Impact of storage on sterility of surgical instruments in autoclave bags

summary of:
Impact of storage on sterility of surgical instruments in autoclave bags
Surgical instruments in packs
Author(s):
Hart, K. and Cartlidge, H.
Published in:
Date:
October 2024
DOI:
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In our edition of: Dec 2024
In our categories of: practice management

our summary:

Hart, K. and Cartlidge, H. (2024) Impact of storage on sterility of surgical instruments in autoclave bags. The Veterinary Nurse, 15 (8), pp. 334-340.

The aim of this mixed methods study was two-fold, to determine an ideal storage duration and method for single surgical instruments (SI) packaged in self-sealed autoclave bags (SSABs), and to determine the current practice of sterilisation and the storage methods for, and duration of, SSABs used in small animal practice.

The study consisted of two parts: an online questionnaire which was aimed at members of the UK veterinary team. This was promoted via social media and was designed to investigate current procedures for autoclave sterilisation in veterinary practice. Alongside this a non-randomised controlled laboratory study was run to assess the sterility of single SI, sterilised via autoclave and packaged in SSAB. This study consisted of six groups, three for the open storage method which were measured at one, three and six months and three for the closed method measured at the same time points. Open packages were stored on an open shelf and closed packages in a closed plastic box. All packages were stored in a non-clinical room.

There were 59 respondents to the survey, of which 53 reported that their practice had a standard operating procedure for the processing, sterilisation, and management of SI. Single bagging was the most common method for packaging and sterilising SI (53/59), the most common storage duration was between 1-3 months. Thirty-seven participants reported that once the expiry date of the package was reached, the unused SI were rebagged and resterilised.

The laboratory analysis was based on 59 samples, one having been omitted due to leakage.  Five of the 59 samples were identified as contaminated, an 8.5% contamination rate. There was no significant difference between storage method at any time point.

Limitations of the study include the small sample sizes, the use of experimental rather than clinical storage conditions and the assumption that bacterial contamination of the samples was not related to storage.

Take Home

The study provides some evidence that the storage of surgical instruments in either open or closed environments for up to six months does not negatively impact the sterility.  Further research on the use of single vs double bagging and the effect of frequent handling and longer storage durations on sterility in a clinical environment are needed to support existing practice protocols and sustainability initiatives.

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