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Steri&disinf

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  • 1. STERILIZATION AND DISINFECTION
  • 2. STERILIZATION
    • Process by which an article , surface or medium is freed of all micro-organisms including viruses ,bacteria ,their spores and fungi , both pathogenic and non-pathogenic
    • DISINFCTION
    • Process of destruction or removal of organisms capable of giving rise to infection .
    • spores are not destroyed .
    • ANTISEPSIS
    • Destruction or inhibition of micro – organisms in living tissues thereby limiting the harmful effects of infection .
  • 3.
    • Medical asepsis
    • Attempt to keep health care staff , patients , and objects as free as possible of agents that cause infection.
    • Surgical asepsis
    • Attempt to prevent microbes from gaining access to traumatic surgically created wounds.
  • 4. AGENTS OF STERILIZATION
    • PHYSICAL AGENTS
    • Sunlight
    • Drying
    • Heat
    • Filtration
    • Radiation
    • CHEMICAL AGENTS
    • Phenols and cresols
    • Aldehydes
    • Vapour phase disinfectants
    • Halogens
    • Alcohols
    • Metallic salts
    • Surface active disinfectants
  • 5. Sterilization by Heat
    • MOST RELIABLE , CERTAIN AND RAPID
    • TYPES
    • DRY HEAT
    • MOIST HEAT
  • 6. STERILIZATION BY DRY HEAT
    • RED HEAT
    • FLAMING
    • INCINERATION
    • HOT AIR OVEN
  • 7. FLAMING
    • Auxiliary method of sterilization.
    • Can be sterilized :
    • POINTS OF FORCEPS
    • CEMENT SPATULAS
    • COTTON PLIERS
    • SILVER CONES
    • Uses Bunsen burner flame .
    • Used only during the of course of procedure.
  • 8. INCINERATION
    • Rapidly destroys contaminated materials such as patient’s dressings and pathological materials.
  • 9. HOT AIR OVEN
    • PRINCIPLE :
    • Hot air causes oxidation of microbial contents leading to cell death .
  • 10.
    • TEMPERATURE ( c ) TIME(min)
    • 160 120
    • 170 60
    • 150 150
    • 140 180
  • 11. HOT AIR OVEN
    • Can be sterilized :
    • Laboratory glassware, glass syringes , instruments .
    • Cannot be sterilized :
    • Grease oil , powders
    • Fabrics and rubber items .
  • 12. .
    • ONLY ADVANTAGE –
    • MAINTENANCE OF SHARP EDGES OF CUTTING INSTRUMENTS such as chisels.
  • 13. Things to note
    • Instruments must be clean and dry prior to wrapping.
    • Wrapping material must be heat resistant.
    • Aluminum foil, metal , glass container may be used .
    • Instruments must be loosely wrapped .
    • It should not be over – loaded .
  • 14. Working
    • Consists of metal cup in which salt is dispensed.
    • To sterilize an instrument properly , immerse it a quarter a inch below salt surface and in peripheral area of sterilizer.
    • Reason – temperature is hottest along its outer rim and lowest in the centre of surface layer of salt.
  • 15. Application
    • Used widely in endodontics for sterilization of
    • broaches , reamers, files : 5 secs
    • Absorbent points , cotton pellets : 10 secs
    • Burs .
  • 16. DRY BEAD STERILIZATION
    • Micro tools , autoclavable instrument trays can be sterilized.
    • Temperature – 320F for 2 hrs
            • , 340F for 1 hr
  • 17. STERILIZATION BY MOIST HEAT
    • BELOW 100 c
    • * Pasteurization
    • * Low temperature steam Formaldehyde sterilization
  • 18. PASTURIZATION
    • Done for milk and milk products
    • Procedure
    • holder method
    • 63 c for 30 mins
    • flash method
    • 72 c for 20 secs
    • Followed by rapid cooling to 13 c or lower
  • 19. Low temperature steam Formaldehyde sterilization
    • Combination of dry saturated steam and formaldehyde.
