chapter 8: prep and pack

sterile packaging must fulfill four fundamental principals

allow sterilant penetration and removal

provide an effective microbial barrier

protect contents during handling and storage

enable aeseptic presentation upon opening

packaging materials should possess

resistance to physical changes, permit sterilant entery and exit, fluid repellence, tamper-evidence, appropriate size, durability and resistance, compatibily with sterilization methods

woven textiles

Reusable materials such as cotton or cotton blends, often used for cloth drapes and gowns. They require inspection for holes, tears, and barrier integrity, and must be laundered and de-linted between uses. They generally have a shelf life of about 30 days and need a quality assurance process to monitor barrier effectiveness.

non-woven textiles

Single-use, made of cellulose fibers, plastics, or paper pulp bonded into sheets. They provide excellent microbial barriers, are available in various sizes and thicknesses, and are often used for wraps, pouches, and sterile barriers. They may have expiration dates printed on the packaging.

square fold

Suitable for large packs like linen sets, requiring precise folding to prevent gaps.

envelope fold

Used for smaller packs, providing a simple, effective method of wrapping.

paper plastic pouches

used for 1-2 lightweight items featuring self-sealing or heat-sealed closures, proper sizing to ensure at least 1 inch of space aroun contents, complete air removal before sealing to prevent pockets that hinder sterilant contact

heat sealing

involves parameters like *temperature, pressure, and dwell time*, which must be validated and maintained according to manufacturer instructions.

rigid containers

designed to hold instruments during sterilization, storage, and transport:

made of metal, plastic, or anodized alumnium, equipped with gaskets, latches, filters, lock mechanisms, and ID tags, perforations or filter rention plates allow air removal and sterilant penetration, filters are single use or reusable, must be used according to manufacturer's validated cycles and cleaned and inspected after each use, locks and tamper-evident seals ensure integrity until opened, proper filter plasment and seal integrity are criticial to prevent contamination

proper assembly involves

Keeping *hinged instruments open using stringers or specialized tools*.

- *Arrange instruments for optimal sterilant contact and drying, placing heavier items* at the bottom.

- Use *non-linting tray liners or corner protectors* to prevent tears and damage.

- Distribute instruments evenly to avoid *condensation and wet packs*.

- Limit set weight to *25 pounds* to facilitate handling and ensure proper sterilization and drying.

- For sets with *large or heavy instruments, wrap with absorbent, non-linting material*

CI indicators should be

type 4 or higher, placed in center of wrapped sets or each level in multi level packs, for rigid containes follow MFU for placement often opposite corners, placement must allow for post-sterilization visibility

devices with lumen or complex structures require

*Disassembly* of removable parts.

- *Flushing lumens* with sterile distilled water or appropriate solutions.

- *Inspection for soil or blockages; use non-linting pipe cleaners or borescopes*.

- *Proper packaging according to manufacturer instructions, ensuring sterilant contact and drying*.

- *Special handling* for delicate or complex instruments (e.g., eye or dental instruments).

labeling packages

include item name, department, initials, sterilization method, and cycle details,