Abstract
ABSTRACTObjective:assess the safety of steam sterilization of assembled laparoscopic instruments with challenge contamination. Method:a laboratory experimental study, using as test samples trocars and laparoscopic graspers. Geobacillus stearothermophillus ATCC-7953 was used, with a microbial population of 106UFC/Filter paper substrate, removed from the biological indicator. Three of them were introduced into each instrument at the time of assembly, and sterilized at pressurized saturated steam, 134oC for 5 minutes. After sterilization, the instrument was disassembled and each filter paper substrate was inoculated in soybean casein culture and incubated at 56oC for 21 days. In case of absence of growth, they were subjected to heat shock of 80oC, for 20 minutes and re-incubated for 72 hours. Sample size: 185 graspers and 185 trocars, with 95% power. We paired the experiments with comparative negative control groups (5 graspers and 5 trocars with challenge contamination, sterilized disassembled) and positive control (30 filter paper supports, unsterilized), subject to the same incubation procedures. Results:there was no microbial growth in experimental and negative control. The results of the positive control were satisfactory. Conclusion:this study provided strong scientific evidence to support the safety of steam sterilizing of the assembled laparoscopic instrument.
Highlights
The videolaparoscopic surgery is a technological innovation that has emerged as an alternative to surgical, diagnostic and therapeutic procedures, which were usually performed through laparotomy
On the issue of sterilization, the pressurized saturated steam is the preferred method for heat resistant laparoscopic instrumental because it brings advantages such as low D* value, high diffusivity and penetration of the sterilizing agent, speed, atoxicity and lower cost[2]
The self-contained biologic indicator is built in a paper substrate (2.5X0.5 cm) with a minimum of 100,000 calibrated dry spores of Geobacillus stearothermophillus ATCC-7953
Summary
The videolaparoscopic surgery is a technological innovation that has emerged as an alternative to surgical, diagnostic and therapeutic procedures, which were usually performed through laparotomy This technique has indisputable advantages for the patients, and new challenges for the nurses responsible for the Sterile Supply Center (SSC), including the establishment of guidelines for the safe processing of instruments and accessories with complex conformation, understood as those with less than 5 mm of lumen or blind-end, inaccessible internal spaces for direct friction, holes or valves[1]. On the issue of sterilization, the pressurized saturated steam is the preferred method for heat resistant laparoscopic instrumental because it brings advantages such as low D* value, high diffusivity and penetration of the sterilizing agent, speed, atoxicity and lower cost[2] In this process pressurized saturated steam in contact with the cold surface of the material disposed within the autoclave, undergoes condensation, releasing the latent heat of vaporization watering and simultaneously heating the material. There is no doubt that autoclaving of disassembled materials through thermal conduction provides the best condition
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