Sterilization: modes, methods. Sterilization as a method of disinfection

To prepare medical instruments for use, various methods are used. Sterilization is one of them. This procedure can be carried out using various means that are capable of providing the desired effect. But to begin with it is necessary to understand the purpose and features of this process.

Means of sterilization

The implementation of disinfection and sterilization of medical devices is necessary in order to destroy or neutralize various types of microorganisms. Such procedures are of great importance, and if they are neglected, there is a risk of infectious diseases, purulent-septic including. And the risk group includes both patients and medical workers.

For this reason, it is important to use different methods of sterilization of medical devices. With regard to the quality of disinfection, it can be checked by flushing for the determination of Staphylococcus aureus, as well as bacteria belonging to the group of intestinal and Pseudomonas aeruginosa.

The very process of disinfection of instruments as a whole implies disinfection, followed by cleaning and sterilization. The rules of these procedures are approved by the Ministry of Health of the Russian Federation. Before considering the methods of sterilization of instruments that are used in modern medicine, it is worth familiarizing with the general concept of disinfection.

What is disinfection

This term is used to determine the procedure that allows to carry out the destruction of opportunistic and pathogenic microorganisms on any surfaces of the room, including on the floor, walls, switches, medical products, utensils, etc.

Such methods should be used in any institution that has a curative and prophylactic profile. The key task of disinfection is liquidation, as well as prevention of the process of accumulation, reproduction, and the spread of pathogens.

Disinfection can have both a focal and preventative form. Various methods can be used in this procedure. Sterilization in this case is focused on protecting people from the possibility of infection. This process involves a wet daily and general cleaning, which is carried out every week. But focal disinfection is carried out only in the event that there is a suspicion of the emergence and spread of infection in the health facility.

What is used for effective disinfection

Speaking about a specific drug that is used to neutralize microorganisms, it is worth noting that his choice is carried out depending on which infectious disease to deal with.

The type of medical device affects the degree of disinfection. On this basis, this process can have a high, intermediate and low level.

The instruments themselves and medical products can be divided into several categories:

1. Critical. Used to penetrate into the vessels, sterile tissues of the body, due to which they are contacted with injectable solutions or blood.

2. Semicritical. In the process of their operation, contact with damaged skin or mucous membranes.

3. Noncritical. They are needed for contact with intact skin.

Methods of sterilization of medical devices

This procedure can be defined as part of disinfection measures. It should be noted that it is conducted using several key techniques:

1. The steam method. In order to obtain the desired result, water vapor is used under pressure. Implement this approach to sterilization can be done with the help of special equipment - an autoclave.

2. Chemical method of sterilization. In this case special chemical solutions are used. Disinfectants such as hydrogen peroxide or alaminol can be used.

3. Air cleaning. It uses dry hot air, which is generated with the help of an oven.

4. Physical. Its essence boils down to processing tools by boiling in distilled water, to which sodium can be added.

5. Biological. It is based on the use of antagonism of different microorganisms. By the action of bacteriophages, the destruction of the pseudomonas aeruginosa, typhoid bacteria, staphylococcus, etc. is achieved.

6. Radiation. Instruments are exposed to gamma rays.

7. Use of plasma.

The most widespread was steam sterilization. Its main advantages are reduced to ease of use, small time costs and versatility (any tools can be processed).

But it is important to understand that all methods and regimes of sterilization Find their application in institutions of treatment and prophylaxis, and the steam technique alone is not limited to. Therefore, the main of them should be given more attention.

Use of steam

Paying attention to the steam method of sterilization, it should be noted that it is still the most accessible and reliable way of processing heat-resistant medical products in health facilities.

Tools are placed in special packages or boxes, which can be either with a filter or without it. As a sterilizing agent, saturated steam is used, which is under excessive pressure. As for those tools that are made of brass or stainless steel, they are practically not exposed to autoclaving. Changes, if they occur, are minor.

The steam sterilization method is used primarily for the disinfection of special and general surgical instruments, parts of apparatus and instruments made of metals resistant to corrosion, syringes (mark 200 ° C), glass, latex and rubber products, certain types of plastics, suture and dressings , As well as surgical underwear.

In addition, the steam method can be used for sterilization of ligature suture material. We are talking about surgical twisted silk and kapron threads, polyester cords, etc.

Air method

The use of dry hot air can be defined as the oldest method. Moreover, throughout the last century it has been the most common way to combat the risk of infection. But at the moment, modern medicine uses the air method of sterilization All less often, giving preference to the steam.

In order to have the right effect on the instruments, air sterilizers are involved in this process, the temperature in which reaches 160-180 ° C. In this case, dry heat is never used to sterilize injectable solutions. This can be explained by the fact that due to the low thermal conductivity of air, the temperature of the solutions does not reach the required level. But talcum powder, heat-resistant powders, auxiliary materials and glass containers can be successfully processed.

The quality of the sterilization process largely depends on how evenly the hot dry air in the chamber is distributed. In this case, the best are considered to be those sterilizers, which allow to obtain a laminar flow of air, which heats up to the desired temperature.

The use of chemistry

The chemical method of sterilization can not be called the main method, but it performs adequately the auxiliary process. This procedure is used to process those tools that are not capable of withstanding high temperatures.

The process itself takes place in sealed chambers filled with ethylene oxide. Usually it takes 15 to 16 hours for complete sterilization. At the same time, the temperature inside is kept at 18 ° C.

Also, to achieve complete disinfection of tools, strong special solutions (formalin, povidone-iodine, pervomur, etc.) can be used.

Plasma technique

If possible, it replaces the chemical treatment in the health facility. The bottom line is that after processing with solutions or ethylene oxide, tools can not be used for some time - due to toxic effects during the sterilization process. When using plasma, such problems are eliminated.

The essence of the method is relatively simple: for the disinfection of instruments, hydrogen peroxide vapor and its plasma are supplied, the temperature of which is at a level of 36 ° C. Further, due to the influence of the electromagnetic field, free radicals are formed, which neutralize pathogens. To achieve the desired result, it will take 30-40 minutes of such an impact on medical instruments and materials.

You can use other methods. Ozone sterilization, for example, also shows good results when processing products that do not fall into the category of heat-resistant products.

Radiation method

In this case, the processing of tools is carried out with the help of gamma rays. Such a method of disinfection is used to prepare those instruments that are sensitive to the influence of chemical compounds and high temperature. With this approach to disinfection, microorganisms are destroyed by the release of ionizing energy.

It should be noted that this method has recently become no less popular than other methods. Sterilization of this type It attracts attention thanks to several tangible advantages:

- tools and materials can be used immediately after the disinfection process is completed;

- effective processing is possible even in sealed packages, which can then be stored for a long time;

- there are no toxic substances left on instruments.

Quality control

In any health facility, various methods of sterilization control are used for disinfection. It is about the following actions:

1. Preparation of tools. It removes small particles that could remain after the operation.

2. Water is chosen only of high quality and necessarily soft. This avoids damaging the autoclave and directly the material itself, which is sterilized. The best option is distilled or demineralized water.

3. Constant monitoring of the pressure, temperature and duration of the entire process is carried out.

4. Compliance with the norms for loading the amount of sterilizable material is fixed.

It is obvious that physical methods of sterilization have long been not the only method of disinfection in modern medicine. Thanks to the rapid development of technology, the approach to preparing the tool in Russian hospitals can be described as flexible and effective.