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Sterilization: Packaging & Storage

What is the purpose of packaging instruments for sterilization?

Packaging materials (e.g., wrapped or container systems) allow penetration of the sterilizing agent and maintain sterility of the processed item after sterilization.

What types of packaging materials are available for sterilizing instruments?

Packaging materials include wrapped perforated instrument cassettes, peel pouches of plastic or paper, and sterilization wraps (which can be either woven or unwoven). Packaging materials should be designed for the type of sterilization process being used and should be appropriate for the items being sterilized.

Types and Use of Sterilization Packaging Materials

Sterilization Method Packaging Material Requirements Acceptable Materials
Steam autoclave
  • Should allow steam to penetrate
  • Paper
  • Plastic
  • Cloth
  • Paper/plastic peel packages
  • Wrapped perforated cassettes
Dry heat
  • Should not insulate items from heat
  • Should not be destroyed by temperature used
  • Paper bags
  • Aluminum foil
  • Polyfilm plastic tubing
  • Wrapped perforated cassettes
Unsaturated chemical vapor
  • Vapors should be allowed to precipitate on contents
  • Vapors should not react with packaging material
  • Plastics should not contact sides of sterilizer
  • Wrapped perforated cassettes
  • Paper
  • Paper/plastic peel packages

Modified from Miller CH and Palenik CJ (2010).

What information should be included on the package label?

Before placing packaged instruments in the sterilizer, at a minimum, include the following information on the label:

  • Sterilizer used
  • Cycle or load number
  • Date of sterilization
  • Expiration date, if applicable

How should items be stored following sterilization?

Sterile instruments and supplies should be stored in covered or closed cabinets. Dental instruments and supplies should not be stored under sinks or in other places where they might become wet. Wrapped packages of sterilized instruments should be inspected before opening and use to ensure that the packaging has not been compromised (i.e., wet, torn, or punctured) during storage.

What is the shelf life of sterilized instruments?

Storage practices for wrapped sterilized instruments can be either date- or event-related. Although some facilities continue to date every sterilized package and use shelf-life practices (first in, first out), other facilities have switched to event-related practices. This approach recognizes that the product should remain sterile until some event causes the item to become contaminated (e.g., a package becomes torn or wet). All packages containing sterile items should be inspected before use to verify that the package is not wet, torn, or damaged in any way. If it is, the instruments should be recleaned, packaged in new wrap, and resterilized.

References

Association for the Advancement of Medical Instrumentation, American National Standards Institute. Comprehensive guide to steam sterilization and sterility assurance in health care facilities. ANSI/AAMI ST79-2010; A1:2010; A2:2011; A3:2012; and A4: 2013. Arlington, VA: Association for the Advancement of Medical Instrumentation, 2010.

CDC. Guidelines for infection control in dental health-care settings – 2003. MMWR 2003; 52(No. RR-17):1–66. Available at: https://www.cdc.gov/mmwr/PDF/rr/rr5217.pdf [PDF-1.2M]. Accessed March 18, 2016.

CDC. Summary of infection prevention practices in dental settings: basic expectations for safe care. Available at: https://www.cdc.gov/oralhealth/infectioncontrol/pdf/safe-care2.pdf [PDF – 844 KB]. Accessed March 31, 2016.

Harte JA, Molinari JA. Instrument Processing and Recirculation. In: Molinari JA, Harte JA, eds. Cottone’s Practical Infection Control in Dentistry, 3rd ed. Baltimore: Lippincott Williams & Wilkins, 2010;221–231.

Harte JA, Molinari JA. Sterilization Procedures and Monitoring. In: Molinari JA, Harte JA eds. Cottone’s Practical Infection Control in Dentistry, 3rd ed. Baltimore: Lippincott Williams & Wilkins, 2010;148–170.

Miller CH, Palenik CJ. Instrument Processing. In: Miller CH, Palenik CJ, eds. Infection Control and Management of Hazardous Materials for the Dental Team, 4th ed. St. Louis: Mosby, 2010;135–169.

Rutala WA, Weber DJ, and the Healthcare Infection Control Practices Advisory Committee. Guideline for disinfection and sterilization in healthcare facilities, 2008:1–158. Available at: https://www.cdc.gov/infectioncontrol/pdf/guidelines/disinfection-guidelines.pdf [PDF – 1.26M]. Accessed March 18, 2016.

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