Surgical Instruments and Drapes - Packaging

Types of instrument packing

• Self-seal sterilisation pouches

• Drape wrap/plane drapes

• Other options include nylon film and metal drums

Instrument packaging - Self-seal sterilisation pouches

Commonly used in practice

Instrument packaging - Drape wrap/plane drapes

• Suitable for large items

• Wrapped like a present

Nylon rolls - Pros

• Cheapest to buy

• Available in many sizes

• Can be made to length that is needed

• If correct fit, unlikely to be damaged

Nylon rolls - Cons

• Time costly

• Needs Bowie Dick tape to seal

• If incorrect size can be opened at seams easily

Self-seal Pouches - Pros

• Readily available

• Available in wide range of sizes

• Saves time making up own pouch

• Cheap?

• Easier to open

Self-seal pouches - Cons

• Single use

• Easily damaged paper backing

• Susceptible to strike through

• More expensive than a nylon roll

Wrapped items in paper drapes - Pros

• Readily available

• Can be made to fit any item (present wrapping)

Wrapped items in paper drapes - Cons

• Single use

• Easily damaged

• Susceptible to strike through depending on material

• Can be awkward to open (Bowie Dick Tape)

Metal drums/containers - Pros

• Not susceptible to strike through

• Unlikely to be damaged or broken in storage

• Reusable

Metal drums/containers - Cons

• Expensive compared to other options - through 1 time purchase

• Limited by size of autoclave/hot air oven

• Can be awkward to open

Sterilisation Indicators

• TST stripes need to be put in the middle of packed kits to prove effectiveness of sterilisation

• Self-seal pouches also have sterilisation indicators on

Rules of Instrument Packaging

• Place instrument in correct way up

• Leave rachets and edges open

• Cover sharp edges

• Seal carefully ensuring no gaps at seal edge

What to include when labelling sterilisation pouches ..

• Name of the item

• Pack date (or expiry date 2-3 post autoclaving)

• Your initials

Labelling sterilisation pouches ..

• items double wrapped in Nylon film or seal and peel pouch can increase shelf

• Package and seal items accordingly

Double bagging/wrapping is done as a precaution in case of ..

• Outer packaging losing integrity

• Accidents i.e. dropping

• To allow the ensure bag and contents to be placed on the sterile field

Fabric Drapes - Pros

• Reusable

• May be plain or fenestrated

Fabric drapes - Cons

• Require ongoing maintenance

• Absorbent/porous - strike through

• Increased infection control risk

Single use disposable drapes - Pros

• Waterproof - no strike through

• May be plain or fenestrated

• Reduced infection control risk

Single use disposable drapes - Cons

• Not environmentally friendly

• Cost of buying drapes greater than the cost of autoclave pouches, running the autoclave

Maintenance of reusable surgical drapes - Process

1 - Soaking and rinsing

2 - Laundering

3 - Drying

4 - Routine checks

5 - Folding and packaging

1 - Soaking and rinsing - process

• Soak in cold water to remove gross contamination

• Hot water will cause blood etc.. to coagulate and become more difficult to remove

• Body fluids and tissues should not be allowed to try

• Rinse in cold water

2 - Laundering - process

• Launder at high temperature to kill microbes, denature proteins

• Can we placed in soluble laundry bags

• Washed separate from other items

• Dried afterwards - Ideally in tumble dryer

4 - Routine checks for drapes

• Inspect for damage, wear and tear

• Should be discarded as soon as frayed

• Replace as necessary

• Remove lint

5 - Folding and packaging

• Folded concertina style

• Fenestration, if present, should be visible

• TST or other indicator placed at the centre pf the drape

• Pouch needs to be labelled with - Date, Initials, Contents i.e. style of drapes, size, quality

Following sterilisation where should packs be stored?

Ensure packs are stored within a clean, dry and dust free environment

Correctly handling packs after sterilisation

Little handling of packaging to avoid damage

How should packs (following sterilization) be kept on the shelves?

Loosely packaging on shelves to avoid damage

How often should expiry dates be checked on packs, and what should occur if they are out of date?

Expiry date must be checked on a monthly basis and re-pack, re-sterilisation process should be preformed on expired items

How to correctly open and pass sterile items ..

• Loosen any tabs

• Open the package without touching inside surface

• Pack opened slowly and carefully

• As the pouch is opened, cover hands with the two sides of the bag