STERILIZATION

Prof. Khalifa Sifaw Ghenghesh

Dept. of Medical Microbiology,
Faculty of Medicine, Tripoli University
Tripoli - Libya

What is Sterilization?
The removal of all forms of living
material.
Important: First Objects to Be
Sterilized Should Be Cleaned by
Washing.

METHODS OF STERILIZATION
1. DRY HEAT
Red Heat
Hot - Air Oven:
160o/ 60 minutes
180o/ 20 minutes

2. MOIST HEAT:
Tyndallization: > 100oC/ 30 minutes
On 3 Consecutive Days.
The Autoclave: > Pressurized Steam.
121oC/ 1.1 bar for 15 minutes.
134oC/ 2.2 bar for 3 minutes.

 TESTS FOR AUTOCLAVE FUNCTION

The Bowie-Dick Autoclave Tape Test:
Browne's Tubes:
Automatic Controls or Pen Records:
Bacteriological Tests (Spore Tests):

 2. IRRADIATION
i. Ultra - Violet Radiation (UV):
a. Not Recommended.
b. Poor penetration in Air.
c. Suitable to Reduce Microbial Counts
in Safety Cabinets.

ii. Gamma - Ray Radiation

Source: Cobalt 60.
a. Lethal to All Forms of Microbial
Life.
b. Used Commercially.

 3. FILTRATION
Bacterial Stopping Filters.

4. GASES
i. Ethylene Oxide Gas:
a. Ventilators.
b. Toxic & Explodes When Mixed
with Air.

ii. Formaldehyde:
a. Rooms and Lab. Cabinets.

 5. LIQUIDES:
Disinfectants.

i. Glutaraldehyde:
a. Sterilizing Heat Sensitive Pieces
of Equipments.

Forms of Sterilization by Heat and Principle Uses.

_______________________________________________________________

Type of Heat

Use

_______________________________________________________________

DRY:
1. Red Heat.

Microbiological Loops. Incineration of Used

Lab. Culture Plates.
2. Hot - Air Oven.
Many Surgical & Dental Instruments but Not
Fabrics or Rubber.
----------------------------------------------------------------------------------------------------------

MOIST:
1. Steam at 100oC
On 3 Consecutive Days.

2. Pressurized
Steam (Autoclave).

Some Bacteriological Media.

Most Surgical and Dental Instruments,

Fabrics & Dressings (If Wrapped); Most
Microbiological Media & Glassware.
_______________________________________________________________

Heat Content of Water and Steam

_______________________________________
Phase
Temp.
Heat Content (kJ/kg)
of
oC
Sensible Latent
Total
Water
Heat
Heat
Heat
----------------------------------------------------------------Liquid
100
419
0
419
Vapour 100
419
2257
2676
Vapour 121
509
2199
2708
Vapour 135
567
2160
2727
_______________________________________

 PROPERTIES OF STEAM
i. Moisture content
ii. Heat content

iii. Penetration

PRESSURE STEAM STERILIZERS

1. Porous Load Sterilizers (Prevacuum type):
Removal of air and heating of the chamber.
Sterilization of the load.
Removal of steam and drying of the load by
mechanical evacuation.
Admission of filtered air to restoration
atmospheric pressure.

2. Downward Displacement Jacketed

Sterilizers:
Gradual displacement of air by incoming
steam while the chamber is heated to the
selected sterilizing temp.
Sterilization of the textile packs for
30 min/ 121oc.
Drying of the load by partial vacuum.
Restoration of the chamber to
atmospheric pressure.

3. Unwrapped Instrument and Utensil

Sterilizers:
DSL autoclaves

4. Fluid Sterilizers:
e.g. water, iv solutions, etc.

 Factors influencing sterilization

time for fluids:
rate of heating of the chamber:
type of container:
viscosity of the liquid:
volume of the liquid:
trapped air:

""
DISINFECTION AND DISINFECTANTS

Prof. Khalifa Sifaw Ghenghesh

Dept. of Medical Microbiology,
Faculty of Medicine, Al-Fateh University
Tripoli - Libya

Disinfection
The removal of most of the
pathogenic microorganism, but
often non-pathogenic or resistant
forms of pathogens remain.

Methods of Disinfection
A. Cleaning
Instruments with high risk organic
material >>
Treat with strong disinfectant >>
Cleaning >> Sterile or dispose of.

B. Disinfection by Heat
i. Pasteurization
ii. Boiling water
iii. Flaming off alcohol

C. Physical Methods
Ultrasonics
Ultrasonic vibration >
Disrupte microorganisms
e.g. Ultrasonic scalers.

D. Chemical Disinfectants
Denaturing protein or lipid
Act: Disrupting the biosynthetic pathways

I. Phenols

Clear phenolic solutions:

Black and White Phenolic Compounds:
Chloroxylenol: (Dettol)
Hexachlorophane: Pre-operative scrub

II. Halogenic Compounds

Hypochlorites: Effective > HBV
Iodine + Alcohol
Pre-operative skin antiseptic.
Bovidone Iodine:
an anti-plaque agent.

III. Aldehydes
Formaldehyde
Gluteraldehyde
Alcohol
-----------------------

Antiseptics
Are bacteriostatic agents that can
be used on skin and mucosal
surfaces.

IV. Diguanides
Chlorhexdine
0.5% + 70% alcohol >>> Skin
disinfectant

Chlorhexidine gluconate
Treatment of oral candidosis + oral
ulceration

V. Quaternary Ammonium Compounds

Cetrimide

VI. Organic Dyes

e.g. gentian violet

 Factors Affecting the Effectiveness

of Disinfectants:
Tests of the Proper Functioning of
Liquid Disinfectants:
" In-use" Tests.

Storage of Sterile Instruments

Never store instruments in liquid
disinfectants.

Waste Disposal
Special Problems
HBV, HCV and HIV (AIDS)

Sterilization and Disinfection

in Dentistry
Sterilization >>> Autoclave.
Dental instruments can and should be
autoclaved after each patient.
Nozzles of air and water spray: ??