    • Requires 127 c to 132 c at 20 to 40 psi for 30 mins .
    • Heat sensitive instruments can be sterilized .
  • 20. ADVANTAGES
    • Lack of corrosion
    • Shorter duration
    • Low temperature
    • DISADVANTAGES
    • Requires provision for ventilation to expel vapours
  • 21. MOIST HEAT AT 100 c
    • Boiling at 100 c
    • Free steam at 100c
    • Figure shows a boiler
  • 22.  
  • 23. MOIST HEAT ABOVE 100 C
    • AUTOCLAVE
    • * most practical and efficient means of sterilization
    • * uses steam under pressure for sterilization
  • 24. PRINCIPLE
    • Saturated steam is more efficient sterilizing agent than hot air
            • HIGH Penetration
            • RAPID effect
            • GREATER lethal action
  • 25.  
  • 26.  
  • 27. PARTS
    • PRESSURE GAUGE
    • TEMPERATURE METER
  • 28.
    • AUTO STOP MECHANISM
  • 29.  
  • 30. PARAMETERS
    • PRESSURE
    • TEMPERATURE
    • TIME
    • 109 C AT 5 psi
    • 115 c AT 10 psi
    • 121c AT 15 psi
    • 126 c AT 20 psi
  • 31. APPLICATIONS
    • STAINLESS STEEL INSTRUMENTS
    • RESTORATIVE BURS
    • HANDPIECE
    • RUBBER ITEMS
  • 32.  
  • 33. FILTRATION DEVICES
  • 34. IRRADIATION
    • IONIZING RADIATION
    • NON – IONIZING RADIATION
  • 35. IONIZING RADIATION
    • Disposable items – needles , syringes , swabs , culture plates , catheters in bulk , suture material , cannulas , pharmaceuticals sensitive to heat .
    • Co – 60 used .
  • 36. NON – IONIZING RADIATION
    • UV , Infra red Rays
    • purification of air in operating rooms .
  • 37. LASERS
    • Can sterilize infected endo instruments in 3 secs.
    • Micro –organisms including spores are destroyed.
  • 38. CHEMICAL AGENTS
  • 39. ALCOHALS
    • Solutions of 70 percent Ethanol and iso – propyl alcohol used as antiseptics .
    • Used for sterilization of dapen dishes , glass slab , gutta percha cones thermometers .
  • 40. AVOID
    • Instruments containing carbon steel should not be soaked in alcohol as corrosive to alcohol .
    • Rubber items absorbs alcohol – can cause tissue reaction .
    • Alcohols dissolve cements holding instruments together and plastics may harden in its presence .
  • 41. ALDEHYDE COMPOUNDS
    • Formaldehyde – not used much .
    • Glutaraldehyde
  • 42. Glutaraldehyde
    • Metal instruments , plastics , rubber , porcelain .
            • Effective against
        • M. TUBERCULOSIS
        • Hepatitis viruses
        • HIV viruses .
            • 2% glutaraldehyde ( cidex ) for 20 mins
  • 43. ETHYLENE OXIDE GAS STERILIZATION
    • Heat sensitive items
    • electric equipment
    • flexible – fiber endoscopes
    • photographic equipment
    • contaminated objects
    • organic compounds – bone morphogenetic proteins extracts
    • *
    • .
  • 44. ADVANTAGES
    • Highly penetrative – even through plastics .
    • Used at low temperatures.
    • Leaves no residue .
    • Heat sensitive articles can be sterilized .
  • 45. DISADVANTAGES
    • High cost
    • Toxicity of gas ,
    • need for venting it .
    • Explosive and inflammable .
