This document discusses sterilization and disinfection of surgical instruments. It defines sterilization as the complete removal of microbes including bacteria and viruses. Disinfection is less stringent and does not remove all microbes. Disinfection is categorized into high, intermediate, and low levels based on the types of microbes eliminated. The document also discusses mechanical washing, ultrasonic cleaning, and lubrication of surgical instruments as important processes to remove soil and microbes and ensure proper functioning.

1. STERILIZATION & DISINFECTION OF SURGICAL
INSTRUMENTS
By
Mr ADNAN ADIL
B.Sc M.Sc (Operation Theatre Technology)

2. 1. STERILIZATION :
• Sterilization is the complete removal or destruction of all forms of
microbial life, including bacteria, viruses, fungi and spores. Sterilization
is achieved by steam, dry heat, ethylene oxide gas and Plasma
(Hydrogen Peroxide) .
• Sterility is a probabilistic notion. There is no absolute assurance that an
item contains zero microorganisms.
• The sterility assurance level (SAL) is used as a measure of sterility. It is
the probability of survival of a microorganism after a sterilization
process.

3. 2. DISINFECTION:
• Disinfection is a process that eliminates a defined scope
pathogenic microorganisms but not necessarily all
forms.
• Disinfection does not attempt to remove all viable
microorganisms.
• Disinfection has been categorized into three levels: high,
intermediate and low:

4. • High LEVEL DISINFECTION :
Eliminates all pathogenic organisms but some viable spores may persist
on an item disinfected to the high level. The critical distinction between
high and intermediate is the elimination of ALL VIRUSES in high
disinfection.

5. • Intermediate LEVEL DISINFECTION :
• Eliminates all pathogenic vegetative bacteria, fungi and most viruses but
some viruses (particularly small viruses without envelopes), and bacterial
spores are not eliminated.
• The critical distinction between intermediate and low level disinfection is
the elimination of the most resistant bacteria in intermediate level
(Mycobacterium tuberculosis is used as an indicator because it is relatively
resistant to disinfection).

6. LOW LEVEL DISINFECTION :
Eliminates most pathogenic bacteria but some of the less sensitive vegetative forms
(M.tb for example), the non-lipid viruses and bacterial spores are not eliminated.

8. • Resistance Of Microorganisms

11. MECHANICAL WASHING OF SURGICAL INSTRUMENTS:
• The mechanical cleaning action of washer/disinfectors relies on spray arm
technology with pressurized water to help clean surgical instruments or other
reusable devices.
• The load inside a washer/disinfector is exposed to a specific water
temperature, chemical concentration, and flow rate.
• The thermal rinse phase in a washer/disinfector provides a level of
disinfection.
• An optional drying phase can be added to reduce manual drying.

12. • Successful cleaning using
washer/disinfectors depends on four
parameters within the cycle.
1.Time
2.Temperature
3.Chemistry
4.Impigment

13. ULTRASONIC CLEANING OF SURGICAL INSTRUMENTS :
• Ultrasonic cleaners work through cavitation where high-frequency sonic
waves create tiny bubbles on the surfaces of the instruments which
eventually implode.
• The implosion of these bubbles helps to dislodge soil from the surface of
the device.
• After the ultrasonic cleaning process, the instruments must be thoroughly
rinsed with either deionized or softened water.
• Advantages of ultrasonic cleaning include a reduction of time spent to
clean complex instruments and removal of residual soil, however not all
materials or devices are compatible with this type of cleaning.

14. LUBRICATION OF SURGICAL INSTRUMENTS:
• Proper lubrication of surgical instrument's and equipment is critical for
effective operation and it helps prolong the lifespan of the devices.
• Moving parts such as ratchets, joints, box locks, and screws should be
lubricated on a regular basis and in strict accordance with the instrument
manufacturer’s instructions for use (IFU).

15. Lubricants created for healthcare include the following types:
• Lubricant sprays – These come in both prediluted and concentrated
forms. This type of lubricant is designed to be sprayed into the
identified areas of the device.
• Aerosol lubricants – These are used for dental drills and some power
instrument attachments that require pressurized application. Aerosol
lubricants are typically mineral oil-based and must only be used on
items specified in the IFU

16. • Silicone spray – This type of lubricant is used for some power equipment and stopcock “O” rings.
It is important to only use silicone spray if specifically stated to do so in the IFU.