4 6 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E M A Y 2 0 1 7
If you're using posts to hold ringed instruments in place, make sure they've
been validated for the sterilization container. Also, turn the container upside
down to make sure these holders were installed properly and are held securely
in place.
The Association for the Advancement of Medical Instrumentation (AAMI) and
AORN both dictate that assembled containers for steam sterilization should
weigh no more than 25 pounds. This guidance is more about protecting sterile
processing staff members who have to lift containers than it is about preventing
contamination of the equipment.
Pay attention to the density of the instruments and items you place in a con-
tainer. Picture 25 pounds of surgical instrumentation spread across a cafeteria
tray. Now picture that same amount of instrumentation jammed into a shoebox.
Because there's less surface area in the shoebox, the instrument mass will be
denser and, therefore, more difficult to sterilize. Because AAMI simply states
that density should be "evenly distributed," you must rely on your own experi-
ence for determining how you should arrange items in containers. When using
sterilization containers for low-temperature sterilization modalities, it's impor-
tant to check instructions for both the sterilizer and the container for load or
poundage restrictions.
4. Inspect closely
Look over containers before each sterilization cycle to ensure there are no nicks,
cracks or warping. While dents are sometimes overlooked, they compromise the
sterility of instruments as much as a tear in blue wrap would. No, it doesn't matter
if you can still close the lid. It's also important to check that a container's gaskets
are still pliable, and this holds true whether the gaskets are meant to be replaced
regularly or whether they're under lifetime warranty. Even a slightly nicked or
stained gasket may affect a container's seal. Also, check that your filter-holding
mechanism is still in good working order. Does it provide a nice snug fit for the fil-
ter and are all the rivets and fasteners still tight? Are the handles still solidly
