In the comprehensive review published by JBJS on November 22, 2023, a focus is placed on the intricate surgical instrument sterilization process, highlighting crucial aspects that every surgeon should comprehend. The study delves into the common methods and their efficacies, shedding light on various pathogens often implicated in post-operative infections.
The review examines two primary sterilization techniques—steam autoclaving and ethylene oxide (EtO) sterilization. The authors demonstrate that steam autoclaving at 134°C for a minimum of 15 minutes eliminates most microorganisms, including bacteria, fungi, and viruses. However, they point out that heat-resistant spores such as Bacillus spp. may require additional sterilization cycles or alternative methods like hydrogen peroxide (H2O2) gas plasma sterilization to ensure complete eradication.
On the other hand, EtO sterilization is often employed for heat-sensitive materials and instruments. The process utilizes a controlled exposure to EtO gas that penetrates porous items, effectively inactivating pathogens. According to the review, the recommended EtO cycle involves exposing instruments to 50°C and a concentration of 600–1200 mg EtO/L for at least two hours.
The study also underscores the importance of adherence to established guidelines in maintaining optimal sterilization practices. These include ISO 17665-1:2018 standards for steam sterilization and ISO 11137:2014 for EtO sterilization. Furthermore, AAMI TIR30 and CDC guidelines are discussed in detail, offering insights into monitoring processes, validating