Flash Sterilization: Carefully Measured Haste

Patient Injury From Flash-Sterilized Instruments

“…2 Several studies showed colonized or infected patients to be a major reservoir of infection. 2,3 Environmental cultures using moistened swabs showed rates of positive samples reaching 19%, similar to other reports. 1 From 1992 to 1996, isolation precautions were not enough to control the outbreak, and the infections became endemic, leading us to consider that some environmental reservoirs might remain unrecognized using the swab technique.…”

“…12 Flash sterilization commonly is used in the operating room for emergency sterilization of dropped or otherwise contaminated instruments, instruments unintentionally left out of a surgical tray or, inappropriately, to compensate for inadequate inventories of instruments or implantable devices. 3 We report here two patients who received clinically significant burns during surgery from instruments that had been flash sterilized.…”

The Surgical Instrument Sterilization Process

“…An IUSS autoclave can be small enough to be operated in the substerile space beside an OR, accessible to all who have OR access. These concerns were compounded by a lack of industry-available biological indicators which could provide a result fast enough to assess whether sterility of the system was achieved on the day it was used as commercially available biological indicators have incubation periods of 24 hours [45][46][47][48] . This meant if an indicator was placed into an IUSS system, the sterility of the system would not be known until the following day.…”

“…One of the most serious complications traced back to IUSS failure was a single hospital in which failed sterilization of implantable devices used in neurological shunting resulted in 6 cases of pseudomonas aeruginosa meningitis or intraabdominal infection 47,51 . Another often cited study by Hutzler et al is a single hospital initiative in which they sought to eliminate preventable causes of IUSS because it was used in 79% of all surgeries.…”