A surgical instrument with a hinged joint and complex lumen is being prepared for steam sterilization. Which action is most critical to ensure effective sterilization?
- A.Wrap the instrument tightly in dense linen to create a secure barrier
- B.Ensure the instrument is clean, disassembled if applicable, and placed with hinges open in the sterilization tray
- C.Soak the instrument in glutaraldehyde for 10 minutes before autoclaving
- D.Place the instrument in a sealed plastic bag before placing in the autoclave
Show answer & rationale
Correct answer
B. Ensure the instrument is clean, disassembled if applicable, and placed with hinges open in the sterilization tray
Rationale
B is correct: Steam sterilization depends on steam penetrating all surfaces. Instruments must be thoroughly cleaned (bioburden prevents sterilization), disassembled if possible, and positioned with hinges open so steam reaches articulating surfaces and lumens. Closed hinges trap steam and prevent sterilant contact. A is incorrect: Dense wrapping impedes steam penetration. Sterilization wrap must allow steam through while maintaining sterility after processing. C is incorrect: Glutaraldehyde is a high-level disinfectant for heat-sensitive items; it should not be combined with autoclaving. Residual chemical may be harmful. D is incorrect: Sealed plastic bags prevent steam penetration and are not autoclave-compatible without appropriate steam-permeable pouching.
Key concepts