Sterilization of Operation Theaters-: Newer Methods to Replace Fumigation
In spite of brief stay of patients in the operation theater, the environment of Operation Theater plays
a great role in the onset and spread of infections, because of multi factor causation of infections. It is usually necessary to study
the epidemiology of infection as a multidisciplinary approach. In resource poor
circumstances as in most developing countries, people work in isolation and few
facilities to make any epidemiological surveys. Many believe that routine
Microbiological monitoring is most essential but in reality it is not
practicable. But every hospital should pay good attention in proper maintenance
of air conditioning plants, ventilator systems, and to have greater control on
mechanisms and personnel involved in disinfection and sterilization of
materials used in the theaters in operative procedures
Fumigation is an age old process of
sterilization, of the environment, may be a sick room or operation
theaters. It is usually done with formalin fumes, which are are very
pungent and harmful. So when a room is fumigated, it is tightly closed and
sealed before fumigation. The room is opened after fumigation (12 - 24 hours).
The room can be used once all fumes are ou
OSHA indicated that
formaldehyde should be handled in the workplace as potential carcinogen and set
an employee exposure standard for formaldehyde that limits an 8-hour time-
weighted average exposure concentration of 0.75ppm. Formaldehyde is the
commonly used agent. Formaldehyde gas is generated from liquid formalin
utilizing potassium permanganate crystals. 40% formalin liquid is added to
potassium permanganate crystals to generate gas. Alternately, formalin liquid
can be dispersed by a sprayer like device in the theatre environment. After a
contact time of at least 6-8 hours, the formaldehyde needs to be neutralized by
using ammonia, allowing at least 2 hours contact time for ammonia to neutralize
the formaldehyde prior to the use of theater.
Fumigation is obsolete in many developed nations in view of toxic nature of Formalin. too frequent use and inhalation is hazardous. Several new safe chemicals are emerging but constrains
of economy limit the use and several hours of closure of operation theatres can
be curtailed as with Fumigation. Aldehydes are potentially carcinogenic and it is thereforerecommended that other agents such as hydrogen peroxide, hydrogen peroxide with
silver nitrate, peracitic acid and other chemical compounds of formaldehyde
should be used in place of the currently prevalent practice of using
formaldehyde. These agents are dispersed with the aid of a fogger-like device
inside the theater environment. The contact time is about an hour and the
theater can be used immediately after the contact time.
Emerging
Compounds in use for Sterilization of Operation theater
Bacillocidrasant:
A newer and effective compound in
environmental decontamination with very good cost/benefit ratio, good material
compatibility, excellent cleaning properties and virtually no residues. It has
the advantage of being a Formaldehyde-free disinfectant cleaner with low use
concentration.
AdvantagesProvides complete asepsis within 30 to 60 minutes.Cleaning with detergent or carbolic acid not required.
-
Formalin fumigation not required.
Shutdown of O.T. for 24 hrs. Not required.
Other Newer and Non Toxic compounds:
A Chemical compound - VIRKON is gaining importance
as non-Aldehyde compound. Virkon is proved to be a safe virucidal
bactericidal, fungicidal, mycobactericidal and non-toxic compound. It
contains oxone (potassium peroxymonosulphate), sodium dodecylbenzenesulfonate,
sulphamic acid; and inorganic buffers. It is typically used for cleaning up
hazardous spills, disinfecting surfaces and soaking equipment. Though Virkon is
shown to have wide spectrum of activity against viruses, some fungi, and bacteria,
it however is less effective against spores and fungi than some alternative
disinfectants. Several other compounds are emerging in the Market for safer
use, may need better resources for utility and implementation.
