Short-cycle steam sterilization is appropriate
Unwrapped settings and short-cycle sterilization (not to be
confused with "flashing") are appropriate for routine use in between
sequential, same-day ophthalmic cases, state the guidelines.
For cataract cases, it's common practice to sterilize instruments,
interrupt the drying phase and transport them — still wet — in a cov-
ered container to the OR where a scrubbed nurse removes the phaco
handpiece, runs irrigation fluid through it and places it on the sterile
tray for use.
"The IFUs for these sterilizers allow for the interruption of the drying
phase for sequential, same-day use because following the full exposure
time, the instrument is sterile whether it's wet or dry," says Dr. Chang,
who adds that residual moisture is only a problem when you store
wrapped instruments wet overnight or when non-sterile hands handle
the packaging.
In 2009, the Joint Commission wanted to require a full, terminal dry
and wrapped cycle for all intraocular instruments — it would have
taken an hour to process instruments in between consecutive cases!
— but an earlier version of the task force provided TJC with evidence
that short-cycle sterilization was acceptable for sequential ophthalmic
cases.
The guidelines also point to confusion about the differences
between immediate-use steam sterilization (IUSS) — formally known
as flashing — and short cycle sterilization. While both are short
cycles of steam sterilization, agencies that license and regulate surgi-
cal centers sometimes mistakenly use "IUSS" to refer to what is in
fact short cycle sterilization. They are different.
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Infection Prevention
IP
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