INTRODUCTION

The provision of sterile surgical supplies is of paramount importance if such supplies are to be used with safety in the treatment of patients. The failure to follow recognized guidelines for the sterilization, disinfection and cleaning of surgical supplies and instruments renders the patient liable to infection, which could result in an increased hospital stay or in certain cases cause infections that are serious enough to bring about a fatality.

The complexity of modern materials used in the manufacture of medical and surgical equipment means that no single sterilization process is adequate to meet the needs of this changing environment. Flexible fibreoptic endoscopes are easily damaged by heat, as are specialist catheters and these materials require specialist sterilization methods. These range from chemical sterilizing agents and the use of toxic gases such as ethylene oxide to the more recent gas plasma systems, which utilize peracetic acid or hydrogen peroxide as the sterilant in conjunction with a radio frequency energy source.

Public awareness of the human immunodeficiency virus (HIV) and other viruses such as hepatitis B has highlighted the need for staff working within the Sterile Supply Department to pay scrupulous attention to the decontamination procedures in use. In addition, procedures should be in place to constantly monitor all aspects of the process. These include the maintenance of the equipment used in the decontamination process, microbiological monitoring and the storage and handling of raw materials. High-profile media coverage relating to salmonella in eggs, Creutzfeldt Jakob disease (CJD) and bovine spongiform encephalopathy (BSE) has also fuelled the need to have systems in place to ensure the adequate decontamination of equipment and materials. However, it should be noted that when dealing with the viruses associated with CJD, BSE and scrapie (in sheep), specialist guidance relating to decontamination and sterilization should be sought from the Control of Infection Microbiologist or other qualified person.

TERMINOLOGY

The misuse of terminology when addressing the subject of sterilization and disinfection frequently occurs and it is important from the outset to establish the correct meanings associated with each term.