Most people think of a steam steriliser as a silver bullet for the sterilisation of dental instruments, however, infection control can be easily compromised by errors and oversights during instrument reprocessing.

1. CATEGORY
102 AUSTRALASIAN DENTIST
Many people think of a steam steriliser
as a ‘sliver bullet’ for the sterilisation
of dental instruments, however, infection
control can be easily compromised by
errors and oversights during instrument
reprocessing.
The most common causes of infection
control failures are:
1. Instruments have not been cleaned
with an effective detergent before
sterilisation
2. Instruments have been over-oiled with
lubricant
3. The correct sterilisation cycle is
not selected to match the load being
processed
4. Air remains inside the vacuum
chamber during sterilisation
5. Instruments are wet at the end of the
cycle
6. The instrument pouch is torn or
expired
According to A-dec Australia, all of
these issues can be easily addressed by
using the appropriate equipment, infection
control protocols and sterilisation cycle.
Cleaning & Lubrication:
Instrument reprocessing starts with
thoroughly washing instruments by hand
– or in a thermo washer disinfector to
remove gross debris and surface biofilm.
This should be followed by further
preparation of dental handpieces in an
automated handpiece maintenance unit
to ensure they are correctly cleaned and
properly lubricated prior to sterilisation.
The ADA recommends automated
instrument maintenance units (such
as the W&H Assistina) over manual
processing because these units provide
more consistent and reliable results.
Hand processing using aerosol
lubricating sprays can cause over-oiling
of handpieces, which interferes with the
sterilisation process, wastes lubricant and
can also clog handpieces.
The Assistina TWIN is the newest
automated handpiece maintenance unit
from handpiece manufacturer, W&H.
Assistina TWIN employs innovative oil
nebulisation technology that enables
it to clean and lubricate an individual
handpiece in the record time of just 10
seconds!
While one handpiece is being
processed, another can be loaded in the
dual chamber for rapid turnaround. This
has proven a popular and affordable choice
for its rapid turnaround and compact
footprint.
ADA Infection control guidelines also
recommend the use of a suitable detergent
designed by the instrument manufacturer
to effectively clean instruments prior to
sterilisation.
W&H ActiveFluid™, which is used
in Assistina handpiece units, is a gentle,
slightly alkaline (pH 7.6) water-based
formulation that contains an anionic
surfactant. This makes ActiveFluid
ideal for cleaning and neutralising acidic
organic contaminants – notably blood and
saliva – while also inhibiting the growth of
viruses and bacteria.
Sterilisation:
A vital aspect of effective sterilisation is
correct load selection matching the size
and type of load. For example, using ‘S’ or
‘N’ cycles for processing wrapped, hollow
or porous loads can compromise infection
control.
It is also important to ensure a
complete vacuum is maintained inside
a vacuum steam steriliser to remove air
from inside instrument pouches and the
lumen (hollow space) inside instruments
to ensure all parts of all instruments are
exposed to saturated steam.
The new Lisa VA steriliser uses
the ‘Universal B’ 134 degrees or Prion
cycle for all load types (solid, hollow,
porous), whether wrapped or unwrapped,
ensuring ‘hospital grade’ sterilisation
of all instruments meeting Australian
Standards AS 4815 & AS 4817. This can
be achieved at the touch of just one button
on the simplified Lisa VA colour touchpad.
Lisa’s patented EcoDry technology
automatically matches cycle time to
the mass of the load, which reduces
cycle time, saving time and energy and
prolonging instrument life. A typical 2 kg
mixed load can be fully sterilised and dried
in just 30 minutes.
Small, unwrapped loads (for example
solid hand instruments without hinged
joints or hollow spaces) can be processed
on a special ‘Fast’ cycle in as little as 13
minutes.
Significantly, the Lisa VA is the
only bench-top steriliser with an air
leak detector, ensuring the entire load is
exposed to saturated steam every cycle.
Because of this feature, the use of test
strips and a test cycle are only required
once a week, instead of once a day – saving
staff time and energy.
Instrument tracking:
The Lisa captures all batch data on internal
memory and USB. It can also be attached
to a LisaSAFE barcode printer, which will
only produce a tracking label if all the
cycle parameters have been met (i.e. time,
steam pressure and temperature).
Lisa VA features optional password-
protected load release with user
identification that enables the operator to
verify that the cycle has been completed
successfully, the load is dry and any
chemical indicators used have changed
colour.
The Lisa can be monitored wirelessly
in real time on the free Lisa app for
tablets and Smartphones, enabling the
management of the sterilisation process
remotely.
The Lisa VA steriliser, Assistina
handpiece maintenance units and high
quality W&H handpieces are exclusively
available from A-dec. u
Phone 1800 225 010 for your nearest
W&H authorised distributor.
If it’s not clean and dry, it’s not sterile!
Fast, secure and simple sterilisation
INFECTION CONTROL, STERILISERS AND STERLISER SOLUTIONS