C.
While rubber and polymer parts can be autoclaved, the air method does not. In addition, it is not possible to blow hot air over the packaging materials. Efficiencysterilization of dressings in a dry-heat cabinet depends on how evenly hot air penetrates to the products, and for this it is extremely important to comply with the sterilizer loading norms and the forced air circulation speed (it must be at least 1 m / s).
Gas sterilization
Unlike other dressing processing methods, air and steam are the safest and most environmentally friendly. Gas treatment of medical devices involves the use of ethylene oxide or formaldehyde. Vapors of these substances are highly toxic. The method of gas sterilization is resorted to, as a rule, if there is no possibility of steam or air sterilization.
To carry out the gas treatment of dressings, you will need to create all the necessary conditions for this. In gaseous form, chemical compounds of ethylene oxide do not harm products, do not provoke corrosive processes. In this way, any fabric can be processed: genuine leather, wool, paper, plastics, plastic, wood, etc. The vapors produced during the sterilization process have a strong bactericidal effect and penetrate as deep as possible.
However, the toxicity and explosiveness of ethylene oxide are its main disadvantages. Vapors of 40% alcoholic formaldehyde evaporating from formalin are used to sterilize products and medical materials. For medical personnel, the vapors of these substances are unsafe, in addition, the gas sterilization process itself isvery lengthy. That is why this method of dressing processing is rarely used.
Processing with chemical solutions
Another auxiliary method of dressing sterilization, which is used only if there is no possibility of using other methods. Chemical sterilization has a number of negative aspects, since the processed products are cleaned without protective packaging. In addition, after such a cleaning procedure, additional rinsing is required, and this, in turn, can lead to secondary contamination. At the same time, the solutions that are used for chemical sterilization are available everywhere and do not require additional preparation of the dressing material.
The things to be sterilized are laid out in biks, not ramming. After the cleaning procedure is completed, the products are immersed several times in distilled water. If sterilization was carried out with hydrogen peroxide, rinsing is carried out twice, in other cases - at least three times. After each immersion of sterilized items, the water is changed.
Radiation method
In medical practice, it is used extremely rarely, mainly when there is a need to sterilize products from heat-labile materials. Ionizing gamma and beta rays are used as sterilizing agents. The radiation method of processing dressings involves the mandatory use of paper and plastic bags. The main advantage of this method is the longsterility period.
The radiation method is used in industry. It is used by manufacturing enterprises engaged in the production of sterile single-use products.
