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STERILIZATION OF OPERATION THEATRES – TIME TO STOP FUMIGATION

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STERILIZATION OF OPERATION THEATRES – TIME TO STOP FUMIGATION

STERILIZATION OF OPERATION THEATRES – TIME TO STOP FUMIGATION

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  • 1. STERILIZATION OF OPERATION THEATRES – TIME TO STOP FUMIGATION Dr.T.V.Rao MD Sterilisation means eradicating germs completely, which is not 100% possible in an operation theatre. The sources of bacterial (germ) contamination are from air and the environment, infected body fluids, patients, articles, equipment etc. Many times we are practising the old tradition of sterilization of operation theatres and sick rooms with the use of formaldehyde for sterilization, Try to give up blind use of formaldehyde which is hazardous and has several unknown health related uses Inhaling those fumes usually has instant side-effects like coughing, nausea, vomiting, secretion of more saliva than usual, sweating, red eyes, itchy skin, laboured breathing and a running stomach, Fumigation is an age old process of sterilisation, of the environment, may be a sick room or operation theatres. It is usually done with formalin fumes, which are very pungent and harmful. So when a room is fumigated, it is tightly closed and sealed before fumigation. The room is opened after fumigation (12 - 24 hours). The room can be used once all fumes are out. OSHA indicated that formaldehyde should be handled in the workplace as potential carcinogen and set an employee exposure standard for formaldehyde that limits an 8-hour time- weighted average exposure concentration of 0.75ppm. Formaldehyde is the commonly used agent. Formaldehyde gas is generated from liquid formalin utilizing potassium permanganate crystals. 40% formalin liquid is added to potassium permanganate crystals to generate gas. Alternately, formalin liquid can be dispersed by a sprayer like device in the theatre environment. After a contact time of at least 6-8 hours, the formaldehyde needs to be neutralized by using ammonia, allowing at least 2 hours contact time for ammonia to neutralize the formaldehyde prior to the use of theatre. Emerging Compounds in use for Sterilization of Operation theatres: Bacillocidrasant: A newer and effective compound in environmental decontamination with very good cost/benefit ratio, good material compatibility, excellent cleaning properties and virtually no residues. It has the advantage of being a Formaldehyde-free disinfectant cleaner with low use concentration. Advantages - Provides complete asepsis within 30 to 60 minutes. - Cleaning with detergent or carbolic acid not required. - Formalin fumigation not required. - Shutdown of O.T. for 24 hrs. Not required. Other Newer and Non Toxic compounds: A Chemical compound - VIRKON is gaining importance as non-Aldehyde compound. Virkon is proved to be a safe virucidal, bactericidal, and fungicidal, mycobactericidal and non-toxic compound. It contains oxone (potassium peroxymonosulphate), sodium dodecylbenzenesulfonate, sulphamic acid; and inorganic buffers. It is typically used for cleaning up hazardous spills, disinfecting surfaces and soaking equipment. Though Virkon is shown to have wide spectrum of activity against viruses, some fungi, and bacteria, it however is less effective against spores and fungi than some alternative
  • 2. disinfectants. Several other compounds are emerging in the Market for safer use, may need better resources for utility and implementation. Do not underestimate the power of simple measures the inanimate surfaces in the operation theatre need proper periodic cleaning and disinfection. Grossly contaminated surfaces are the potential sources of hospital acquired infections. The operation theatre should be thoroughly washed with water and detergent mixture so as to get rid of all spills and proteinaceous materials before a disinfectant is used for mopping the surfaces. Many scientific studies prove simple cleaning measures and human behaviour can make a change in up keeping the human and patient safety It has been observed that there is a general relationship between the aerobic bacterial count and the risk of infection. There is a significant risk of infection when there are more health care workers and permitting many medical students in the theatre the counts certainly reduce when the staff follow the principle of lesser talking and more scientific behaviour for human safety , My experience with renowned surgeons, they encountered few infection WHEN there is an optimal human discipline as dedicated hand washing and care of mask and head gear when operating and above all a respect for the tissue, they are operating, AND the chemicals alone are no solutions. The above mentioned chemicals are only examples do not carry any conflict of interest Dr.T.V.Rao MD Professor of Microbiology Freelance writer

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