rigid trays used in ethelyne oxide sterilization

[Guest anonymous]

Can anyone comment as to how sure can the use of rigid tray can meet maximum aeration atfter 8 hours? Is it safe to EO sterilize breast implants?

[New SPD Manager]

I would check with the manufacturer for both questions. In my experience with working in the OR with plastic surgeons, breast implants come from the manufacturer already sterile. I don't believe the surgeons would have accepted them reprocessed. But, check with the manufacturer of the implants to see what their recommendations are. Also with check with the manufacturer of your rigid containers as to their recommendation for ETO.

[midi]

I am concerned that the EO method of sterilization is slowly being phased out. We have heard this recently from our new OR manager. She thinks that a Steris machine would be less expensive, and would do the same job. I strongly disagree. I need some ammunition and info on this way of sterilization.There are items that can't be sterised.Can anyone give me some feedback on this subject? It is very important to me. There is not a thing wrong with our machine. Yes, its an older model, but doesn't cause problems. We have regular preventitave maint. regularly. EO to me, is the best method. Thoughts on this please. Much appreciated. Thanks

[djw]

I can only give personal experience, not $ info-we got rid of our EO years ago. We currently use the Sterrad for almost all the items we use to gas. The cycle is less than an hour. For the very few items that do not fit the parameters for the Sterrad,they are put through the Steris. The only items needing to go to Steris are the scopes that have either too small a lumen or are flexible with a long lumen. I like the Sterrad much better than the EO. Shorter cycle, no monitoring, no emergencies where they need something that won't be available for hours and hours.

[autoclave1]

Technology and cost of operation is what is driving EO sterilization to be phased out. With strict EPA, Air Quality Control Board Standards, OSHA regulations, internal environmental HAZMAT control, and strict record keeping requirements it is no longer cost effective to processs an EO load like in the past. If you are running a 100% unit as opposed to a 90/10 mix, it is much easier and safer to dispose of the used gas than that of a medium vessel. There are alternatives to EO, but that depends on your individual resources and finances. At some point the manufacturer's will probably obsolete medium machines, so be prepared for the worst and have an action plan ready. Include in your plan the cost of re-instrumentation of those items than can only be EO sterilized and switch to an alternate product of approved use.
The pros and cons to use are; employee safety, cost of operation, turn-around time, environmentally friendly, safety, and many others to numerous to mention.
This is truly a business plan that must be "sold" to your administration---do your homework, document everything, reference hospitals in your surrounding area, reference OSHA and EPA documents and good luck.

[midi]

Thank you all for the EO information. I apppreciate your help, as always.How much more effective is the Sterrad, and so you have a approximate cost? Are there any special packaging needed? As you can see, all I have ever dealt with is the EO. Can I ask your help again?

[RMS]

All sterilization methods have to be validated by the manufacturing company as well as validated by the Sterrad company. With Sterrad there are guidelines defining what items can be sterilized using Sterrad depending on the material make-up and lumen size. You will need to do an evaluation of everything you EO sterilize and make sure it is compatible and validated with Sterrad.
When referencing Sterrad compared to EO for a cost analysis, several things need to be taken into consideration for example the structure of the outside air venting, internal environmental regulations, quarterly testing for the saftey of bothe the staff and environment.
There are materials needed for Sterrad tape, biologicals, incubators not anything you would not need for any other sterilization method.
Although, your initial Sterrad investment will be significant the long term effects as far as safety and turn around time are far more important and environmentally friendly. You possibly might even want to think about selling your old EO sterilizer and aerator in order to help reduce initial start up costs for the Sterrad system.
You can call Sterrad they will send a rep to help you prove your point. They can do most of the work if you supply the initial information.
Good Luck

[arlene pavlekovich]

I Thought the steris machine is a just in time form of sterilization. How would that work for things that you would need to have a shelf life for future surgeries?
We have two Steris machines and two Starad machines the 100 and NX.
We no longer use ETO.

[chipmoore]

Food for thought regarding aerating items sterilized with EO. The required aeration time is dependent on the physical make up of the item. Glass and metal do not absorb EO, thus little if any aeration is required. material like rubber and PVC on the other hand do absorb EO, thus the requirement for aeration. At room temperature, it could take PVC 7 days to degas all the EO from within the material, at elevated temperatures, a shorter time. In order to determine an adequate aeration time, it takes destructive testing of samples, a gas chromatograph machine and numberous measurements of the EO dilution over time. That's why there should be no rule of thumb about aeration time because each item could be different. High concentrations of EO inside material (like PVC) can be harmful if its for patient use.
Chip Moore
Getinge
Rochester, NY