Sterilization surgery-1

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Stapler before sterilization clear of mineral oil, grease, after which their use, collect, charge. Sterilization was boiling in distilled water and charged in the assembled form. The machine is heated charged spare stores with tantalum clips. If the machine is cutting parts, they are sterilized separately by the rules of the sterilization of cutting tools.
Sterilization of synthetic materials: vascular prostheses of Dacron, Terylene, taflona, nylon and Dacron, and networks of these materials — produced by boiling in distilled water for 30 min. followed by immersing them for a few minutes in alcohol and washed with saline. Standard dentures come from the factory in a special sterile packaging.
Glass products are sterilized in an autoclave at 2 am for 20 minutes. or by boiling in distilled water — 30 min., or dry-air chamber at t ° 150-160 ° — 1:00.
Preparation for sterilizing soft suture material (silk, catgut, nylon, Dacron, hair) and sterilization carried out in the operating room.
To process the silk used method Kocher: silk wash with soap and warm water, rinse until the water runs clear, and dried in a sterile towel. For this and subsequent manipulation nurse dresses like an operation. Washed silk wound on glass, coil or gauze rolls and dip consistently to degrease the air for 12-24 hours and in 70% alcohol at the same time. Then, after 10 minutes of boiling solution of mercuric chloride 1:1000 silk placed for storage in 96% alcohol to the banks with ground stoppers. Before the operation, the required number of silk boiled for 2 min. in a solution of corrosive sublimate 1: 1000.
Modification of the method often used Kocher.
1. Bakulev way: silk in coils washed in 0.5% solution of ammonium chloride, dried and immersed degreaser for 1 day on the air. Silk sterilized in an autoclave for 30 minutes. Stored in 96% ethanol in sterile jars with a glass stopper.
2. After washing, winding coil, degreasing in ether and 70% alcohol and boiling in a solution of corrosive sublimate 1: 1000 (№ 0-4 in 15 minutes., № 5-8 in 30 minutes.) Silk placed for 3 days at 96 % alcohol, then make his bacteriological tests (culture) and filled to store 96% alcohol.
3. Wash the wound on the coil and fat silk sterilized in autoclave 15 min. at 2 am, and placed for 5 days in 96% alcohol. After control of sowing silk ready for use. Autoclaving reduces the strength of silk. Every 10 days of alcohol, which houses silk, change, and sterility test silk crop.
Nylon thread and lavsan sterilized in an autoclave 15 min. at 2 am, placed in 96% alcohol for 5 days, then seeded. Stored in 96% alcohol. Allowed sterilization boiling in water (20 min.), and then in a solution of mercuric chloride 1:1000 (5 min.), as well as the ways suggested for sterilization of silk. Nylon thread and lavsan withstand any number of boiling, including mercuric chloride.
Paper and linen threads sterilized as silk, or autoclaved together with bandages and linens.
Catgut sterilization requires more complicated due to the fact that it is made from highly infectious material — sheep intestines, and boiling and autoclaving, he can not stand. Sterilization of catgut in the way Sitkovskiy: catgut degreased in the air for 12-24 hours, wipe the threads swab dipped in a solution of corrosive sublimate 1: 1000, immersed in 2% aqueous solution of potassium iodide (№ 0-1 for 30 seconds., № 2-5 for 1 min., № 6 to 2 min.) and then coiled into rings catgut placed in suspension in a jar with a glass stopper and paraffin embedded at a distance of 6-7 cm from the bottom, where the dry iodine (3-liter jar — 40 g, 5 -liter jar — 60 g.) Periodically, banks slightly shaken for uniform access to all of the iodine vapor skein of catgut. Catgut believe prosternlizovannym № 0-1 — after 3 days, № 2-4 — after 4 days, № 5-6 — 5 days after sowing and placed in a dry sterile jars with ground glass stoppers.
Claudius way: within 14 days of gut left in the solution: 1000 ml of distilled water, 10 g of pure iodine and 10 g of potassium iodide. The water can be replaced with alcohol formalin 1: 1000.
There are other ways to modify Claudius: coiled strands of catgut degreased in the air one day and 14-day are placed in a solution of 1000 ml of pure alcohol, 10 g of iodine and 10 g of potassium iodide, changing this solution after 7 days. Then produce bacteriological control and stored in the same solution with the change it every 7-10 days. This is one of the most accepted ways of the USSR. Catgut can be sterilized in a solution of the following composition: 1000 ml of distilled water, 20 g of potassium iodide and 10 g of pure iodine. Coiled catgut placed in a solution twice for 8-10 days after holding it for 12-24 hours. in the air and then at 4 — 6 nights — 96% alcohol. After bacteriological seeding catgut stored in 96% alcohol, which is replaced every 7-10 days.
Sterilization tools, including cutting is possible with ultrasound. The advantage of this method is that ultrasound provides tools and mechanical cleaning of the blood and pus, without damaging them. Instruments are placed in a container with distilled water, there also lowered radiator. Apply ultrasound frequency of 800 kHz, with a capacity of 20-30 W/cm2. After 10 minutes. reached full mechanical cleaning and sterility. Very effective sterilization of linen, dressing, tools, equipment, solutions and the like gamma radiation. Dose of ionizing radiation should be at least 2 000 000 — 2.5 million x-ray.

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