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Flash Sterilization Procedures for Surgical Instrumentation

Flash sterilization -- also called steam sterilization -- is the process of sterilizing items at high temperatures for immediate use in the operating room. It is designed for special circumstances, such as when a one-of-a-kind instrument becomes contaminated and must be resterilized to use. The process has come under scrutiny for being overused, misused and possibly responsible for an increase in infection. However, it remains a fundamental element of operating room procedures.

  1. Uses and Limitations

    • Flash sterilization should not replace traditional instrument cleaning, nor should it be used to compensate for low inventories of necessary instruments. It should be used when there isn't time to sterilize an instrument that is needed to accomplish the procedure. Also, the instrument that is "flashed" must be used immediately. Certain instruments should not be flash sterilized, such as implants, unless it is the only method available.

    Cleaning

    • Often neglected is the important step of cleaning and decontamination. Removing visible soil -- such as blood, tissue and other biohazard materials -- will ensure a greater success of sterilization. Each instrument should be cleaned thoroughly with water, detergent and an enzyme cleaner before it is flash sterilized. Every hospital has a specific guideline on how this is done.

    Sterilization

    • Once clean, each instrument can be loaded into the sterilization tray. All parts must be disassembled or opened and spaced apart from each other. A monitoring device should be placed with the load to indicate effectiveness of the sterilization. This may be a chemical indicator or a biological type.

      Flash sterilization has two distinct methods: the gravity method and the prevacuum method. Different kinds of instruments may require different methods and sterilization times, so be sure to check specific manufacturer guidelines.

      Once the sterilization cycle is completed, prior to the removal of the instrument, a report is reviewed to ensure that the process has been successful by reaching the appropriate temperature and processed for the correct length of time. After this has been verified, the instrument must be brought to the sterile field without being contaminated. The instrument may be in an open, sterile tray or a closed container during transfer.

    Documentation

    • The final step is proper documentation. The log should include the instrument sterilized, type of procedure used, cycle length, temperature, type of container, name and results of the biological or chemical indicator used, time, date and names of all persons involved and any other information required by the hospital.

    Other Considerations

    • All staff involved in the flash sterilization process must be properly trained. Initial training should be thorough at the time of hire and continue with periodic retraining and updates, if there are any. New equipment should always include repeat training.

      Other methods of sterilization should be utilized if at all possible. Flash sterilization is only for use in certain situations and should not be used as a shortcut. Because flash sterilization is performed under time constraints, there is an increased risk of errors.

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