Sterilization Indicators Inside Packages
Chemical indicators, internal and external, use sensitive chemicals to assess physical conditions (e.g., time and temperature) during the sterilization process. Although chemical indicators do not prove sterilization has been achieved, they allow detection of certain equipment malfunctions, and they can help identify procedural errors.
External indicators applied to the outside of a package (e.g., chemical indicator tape or special markings) change color rapidly when a specific parameter is reached, and they verify that the package has been exposed to the sterilization process. Internal chemical indicators should be used inside each package to ensure the sterilizing agent has penetrated the packaging material and actually reached the instruments inside. A single-parameter internal chemical indicator provides information regarding only one sterilization parameter (e.g., time or temperature).
Multi-parameter internal chemical indicators are designed to react to >2 parameters (e.g., time and temperature; or time, temperature, and the presence of steam) and can provide a more reliable indication that sterilization conditions have been met. Multi-parameter internal indicators are available only for steam sterilizers (i.e., autoclaves).2
Additionally, many pouches on the market now feature built in internal and external indicators, which Dr. Chris Miller said is an advancement that saves clinicians time and money previously spent purchasing and inserting indicator strips into the pouches.3 Utilizing sterilization pouches/bags with built in internal and external indicators eliminates the need to insert another indicator strip into the bag. However, dental infection control experts do recommend that the sterilization pouches contain built in internal/external multi-parameter steam indicators verses those that only measure one parameter. Resources:
1) Practical Infection Control In Dentistry, 3rd. edition. By Molinari and Harte. Kluwer/Lippincott/Williams & Wilkins Publishers. Copyright 2010. Page 160.
2) CDC Guidelines for Infection Control in Dental Healthcare Settings (December 2003) http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm
3) Dental Products Report: http://www.dentalproductsreport.com/articles/show/dpr0709_stm_sterilization-pouches/2
For the most current information on infection control issues, please join us in Tampa, Florida, June 10-13, 2010, for the OSAP Annual Symposium. This information is also available on the OSAP website.
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