The traditional cotton packaging has a lot of problems, such as short shelf life, fiber deformation after washing, high cost, poor antimicrobial barrier, etc.. 2006 Our hospital began to use disposable non-woven fabrics and 3M paper plastic packaging as the material sterilization packaging, the author did monitoring and observation of the bacteria resistance performances of the three package materials and sterile validity under different steam pressure sterilization. Now share monitoring methods and results as follows.
1.1 Choosing commonly used clinical kits, such as small operation pack, vein incision package, tracheotomy package, all kinds of puncture packs, wound dressing packs, oral care package, tongue depressor, gag, pull the tongue forceps etc. Using methods of A, B, C and D. Method A. Using > 120 yarn / cm2 domestic cotton (cotton) to pack of all the above instruments. Method B Using disposable non-woven fabric with a inner towel, 2 layers of wrapping cloth for folding package; Method C. Using 2 layers of disposable non-woven fabrics wrapped into 3M paper plastic bag packaging; Method D. Putting the materials directly into the 3M paper plastic package bags.
1.2 Methods. Methods A and B: After conventional treatment of various therapeutic packs and equipment kits which are used commonly in clinical treatment, put the different sizes of equipment kits on 80 * 80 * 3cm, 65 x 65 x 3cm, 50 x 50 x 3cm packaging materials. Absorbent paper should be placed and between the disc and the equipment, try to reduce overlap, which is good for steam penetration and air discharging. First of all folding pack with one layer inner towel, and then covered with second layer wrapping folding pack for high pressure steam sterilization. Method C using rate is low in clinical departments. But for the necessary essential kit, dressing, such as trachea incision pack, vein incision pack etc., we use 2 layers of disposable non-woven cloth wrapping, and then put into 3M paper plastic bag packaging. Then finish pack with sealing for high pressure steam sterilization and stored in clinical department emergency vehicles and storage cabinet for emergency use. D method is for emergency spare items of clinical department emergency vehicles and nursing cabinet, such as the pressure tongue plate, gag, pull the tongue forceps, puncture needle etc. We put the items directly mounted in the 3M paper plastic bag, and let the puncture needle insert disposable plastic composite pipe in order to avoid needle puncturing the packing bag to avoid pollution and hurting others. Then the final treatment- heat sealing and high pressure steam sterilization. For each packaging methods, we take 35 specimens for bacteriological detection, monitor sampling according to monitoring requirements of the "technical standard for disinfection”. We do germiculture of the packing items after 7 days according to methods A and B. For methods C and D we do germiculture after 5 months.
2 Results
Test results show that the sterile items have no microbe growth after 9 days in the supply room storage room. No microbe growth within 7 days in sterile storage cabinet of the hospital clinical department. In the same places the results for Method B no microbe growth time are 13 days and 10 days. For method C and D the results are 8 months and 7 months. All in all, disposable nonwoven package and 3M paper plastic bag package have much better non microbe growth validity time than cotton cloth package.
3 Discussion
According to 2002 version of requirements of the national Ministry of health "disinfection technical specifications", effective period of the storage of goods after sterilization is affected by the packing materials, the tightness of the seal, the conditions of sterilization, the storage environment and so on.
3.1 The feature and quality of packaging materials
3.1.1 Cotton cloth packing material has the advantage of economic benefits and strong tensile strength. But there are also many shortcomings: the loose structure of cotton tissue, poor antimicrobial barrier, air pollution caused by the releasing of cotton dust, especially the reducing antimicrobial barrier after repeated use.
3.1.2 Disposable non-woven characteristics: does not produce cotton dust causing air pollution; easily to keep dry inside the package, suitable for a lot of the sterilization process such as steam pressure sterilization, does not contain toxic substances, has special structure to avoid damage, and good bacteria barrier,13 days no microbe growth in the supply room storage room.
3.1.3 3M paper plastic packaging materials, has the advantages of good sealing performance, long effective sterilization period, extend equipment life, reduce the nursing workload, reduce cost, and easily to do visual inspection of the items in the transparent plastic surface and chemical indicating card discoloration. No microbe growth period 8 months. But we found that paper layer is easily broken and damp during using, high pressure steam can achieve sterilization for the inside items through the paper layer. But if the paper layer plastered the plastic layer all the advantages will decrease.
3.2 packaging tightness
For 3M paper plastic packaging materials the temperature should be adjusted between 180 to 183 ℃ when packaging and sealing materials, It‘s easy to cause damage when the packaging material if the temperature is too high or too low. If temperature is too high plastic surface of the packing material is damaged; If the temperature is too low, the plastic surface of the packing material and the paper surface can’t be closely dissolved, and the vacuum pumping action is easy to make the sealing rupture.
3.3 sterilization conditions
Correct implementation of sterilizer operating process, the sterilization effect monitoring and strictly carrying out the operation procedures according to rules and choosing steam sterilization temperature, time and pressure according to the different items. If we sterilize items by pulsating vacuum, vacuum sterilization, temperature should be controlled between 132 ~ 134 DEG C. if the temperature is too high steam sterilization will become dry sterilization, which will reduce the effect of sterilization. For the sterilization of implantable surgical instruments pack it is necessary to do thermophilic bacteria culturing before sterilization and make sure it is feminine after rapid culturing after the sterilization.
3.4 Storage requirement of sterile items
storage environment, bacterial content in the air in less than or equal to 200cfu/m3, temperature control between 18 to 22 ℃ , indoor storage shelves should keep clean and dry, isolated transfer window is necessary for storage room, which avoid outside air pollution.
