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Posted: 6/30/2012 7:02:10 PM EDT
So does anyone autoclave at home or at work?  What's the best method?  Can I just buy some autoclave bags and use a pressure-canner, or does it really require a machine?

 
Link Posted: 6/30/2012 8:57:12 PM EDT
[#1]
Pressure cooker will work fine. Here's the citation

According to the paper, 13 minutes is enough, but 30 minutes will provide a deep sterilization.
Link Posted: 7/1/2012 6:46:27 AM EDT
[#2]
It depends - what you are trying to accomplish?

A steam autoclave is simply a specialized pressure cooker, but sterilizing is complicated.  Thorough pre-cleaning is essential - any oil or debris stuck to the instruments can harbor spores that can survive a cycle.  Time is dependent on pressure and temperature, but the instruments must also be carefully packed in such a way that steam can circulate.

Even sealed in an autoclave bag they are only considered sterile for a limited time depending on the type of wrap or bag.  Any tear or break in the bag and the instruments must be considered to be contaminated.

Additionally, sterilization is only one component of infection control.  Sterile gloves, masks, gowns, operating theater, etc..
Link Posted: 7/1/2012 9:33:16 AM EDT
[#3]
Quoted:
It depends - what you are trying to accomplish?

A steam autoclave is simply a specialized pressure cooker, but sterilizing is complicated.  Thorough pre-cleaning is essential - any oil or debris stuck to the instruments can harbor spores that can survive a cycle.  Time is dependent on pressure and temperature, but the instruments must also be carefully packed in such a way that steam can circulate.

Even sealed in an autoclave bag they are only considered sterile for a limited time depending on the type of wrap or bag.  Any tear or break in the bag and the instruments must be considered to be contaminated.

Additionally, sterilization is only one component of infection control.  Sterile gloves, masks, gowns, operating theater, etc..



This, plus some things require a vacuum cycle at the end of autoclaving to dry them. You might be able to get away with low-temp baking to dry after pressure-cooker sterilization, but any time you add extra manipulations you end up greatly increasing the chance of contamination.

I work in a molecular microbiology and genetics lab. We sterilize lots of media, instruments, and trash in the autoclave. Things come out of the autoclave and go straight to a glass cabinet where they stay until used. Everything is placed in bags, foil, flasks, or bottles and then covered before autoclaving. Everything is marked with temperature-sensitive autoclave tape to confirm sterilization.

We can give you better info if you tell us what you're trying to sterilize.

Link Posted: 7/1/2012 11:42:38 AM EDT
[#4]
Okay excellent info gents.  What I want to be able to accomplish is sterilization of tools for minor surgery, wound and burn care, and as a last resort trauma care.  Hemostats, scissors for removing field dressings, re-usable glass syringes (if I can find any,) surgical prep brushes, autoclavable EMT shears etc.  Under most circumstances I want to be able to treat a wound, remove glass/debris, irrigate etc without causing a secondary infection.  This would of course be under circumstances where professional medical care is unavailable.





Also before someone mentions it, yes I am undertaking training to be able to use these tools
effectively.  I realize if I've got a bleeder I got heap big trouble. The training I plan to achieve is that of an EMT-P with some additional training in trauma.  I would like to have more advanced medical facilities as part of my larger preparedness plan that will be another element to be built in over time.  I also have relatives that have advanced medical training that will be protected assets and shelter with me if circumstances dictate. I'd like them to have some tools at hand.



ETA: Any info/insight on sterilizing bandages might be good too, but for the most part I'm thinking stainless instruments.



 
Link Posted: 7/2/2012 9:44:05 AM EDT
[#5]
Ok, well the best you can do is wrap them, sterilize them and redo it every so often.  Since time is not a factor you can keep them in the pressure cooker for an hour - you can't hurt the instruments by going longer.  

You probably won't find reusable glass syringes anywhere - anything injectable is single use.  Even dental syringes use a disposable tip and carpule - the syringe itself is all steel and autoclaved after every use.   Besides, they're restricted to professional use so the junkies don't get them.  

If you just want something for wound irrigation you can find blunt tipped syringes online.  Scissors, hemostats and the like are easily available.

As for bandages you can wrap them just like instruments but they have to go through a drying cycle so they don't get soggy.  It's much easier just to buy sterile bandages pre packaged.
Link Posted: 7/2/2012 10:20:43 AM EDT
[#6]
The need for sterilization really is going to depend on what you're doing with them. If you're cutting clothes away from a wound, no sterilization is needed as what you're cutting away is more dirty than a pair of scissors that's been in a drawer most likely. If you're removing bandages that have been exposed to air, the upper surface will have contamination so the act of cutting through them will introduce bacteria to the lower surface. Using utensils that have been washed would be sufficient. Cutting away bandages that have been covered can use scissors dipped in alcohol. You can even flame them and let them cool if you're worried about it.
As far as utensils for minor "surgery", I can understand wanting to autoclave them, but you may also want to just look into presterilized packaged floor trays. Have the instruments necessary to change dressings, remove sutures, suture wounds, etc. Same goes for syringes. You can get plenty of sterile syringes for livestock use and don't have to worry about cleaning.
For anything considered true surgery, you're going to need high quality surgical instruments as any imperfections to the surface can carry potential contamination, even after attempting sterilization. I echo the above comments that the instruments must be clean and free from grease before sterilization.
In summary, I'd divide out what my goals would be and would have general use tools that are clean but don't have to be sterile for non-sterile use. I'd have very clean or presterilized instruments for general surface use, and reserve very good instruments for emergency last resort use.





ETA:  Wanted to add, sterilization, in the sense of killing microorganisms via pressure cooking is but one part. I wanted to again stress the need for tools to be clean. Dead bacteria can cause problems just as live bacteria can. Bacterial components can cause inflammation and set off immune responses. There have been various threads over the years I remember coming up where things like baking instruments in the oven to destroy contamination, etc., were discussed. But just because bacteria have been autoclaved and are unable to reproduce (dead) doesn't mean they're 100% clean.
 
Link Posted: 7/2/2012 6:15:31 PM EDT
[#7]
Thanks guys, I had not considered everything.  Scrubbing sounds pretty important too.
 
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