集中供应手术器械灭菌湿包原因分析及对策

Causes of wet packages of surgical instruments under centralized supply and the countermeasures

目的探索供应室集中供应手术器械和敷料灭菌包湿包的原因,并讨论解决方法以保证灭菌质量。方法将使用纺织棉布或无纺布包装的手术器械包和敷料包称重随后放入灭菌器,按脉动真空压力蒸汽灭菌器的正常操作流程运行1个灭菌周期,观察灭菌后的器械包和敷料包是否有水渍、水珠、水印后,立即、放置10、20min分别进行称重,连续检测3d。结果器械包中有两包出现边角湿,敷料包中有两包外有水珠存在;灭菌前后称重发现,超重的敷料包和器械包易产生湿包;灭菌包使用无纺布比纺织棉布包装易湿包;灭菌后立即称重约73.0%超重;放置10min后17.3%超重;放置20min后无超重。结论可通过减轻灭菌包重量,使用棉布代替无纺布包装可缓解湿包现象;灭菌包在灭菌器内延长放置时间等也可缓解湿包现象。

OBJECTIVE To explore the causes of the wet packages of the surgical instruments and the dressing sterilization bags in central sterile supply department so as to put forward the solutions to ensure the sterilization quality.METHODS The surgical instrument packages and dressing kits packed by textile cotton or non-woven fabric were placed into the sterilizer after weighing all of them to run a sterilization cycle in accordance with the standard operation procedure of pulsating vacuum pressure steam sterilizer.The water stains,water droplets,and watermark were observed after the sterilization to see whether they remained on the packages,then all of the packages were weighed after being placed for 10min or 20min,a consecutive monitoring for 3 days.RESULTS Of all the instrument packages,there were two packages being wet at corners,and of all the dressing packages,there were two packages with water droplets remaining outside the packages;demonstrated by the weighing before and after the sterilization,the overweight dressing packages and instrument packages were prone to be wet;the non-woven fabric packages were easier than the textile cotton ones to be wet;73.0% of the packages were overweight when weighing immediately after the sterilization,17.3% overweight after being placed for 10 min,and none overweight after being placed for 20min.CONCLUSION The wet packages can be reduced by lessening the weight of the packages and by using the textile cotton packages instead of the non-woven fabric packages as well as extending the time of the packages′ placement in the sterilizer.