Sterilization of Surgical Instruments | OT Instruments Classification

PPT on Classification of OT Instruments & Sterilization Methods. Covers Cutting, Grasping, Clamping, Retracting, Suturing, Suction Instruments and Autoclave Sterilization for Critical Instruments. Useful for OT Technician, DMLT, Nursing students.

Transcript

1. Sterilization of surgical instrument By- Annu Maurya b.Tech in biotech, M.Sc. Plant pathology
2. Classification of instrument  Surgical instruments in an operation theater (OT) are primarily classified based on their functional usage during a procedure
3. 1. Cutting and Dissecting Instruments  Purpose: Used to cut skin, tissue, cartilage, or bone, and to separate anatomical planes.  Examples: Scalpels (handles with disposable blades), surgical scissors (such as Mayo scissors for heavy tissue and Metzenbaum scissors for delicate tissue), and bone cutters or saws
4. 2. Grasping and Holding Instruments  Used to pick up, hold, or retract tissue, organs, or sterile drapes.  Examples: Tissue forceps (toothed for firm grip), smooth/dressing forceps (non-toothed, like DeBakey forceps), and towel clips.
5. 3. Clamping and Occluding Instruments  Purpose: Used to compress blood vessels or hollow organs to control bleeding or prevent fluid leakage.  Examples: Hemostatic forceps (like Mosquito or Kelly clamps) and Kocher clamps
6. 4. Retracting and Exposing Instruments  Purpose: Used to hold back or pull aside edges of a surgical incision, organs, or bulky tissues to maintain a clear view of the surgical site.  Examples: Hand-held retractors (like Langenbeck retractors or Morris retractors) and self-retaining retractors (like Gelpi or Balfour)
7. 5. Suturing and Stapling Instruments  Purpose: Used to close wounds, approximate tissue edges, or ligate structures at the end of or during a procedure.  Examples: Needle holders (needle drivers), surgical needles, and skin or surgical staplers
8. 6. Suctioning and Aspirating Instruments  Purpose: Used to clear blood, mucus, and other bodily fluids from the surgical field to maintain visibility.  Examples: Yankauer suction tips and Frazier suction tubes
9. 7. Dilating and Probing Instruments  Purpose: Used to gently expand the size of an orifice/duct or explore a wound or fistula tract.  Examples: Urethral dilators, uterine dilators (such as Hegar dilators), and grooved probes
10. Critical Instruments  Critical instruments are items that enter normally sterile tissues, the vascular system, or blood. They carry the highest risk of infection if contaminated  Requirements: Must be completely sterile before use (free of all micro-organisms, including bacterial spores). Sterilization is done via high-pressure steam (autoclave), dry heat, or ethylene oxide
11. Examples  Surgical scalpels and blades  Surgical forceps and clamps  Bone chisels and surgical burs  Vascular and cardiac sutures, and implants cathetersSurgical needles,
12. Semi-Critical Instruments (Intermediate Risk)  Though often grouped between the two, semi-critical items touch mucous membranes or non-intact skin but do not penetrate sterile tissues.  Requirements: Require high-level disinfection at a minimum, though heat sterilization is used whenever possible.  Examples: Laryngoscope blades, endotracheal tubes, and flexible bronchoscopes.
13. Non-Critical Instruments  Non-critical devices only touch intact, unbroken skin and do not touch mucous membranes. They carry the lowest risk of spreading infection.  Requirements: Need low-level to intermediate disinfection or routine cleaning with a detergent and water.
14. Examples:  Blood pressure cuffs  Stethoscopes  Pulse oximeters  Operating table surfaces and patient beds  ECG leads and skin electrodes
15. Cleaning  Remove debris: Wash items with water and enzymatic or detergent cleaners to strip away blood, tissue, and organic soil.  Scrub carefully: Use brushes on hinges, teeth, and lumens to eliminate any trapped biological matter.  Rinse thoroughly: Flush the equipment with clean water to wash away residual detergent
16. 2. Decontamination  Kill pathogens: Apply thermal, chemical, or high- level disinfection methods to neutralize bacteria, fungi, and viruses.  Reduce bioburden: Make the items safe for handling by staff before they move to the next sterile processing stage
17. Drying  Prevent moisture: Dry instruments completely using lint-free towels or filtered compressed air.  Stop contamination: Eliminate residual water that can block sterilizing agents or create wicking channels for microbes
18. Packing  Inspect items: Check every device for damage, rust, or leftover residue under bright light.  Seal packages: Wrap or place instruments into FDAcleared sterilization pouches or wraps to maintain future sterility.  Add indicators: Insert chemical indicators inside the packs to verify that future sterilization parameters are met
19. wrapping material and preparation  Proper wrapping and preparation of surgical instruments in the operating theater (OT) ensure a sterile barrier and prevent contamination until use
20. Types of Wrapping Materials  Woven (Textile) Wraps: Reusable cotton or linen fabrics that require regular laundering, inspection for holes, and proper rehydration before use.  Nonwoven Materials: Disposable synthetic sheets (like SMS fabric or blue wrap) that offer superior microbial barrier protection and tear resistance.  Paper Wraps: Medical-grade or crepe paper designed specifically for single-use steam or gas sterilization.  Paper-Plastic Pouches: Clear plastic bonded with medical-grade paper, ideal for smaller individual instruments.
21. Preparation and Inspection Steps  Wash and completely dry all surgical instruments to prevent moisture retention and incomplete sterilization.  Inspection: Check instruments for cleanliness, correct alignment, and functional integrity; lock ratchets to the first notch.  Arrangement: Place heavy items at the bottom and delicate tools or sharp tips in safe holders or guards to prevent puncturing the wrap. Leave space between items for steam circulation.  Internal Indicators: Place a chemical sterilization indicator strip directly inside the center of the pack.
22. Wrapping Techniques  Double Wrapping: Use sequential double-wrapping (wrapping twice) to establish a redundant sterile barrier.  Folding Methods: Apply standard methods like the envelope fold or square fold to allow aseptic opening without contaminating the inner contents  Security and Labeling: Fasten the final wrap securely using sterilization indicator tape. Label the package with the specific contents, processing date, expiration date, and the packager's initials
23. indicator chemical strips biological spores  use different methods to monitor and verify the effectiveness of sterilization processes like autoclaving or ethylene oxide treatment.
24. Chemical Indicators (CIs)  How they work: Use chemical dyes or inks that change color when exposed to specific physical conditions.  What they measure: Check parameters like temperature, time, pressure, or the presence of steam/gas.  Speed: Provide immediate, real-time visual results (e.g., color changing on a strip or tape).  Limitation: Confirm that parameters were present, but do not prove that actual microorganisms were killed.
25. Biological Indicators (BIs) and Spore Strips  How they work: Use highly resistant, live bacterial endospores (such as Geobacillus stearothermophilus or Bacillus atrophaeus) inoculated onto filter paper strips or carriers.  What they measure: Directly test if the sterilization cycle can destroy hardy microbial life.
26.  Process: After the sterilization cycle, the Spordex Biological Indicator Strips or similar spore strips are placed in a growth medium and incubated to check for any surviving spores.  Advantage: Provide definitive proof of microbial inactivation and cycle efficacy, though results take 24 to 48 hours (or longer) of incubation
27. Thank you