Proper prep for "Flash" sterilization

[Chris Dodd]

I am seeking input on how to properly prepare instruments for flash sterilization. I say that items should be fairly dried. It is past practice at the facility that I am at to put instruments and (god help us) whole trays into a flash cycle dripping wet. If anyone has any idea where I can get info to post reguarding this pracitce or if it is an acceptable practice I would like that information also so I can tell my staff the correct way to do it. Thanks-Chris.

[sonny1388]

I have not read or seen any information on this, but here's the way I see it, be it right or wrong. In normal sterilization cycles, our sets are wrapped and are going to be stored before using. Having these sets dry when they are put in makes sense because extra moisture results in wet packs. When we are flashing, we don't have to worry about extra moisture or wet packs as the instruments will be going directly into service. Does this mean that we can sterilize a set sitting in a bucket of water...no. But some moisture shouldn't effect the outcome of sterility.

[Chris Dodd]

Common sense tells me the same thing. Thanks for your input! I don't feel crazy anyomre.

[autoclave1]

Remember that AORN does not like to see "flashing" used at all. If an instrument(s) are processed wet, the end result will be wet. By processing the instrument(s) wet, it has a damaging effect on the metal. Impurities from the water droplets will be depositied on the surface of the metal causing possible pitting and or rust and staining. If you like replacing instruments on a regular basis this is probably not that great of an issue. Instruments cost money which in turn takes money away from salary increases. Department heads and administrators listen when costs savings are suggested. Think about increasing instrumentation to lower mainetnance and repair costs, not to mention surgeon satisfaction when working with proper instrumentation.

[libra]

amen, you should keep a list of what you are flashing and perhaps increase your tray inventory.

[chipmoore]

Good subject matter.
Those of you who have access to AAMI ST37-1996 could learn about Flash Sterilization and the thinking that went on during the Working Group/Committee sessions back then. Read the "Foreward" for insights.
There is nothing wrong w/ the Flash process as long as there is one level of cleaning practiced in the facility and there is a means to deliver the items aseptically. In the Forward, there are 4 key points.
1. Correctly selected time and temp for the load
2. defined practices to deliver the items
3. the items will be wet out of the sterilizer
4. transfer for use immediately, using aseptic technique
Included is reference to bioburden reduction and policies consistence w/ instruments processed by the wrapped technique.

There are a number if institutions today that have instrument processing areas within surgery and double door, vacuum sterilizers that load from a sterile corridor and unload right into the OR, ready for use. Good cleaning and good delivery of items for immediate use. Results in faster turnaround times and lower instrument inventory. I don't know for sure, but would think the trays of instruments would be mostly dry prior to processing in the double door sterilizer.
Regarding the orginal question of "wet" instruments being loaded into a flash cycle, in my years, haven't seen documents that discusses negative effects of putting them in wet. I would suspect that flash cycles typically have wet items loaded, just how wet would depend on each location. Could this cause the early replacement of instruments due to deposits/rusting/pitting, don't know that either.
Chip Moore
Getinge
Rochester, NY