    • Long period of aeration
  • 46. IODOPHORS
    • MOST EFFECTIVE ANTISEPTICS
    • ACTIVITY dependent on release of FREE IODINE
    • 1% IODINE SOLUTION – BETADIENE , ISODINE
  • 47. ADVANTAGES
    • * LOW TOXICITY
    • * PROLONGED RESIDUAL effect
    • * INEXPENSIVE
    • * ODOURLESS
  • 48. Sodium hypochlorite
    • Gutta percha cones
    • 2.5 % aq for 10 secs followed by rinsing with hydrogen peroxide
    • Complete dentures
    • 2.5 % for 5 min
    • prevents denture stomatitis
  • 49. List of disinfectants
    • Ethanol – 70%
    • Glutaraldehyde – 2% activated
    • cidex , procide , omnicide , glutarex
    • Sodium hypochlorite -1%
    • Hydrogen peroxide – 3%
    • Iodophors – 1% iodine
    • betadine , isodine
    • Others preparations – lysol, savlon, dettol
  • 50. Waste disposal
    • Waste material can be
    • biohazardous material
    • non – biohazardous materials
  • 51. Biohazardous material
    • Waste for infectious disease
    • Waste for poisonous material
    • Human tissue
    • Teeth
    • Blood soaked material
  • 52.  
  • 53.  
  • 54. Non – biohazardous materials
    • Matrix band
    • Masks
    • Head caps
    • Impression material
    • X – rays packets
  • 55. WASTES FROM DENTAL MATERIALS
    • MERCURY – AMALGAM
    • SILVER THIOSULPHATE – X- RAY FIXER
    • LEAD FOILS
  • 56. Sources Of material
    • Remaining amalgam after its use
    • Scrap amalgam
    • Extracted teeth containing amalgam filling
    • Removal of old amalgam fiiling
  • 57. Mercury containment kit
    • Designed kit to collect any spillage of mercury
    • It contains
    • face mask
    • protection for eyes
    • scotch tape
    • 10 cc syringe
    • covered plastic container with water
  • 58. STEPS
    • Clear the area around spill
    • Wear all protective gears
    • Contain the spread of mercury
    • Use regular syringe to suction out all mercury
    • Pour the contents of syringe into plastic container with 5-10 ml of water
    • Put scotch tape
    • Put the used syringe in a separate container
    • Mercury thus collected can be reused
  • 59. CATEGORIES OF BIO – MEDICAL WASTES
    • Category – 1
    • Human tissues , organs, body parts
    • Category – 2
    • Body fluids , blood .
    • Category – 3
    • Lab cultures , live or attenuated vaccines .
  • 60.
    • Category – 4
    • Needles , syringes , scalpels , blades , glass
    • Category – 5
    • Discarded medicines , cytotoxic drugs .
    • Category – 6
    • Items contaminated with blood or fluids ,cotton , dressing , soiled plaster cast , linen .
  • 61.
    • Category – 7
    • Disposable items such as tubings , catheters , intravenous sets .
    • Category – 8
    • Liquid waste – waste from cleaning , disinfection activities .
  • 62.
    • Category – 9
    • Incerination ash
    • Category – 10
    • Chemical waste – biologicals , chemicals used in disinfection
  • 63. Bags for disposal
    • YELLOW bags
    • BLACK bags
    • BLUE bags
    • RED bags
  • 64.  
  • 65.  
  • 66.  
  • 67. Type of bag Waste material Treatment option Yellow bag Glooves masks head caps suction tips disposable glooves Incerenation deep burial Red bag Body tissues extracted tooth Autoclaving chemical treatment microwaving Blue bag Needles syringes scalpels blades glass endodontic files Autoclaving chemical treatment microwaving Black bag Discarded medicines incineration ash chemicals used in disinfection Disposed in secure land fill
  • 68. RESOURCES IN INDIA
    • Occupational Safety And Health Adminstration – OSHA
    • http://www.osha.gov/SLTC/dentistry/index.html
    • Centers of disease control and prevention – CDC
    • http://www.cdc.gov.co.in
  • 69. CONCLUSION
    • Sterilization is very essential for both patient protection and ethical reasons.
    • Hence should be strictly followed.
  • 70. THANK YOU