Sterlization and disinfection

Sterlization and disinfection

1. Sterilization and Disinfection Aaron Sarwal MDS Batch 2017 Department of conservative Dentistry and Endodontics

2. INDEX INTRODUCTION Definitions EXPOSURE RISK PERSONAL BARRIER PROTECTION CLEANING STERILIZATION Methods Agents MONITORS OF STERILIZATION DISINFECTANTS Agents ANSTISEPTICS Agents REFERENCES

3. Introduction The increase in serious transmittable diseases over the last few decades have created global concern and have affected the treatment approach of all healthcare professionals. The concepts of asepsis and prevention of infection is the single most important consideration for the success of surgery. Diseases like anemia, metabolic disorders, diabetes, TB, liver/kidney disorders affect wound healing. Modern antibiotics are a great support to the surgeon, but they are not, in the least, a substitute for good surgical principles of aseptic technique and atraumatic surgery. Air-borne contamination generated by a high speed hand piece

4. EXPOSURE RISK

5. Exposure Risk Obvious risks -- contaminated instruments -- patient  professional and professional  patient High-speed hand pieces create air-borne contamination. With respect to size, there may be 3 types of airborne contaminants generated by the high speed hand piece: Aerosols Mists Spatter Thus, need for sterilization .

6. Exposure Risk

7. Personal Barrier Protection

8. Personal Barrier Protection 1. Hand Washing

9. Personal Barrier Protection 2. Gloves Sterile Surgical Gloves Examination Gloves Utility Gloves Over Gloves

10. Personal Barrier Protection 2. Gloves

11. Personal Barrier Protection 3. Protective Eye Wear

12. Personal Barrier Protection 4. Face Mask FLAT TYPE DOME TYPE

13. Personal Barrier Protection 4. Hair Protection

14. Personal Barrier Protection 5. Protective Over-Garments

15. OPERATORY ASEPSIS

16. CDC Classification Category Definition Dental instrument or item Critical Penetrates soft tissue, contacts bone, enters into or contacts the blood- stream or other normally sterile tissue.   Surgical instruments, periodontal scalers, scalpel blades, surgical dental burs Semicritical Contacts mucous membranes or nonintact skin; will not penetrate soft tissue, contact bone, enter into or contact the bloodstream or other normally sterile tissue. Dental mouth mirror, amalgam condenser, reusable dental impression trays, dental handpieces Noncritical Contacts intact skin. Radiograph head/cone, blood pressure cuff, facebow , pulse oximeter

17. STERILIZATION INSTRUMENT PROCESSING

18. INSTRUMENT PROCESSING

19. Sterilization Stages for instrument sterilization: Presoaking and Cleaning Corrosion control and lubrication Packaging Sterilization Handling sterile instruments Storage Distribution

20. Ultrasonic Cleaners and Solutions

21. METHOD MATERIAL USED Steam sterilization Papers, cellulose, cotton/polyester cloths, window packs, perforated rigid containers with bacterial filters, glass containers for liquids Dry heat (hot air oven) Metal canisters and tubes of aluminium foil, glass tubes, bottles ETO Paper & Plastic, perforated rigid containers with bacterial filters Low temperature steam Paper, cloth Radiation sterilization Polyethylene, PVC, polypropylene, foil. Selection Of Packaging Materials For Sterilization

22. Agents Used In Sterilization

23. Agents Used In Sterilization

24. METHODS OF STERILIZATION Steam pressure sterilization (autoclave) Chemical vapor pressure sterilization- ( chemiclave ) Dry heat sterilization ( dryclave ) Ethylene oxide sterilization

25. STEAM PRESSURE STERLIZATION

26. Advantages Of Autoclave Autoclaving is the most rapid and effective method for sterilizing cloth surgical packs and towel packs. Is dependable and economical Sterilization is verifiable.

27. Disadvantages of Autoclave Items sensitive to the elevated temperature cannot be autoclaved. Autoclaving tends to rust carbon steel instruments and burs. Instruments must be air dried at completion of cycle

28. Chemical Vapor Pressure Sterilization Chemiclaving

29. CHEMICLAVING

30. CHEMICLAVING

31. Dry Heat Sterilization

32. Glass Bead Sterilizer For small instruments eg Endodontic Instruments . Temp 218-280*C

33. Salt Sterilizer

34. Dry Heat Sterilization

35. Dry Heat Sterilization

36. ETHYLENE OXIDE STERILIZATION (ETO)

37. ETHYLENE OXIDE STERILIZATION (ETO)

38. Irradiation Sterilization UV radiation

39. Irradiation Sterilization Gamma radiation

40. NEW METHODS OF STERILIZATION Various new methods of sterilization are under investigation and development. Peroxide vapor sterilization - an aqueous hydrogen peroxide solution boils in a heated vaporizer and then flows as a vapor into a sterilization chamber containing a load of instruments at low pressure and low temperature Ultraviolet light - exposes the contaminants with a lethal dose of energy in the form of light. The UV light will alter the DNA of the pathogens. Not effective against RNA viruses like HIV.

41. MONITORS OF STERILIZATION Sterilization monitoring has five components: Mechanical monitoring a sterilization indicator on the instrument bag, stamped with the date it is sterilized, daily color-change process-indicator strips in the bag. weekly biologic spore test documentation notebook.

42. MONITORS OF STERILIZATION STERILIZATION METHOD SPORE TYPE INCUBATION TEMPERATURE AUTOCLAVE Bacillus stearothemophilus 56 ° C CHEMICAL VAPOR DRY HEAT Bacillus subtilis 37 ° C ETHYLENE OXIDE Gamma radiation B. Pumilus E601 37 C

43. DISINFECTANTS

44. DISINFECTANTS Sodium Hypochloride Phenols Aldehyde Compunds Chlorhexidine Cetrimide

45. Disinfectants: Boiling Water Boiling instruments in water doesn’t kill spores and cannot sterilize instruments.

46. ANTISEPTICS

47. Antiseptics Alcohol Hexachloropene Iodine and Iodine Compunds Aqueous Qaternary Ammonium Compunds H202 A

48. CLINICAL WASTE DISPOSAL

49. CLINICAL WASTE DISPOSAL Red : Anatomical waste Yellow: waste which requires disposal by incineration only Black: Domestic waste minimum treatment/disposal required is landfill, municipal incineration. Blue: medicinal waste for incineration White: amalgam waste for recovery.

50. REFERENCES: CONTENT: Text book of Oral and Maxillofacial Surgery, Vinod Kapoor Sturdevant’s the Art and Science of Operative Dentistry Essentials of Endodontics, Vimal K Sikri CDC Website IMAGES AND GIF Google Image Search