Sterile Paper

[raverill]

I know this one has come up before, pardon my short term memory. The OR is still hounding me about sterilizing "Cheat Sheets", typed notes on what and how to use the Total Hip Trays, etc. Is anyone else sterilizing paper in heat seal pouches?
Ray

[cpdguy]

This is a hot topic.

The AORN "Recommended Practices for Selection and Use of Packaging Systems for Sterilization" states "Count sheets should not be placed inside wrapped sets or rigid containers". The concern is that there is no research evidence on the safety of papers and toners that have not been specifically designed for steam sterilization that are commonly used for this purpose. Because this is a possible safety issue , AORN made the recommendation that the count sheets not be placed in the containers for sterilization.

Hope this helps

[raverill]

Thanks CPD Guy! I am familiar with the AORN Recommendation. However, I was not speaking about putting them in trays, I was asking about sterilizing them in heat seal packages not in trays. I just w3ondered if there were others that did this.
Ray

[cpdguy]

Sorry, my bad in reading the posting. Interesting question. Now that i read it correctly.
hope all is well in NY. Stay warm.

[CSS TECH]

Cpdguy, I believe the concern would be more about the impossibility to sterilize paper by steam. It would not be a problem with EtO though. Anyway! In my facility we sterilize needed count sheets in advance in EtO.
I hope this answer would apply to Ray's question too.

[wperez]

We sterilize countsheets inside our containers. Although AORN does not advise we do that , they do not have supportive scientific studies to back it up. We do fold our countsheets inword with no printed words exposed. The real issue is transference of the ink to the instrument. where did you get the information that paper cannot be steam sterilized? Are you not using peel packs for individual instruments? What standards reflect this. Plaes let me know.

[CSS TECH]

We sterilize countsheets inside our containers. Although AORN does not advise we do that , they do not have supportive scientific studies to back it up. We do fold our countsheets inword with no printed words exposed. The real issue is transference of the ink to the instrument. where did you get the information that paper cannot be steam sterilized? Are you not using peel packs for individual instruments? What standards reflect this. Plaes let me know.
Well! Believe it or not, the kind of paper you buy from OfficeMax or OfficeDepot to generate your count sheets cannot be sterilized by steam. And that cannot be for the same reason wood cannot be sterilized by steam. Check the paper used to make peel pouches and let us know if it looks and feels like the one you use to make your tray lists!
I am sorry to have said paper cannot be sterilized by steam. Yes, the kind used to make peel pouches can, but not the one you have in your office!

[Harvey Johnson]

With all due respect CSS, you make a pretty broad statement.
We have wood handles on instruments in several loaner specialty trays, are these not coming out sterile?
Do you have any studies or documentation to back up your claim that paper cannot be sterilized by steam?
I have placed BI's and integrators inside several folds of the instrument count paper and placed them inside paper sterilization pouches and all have turned negative. This would indicate the steam is penetrating the paper to the point the contents inside are sterile, shouldn't the paper be considered as sterile also?

[CSS TECH]

With all due respect CSS, you make a pretty broad statement.
We have wood handles on instruments in several loaner specialty trays, are these not coming out sterile?
Do you have any studies or documentation to back up your claim that paper cannot be sterilized by steam?
I have placed BI's and integrators inside several folds of the instrument count paper and placed them inside paper sterilization pouches and all have turned negative. This would indicate the steam is penetrating the paper to the point the contents inside are sterile, shouldn't the paper be considered as sterile also?
Those handles that look like wood on instruments are made of a propylene material. If you have real wood handles, they cannot be sterilized by steam. Make no mistake about that! Paper and wood are to be sterilized by EtO!

[Harvey Johnson]

Yes, I have seen the handles with a poly material that is molded to look like wood, we also have wood handles.
Believe me, people raised in the Northwest U.S. quickly learn difference between plastic and wood.
You sound positive about your position, could you cite the resource for your claim paper and wood can only be sterilized by EtO?

[wperez]

I don't buy this for a minute. I need to see documentation that the paper from office max cannot be sterilized. Show me the money. Sounds like a lot of bull to me! Sorry but I'm not buying it! What do you do with the count sheets after your ETO them?

[CSS TECH]

I don't buy this for a minute. I need to see documentation that the paper from office max cannot be sterilized. Show me the money. Sounds like a lot of bull to me! Sorry but I'm not buying it! What do you do with the count sheets after your ETO them?

Wow! Who said that the paper from OfficeMax cannot be sterilized? I never said that!
I learned from a book that I read years ago that wood and paper cannot be sterilized properly by steam. I will look for the reference and I will submit it here. In the meantime, try to do some research of your own. I am sure you will find the basis of my argument. Moreover, talk like a gentleman! Otherwise, there will be no need for me to discuss with you.

[sheper1]

What happens with regular paper that is steam sterilized is microscopic fibers can be blown off the paper and on to the instruments that is why the peel pouchs use a medical grade paper that is design for the type of sterilization be it steam, ETO, Sterrad, or Ozone. As to wood it is the difficulty in getting it clean because of its porus nature it is almost impossible to fully clean all micro organism from the wood that is why in the operating rooms they quite uses wood floors because you could not get them throughly clean nor could you get them disinfected. The issue with the count sheets is the ink that some of the toner cartridges uses is toxic.

[wperez]

Sorry if my response offended you. I simply want those statements substantiated. We cannot afford to send messages that could affect how we practice without some type of supportive documentation. I looked through the AAMI standards and could not find any documentation. I also checked with our infection control administrator and she could not stand behind your statements. If you can't take the heat stay out of the kitchen!:)

[CSS TECH]

If you can't take the heat stay out of the kitchen!:)
You don't think the kitchen is really hot, do you? Probably hot, but not too hot for CSS TECH!:p