Common mistakes to avoid when using the autoclave for sterilizing

Before being placed in the autoclave, the instruments must be properly prepared. The sterilization of surgical instruments and tools is a multi-stage process, the success of which depends on the correct execution of each step, from collection to storage. Errors in the preparatory steps prior to autoclaving can compromise the entire sterilization process. Find out more about sterilization protocol: https://prosystem.euronda.com/the-sterilization-protocol/

Here are the steps for a proper sterilisation protocol for surgical instruments:

Clean the instruments thoroughly to remove organic and inorganic residues.

The cleaning phase for surgical instruments is the first step in the sterilization process and aims to remove dirt from the instruments. The removal of such impurities before sterilization is mandatory, as residual dirt can render the sterilization process ineffective. Following the inactivation of viruses and bacteria by decontamination, the instruments must be manually or mechanically washed. Read the in-depth article: https://prosystem.euronda.com/cleaning-instruments/

Dry the instruments to avoid condensation and package them correctly.

The purpose of packaging surgical tools and instruments is to preserve sterility before subsequent use. This phase consists of placing the instrument (decontaminated, washed, cleansed, disinfected, rinsed, dried, checked and maintained) in a specific disposable bag, made in materials compatible with the steam sterilization process, that will be sealed to keep the instrument sterile over time (in accordance with UNI EN ISO 11607-1 and UNI EN 868-5). Find out more about the packaging phase here: https://prosystem.euronda.com/packing/

Choosing the wrong cycle can result in instruments not being properly sterilized, as each type of material and instrument used in dentistry requires specific sterilization parameters. Using inappropriate temperatures, times or pressures can compromise sterilization.

It is vital to:

• Understand the sterilization requirements for different types of instruments.
• Set up the autoclave correctly according to the materials to be sterilized.
• Check the calibration of the autoclave periodically.

EN 13060 identifies the different sterilization cycles, which vary according to the characteristics of the material to be treated (solid loads, and type A and type B hollow instruments).

The table below shows the load classification according to EN13060. There are different types of load that can be sterilized unbagged and kept sterile until use, and other types of load to be sterilized bagged.

N, S and B cycles: what’s the difference?

There are currently three different types of autoclaves on the market for sterilization: N-class autoclaves, S-class autoclaves and B-class autoclaves. Find out more in the article: https://prosystem.euronda.com/what-is-the-best-autoclave-for-a-dental-practice/

The N cycle is suitable for sterilizing loose solid products. Autoclaves carrying out this type of cycle do not allow the sterilization of textiles, porous loads or hollow instruments, or even bagged products, as the characteristics of the cycle do not allow barriers such as sterilization pouches or specific physical tests to be overcome.

The S cycle is only suitable for sterilizing the loads for which it is intended. S-type autoclaves belong to the intermediate class between N-type and B-type autoclaves, and their characteristics are not defined by any standard, in the sense that they simply depend on how they are manufactured. Their performance is only specified by the manufacturer, and defined according to specific tests.

The B cycle ensures medical grade sterilization, like a large sterilizer, and is capable of sterilizing any unpackaged or packaged object, such as porous materials, for example, but also bagged materials, textile loads and hollow instruments such as handpieces, turbines and tips.

Given the characteristics of this class and the levels of efficiency and safety required by the regulations, the class B autoclave proves to be the most appropriate choice; in fact, the dentist has the certainty of not making any mistakes when choosing the cycle.

One of the most common errors is the incorrect loading of the autoclave. Overloading or arranging the instruments in a haphazard way can compromise the sterilization effectiveness. The instruments must be positioned so that the steam can circulate properly. Be sure to:

• Not overlap the pouches on the trays;
• Turn the pouch paper in the direction indicated by the roll and pouch manufacturer to facilitate steam penetration and drying;
• Only store dry pouches at the end of the sterilization cycle; instruments in wet or open pouches must be reprocessed.

Like any other device, the autoclave requires regular maintenance to function properly. Ignoring maintenance can lead to malfunctions and ineffective sterilization cycles.

In accordance with article 2 of European Directive no. 93/42/EEC (Legislative Decree no. 46/1977 as amended), maintenance of Medical Devices (and therefore also of autoclaves) is mandatory and essential to maintain CE marking. (Read the in-depth article on autoclave maintenance: https://prosystem.euronda.com/autoclave-maintenance-in-5-steps/).

• It guarantees the reliability of the equipment.
• It is essential to keep the warranty or warranty extension active.
• It must be carried out by authorised technicians using original spare parts, and must be verifiable. Failure to do so will invalidate the warranty or warranty extension.

In addition to the technical maintenance programme, professionals recommend that operators who use it on a daily basis:

• Regularly clean the chamber and trays in which instruments and tools are stored
• Clean the water tanks
• Contact authorised technical support if messages are shown on the display.

It is not enough to start a sterilization cycle to be sure of its success. It is essential to check the results. Professionals recommend that you:

• Use chemical and biological indicators to monitor the effectiveness of each cycle.
• Record test results to have traceability and be able to act quickly if there are any problems.
• Carry out periodic validation tests to ensure that the autoclave is working properly.

The correct use of the sterilizing autoclave is essential to ensure the safe and effective sterilization of medical tools and surgical instruments. Avoiding these common mistakes and following the advice of professionals can make the difference between a safe environment and one that is risky. Remember, the key to success in the sterilization process is knowledge and a thorough approach in applying the correct procedures.

By following these guidelines, you will be able to exploit the full potential of your autoclave, ensuring flawless sterilization and protecting the health of your patients and staff.