Today markets are flooded
with many chemicals and need to think to select the needed disinfectant in the
circumstances they work
HOWEVER IT IS NECESSARY TO KNOW THE WORD
STERILIZATION OF OPERATION THEATERS IS NEVER A ABSOLUTE, DEPENDENT MORE ON HYGIENIC CONDITIONS
STANDARDS AND THE BEHAVIOR OF THE MEDICAL AND PARAMEDICAL STAFF
NO CONFLICT OF INTEREST
Dr.T.V.Rao MD Professor of Microbiology
Freelance reporter on Infectious diseaseThis topic needs more contributions and corrections
a great role in the onset and spread of infections, because of multi factor causation of infections. It is usually necessary to study
the epidemiology of infection as a multidisciplinary approach. In resource poor
circumstances as in most developing countries, people work in isolation and few
facilities to make any epidemiological surveys. Many believe that routine
Microbiological monitoring is most essential but in reality it is not
practicable. But every hospital should pay good attention in proper maintenance
of air conditioning plants, ventilator systems, and to have greater control on
mechanisms and personnel involved in disinfection and sterilization of
materials used in the theaters in operative procedures
Fumigation is an age old process of
sterilization, of the environment, may be a sick room or operation
theaters. It is usually done with formalin fumes, which are are very
pungent and harmful. So when a room is fumigated, it is tightly closed and
sealed before fumigation. The room is opened after fumigation (12 - 24 hours).
The room can be used once all fumes are ou
OSHA indicated that
formaldehyde should be handled in the workplace as potential carcinogen and set
an employee exposure standard for formaldehyde that limits an 8-hour time-
weighted average exposure concentration of 0.75ppm. Formaldehyde is the
commonly used agent. Formaldehyde gas is generated from liquid formalin
utilizing potassium permanganate crystals. 40% formalin liquid is added to
potassium permanganate crystals to generate gas. Alternately, formalin liquid
can be dispersed by a sprayer like device in the theatre environment. After a
contact time of at least 6-8 hours, the formaldehyde needs to be neutralized by
using ammonia, allowing at least 2 hours contact time for ammonia to neutralize
the formaldehyde prior to the use of theater.
Fumigation is obsolete in many developed nations in view of toxic nature of Formalin. too frequent use and inhalation is hazardous. Several new safe chemicals are emerging but constrains
of economy limit the use and several hours of closure of operation theatres can
be curtailed as with Fumigation. Aldehydes are potentially carcinogenic and it is thereforerecommended that other agents such as hydrogen peroxide, hydrogen peroxide with
silver nitrate, peracitic acid and other chemical compounds of formaldehyde
should be used in place of the currently prevalent practice of using
formaldehyde. These agents are dispersed with the aid of a fogger-like device
inside the theater environment. The contact time is about an hour and the
theater can be used immediately after the contact time.
Emerging
Compounds in use for Sterilization of Operation theater
Bacillocidrasant:
A newer and effective compound in
environmental decontamination with very good cost/benefit ratio, good material
compatibility, excellent cleaning properties and virtually no residues. It has
the advantage of being a Formaldehyde-free disinfectant cleaner with low use
concentration.
AdvantagesProvides complete asepsis within 30 to 60 minutes.Cleaning with detergent or carbolic acid not required.
-
Formalin fumigation not required.
Shutdown of O.T. for 24 hrs. Not required.
Other Newer and Non Toxic compounds:
A Chemical compound - VIRKON is gaining importance
as non-Aldehyde compound. Virkon is proved to be a safe virucidal
bactericidal, fungicidal, mycobactericidal and non-toxic compound. It
contains oxone (potassium peroxymonosulphate), sodium dodecylbenzenesulfonate,
sulphamic acid; and inorganic buffers. It is typically used for cleaning up
hazardous spills, disinfecting surfaces and soaking equipment. Though Virkon is
shown to have wide spectrum of activity against viruses, some fungi, and bacteria,
it however is less effective against spores and fungi than some alternative
disinfectants. Several other compounds are emerging in the Market for safer
use, may need better resources for utility and implementation.
Today markets are flooded
with many chemicals and need to think to select the needed disinfectant in the
circumstances they work
HOWEVER IT IS NECESSARY TO KNOW THE WORD
STERILIZATION OF OPERATION THEATERS IS NEVER A ABSOLUTE, DEPENDENT MORE ON HYGIENIC CONDITIONS
STANDARDS AND THE BEHAVIOR OF THE MEDICAL AND PARAMEDICAL STAFF
NO CONFLICT OF INTEREST
Dr.T.V.Rao MD Professor of Microbiology
Freelance reporter on Infectious diseaseThis topic needs more contributions and corrections
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