Ortho Sets - plastic - wet after sterilization

[Rod Brueggeman]

We have been getting more and more loaner instrument sets from vendors that have plastic trays and containers. We have been getting many trays returned form surgery with the complaint " water on the inside of the tray". We don't see this problem with any sets unless it is a plastic container. I have opened these sets that feel cool to touch on the exterior but on the inside the metal instruments are hot still. I believe the water in the tray is a direct result of varying cooling properties of the metal instrumets vs the plastic trays. Does any one have any suggestions on how to prevent this. We have our dry time set at 30 minutes and we allow the load to sit in the chamber for an additional 20 minutes with the door cracked 6-10 inches. This is very frustrating and I feel the mfgs are taking the cheap out because it costs them less to make the plastic container vs metal.

[linnma]

It is important to check the bottom of the plastic trays to see if they have enough drainage holes to drain away all the excess water.

[Uprooted Scrub]

I agree with linnma...also if you're not already doing it, a towel under the plastic tray may help wick away the moisture. The other suggestion I have would be to bump up your dry time. If all else fails, put your sterilizer/loaner company reps to work to help you find the reason for the wetness.

Hope this helps.

BLaine

[chipmoore]

Here's a few things you might check:
1. Have your service technician verify that the steam connected to your sterilizer is properly trapped to avoid a slug of condensate entering the chamber. Most wet pack issues start with the steam supply.
2. Check the room temperature of the sterilizer maintenance area, should be above 80°F but less than 100°F.
3. Wet pack occur in the spring and fall months when building switch heating/cooling. Has there been a change?
4. A dry load depends on a fairly rapid chamber exhaust after the exposure phase ends, is there good water pressure connected to the sterilizer?
5. Have a service rep verify vacuum depths during the dry phase achieve 0.5 psia or something close to this value. Also check whther the drain valve is functioning properly.
6. Is the plastic tray wrapped in the right size wrapper? Too many layers of nonwoven wrap might trap condensate inside.
7. Have you physically observe what the OR staff describes as wet? Had one case where there was too much instrument lube used and what the OR felt was the lube not water.

Chip Moore
Getinge
Rochester, NY

[sonny1388]

All very good points! I would venture to guess that if you are only having the problem when using loaner plastic containers, it is probably a problem with the containers, either not enough holes in the bottom to drain, or there is too much heavy metal in the plastic trays. Are there 'extra' instruments in the sets, ones that don't have a home but are just stuck in there? The trays are made to be sterilized with only the instruments that are labeled, and 'extras' might be causing an excess of moisture build-up. We only use 20min dry times, and very rarely have a problem with wet packs.

[lariles]

We have changed to a paper underlayment from HealthMark to use on the outside instead of towels and have seen marked improvement with loaner trays (especially the heavier ortho). If all else fails, remove extra items out to another tray and see if the issue resolves.
Especially pay attention to the thread about your steam quality. I had my steam gates clogged causing the same problem and they had never been opened in the hospital history to be checked. Needless to say they get checked regularly now by plant ops.

[JUNGLIISS]

I think all the suggestion are very good ones but i have not seen one ..The csp tech failier..Was the sterilizer cart pack properly?. Check to see if you have this problem when the same tech is working the sterilizer. Was there enuff space between trays?. Was the trays prop up on the side so the cart can hold more?. Proping up trays on the side is done by some tech for a while,and will not stop unless you stop them .I hope you do find the problem soon your patients are depending on you

[autoclave1]

Sterilizers are designed to perform the same function over and over, just like a robot on a assembly line. The variables include the human factor. If you see this problem with this tray and no other, I would suspect the tray or the way in which you process it. Touch base with the instrument mfg. and have them provide you with written documentation for sterilization recommendations. The mfg. has this information to meet FDA requirements. If, for some reason, they will not provide you this information then take the issue up with your OR manager/risk manager/infection control manager. By doing this, you have the patients best intrest in mind and pease of mind for yourself.