Instrument Handling & Sterilization
Clinical Objective
Ensure all instruments and implants used in surgery are properly decontaminated, packaged, sterilized, and maintained in sterile condition until the moment of use. Instrument-related contamination is one of the few SSI causes that is entirely preventable.
Protocol Steps
- 1
Decontaminate all soiled instruments immediately after use: manual scrubbing or ultrasonic cleaning.
- 2
Inspect instruments for defects (bent tips, broken ratchets, compromised insulation) before packaging.
- 3
Package in validated sterilization wrap or pouches appropriate to the sterilization method.
- 4
Sterilize using validated autoclave cycles: 134°C for 3 minutes (pre-vacuum) or 121°C for 15 minutes (gravity).
- 5
Confirm and document chemical indicator and biological indicator results.
- 6
Store sterilized packs in clean, dry, closed storage away from contamination risk.
- 7
Check pack integrity and expiry date immediately before opening for use.
Key Pitfalls to Avoid
Failing to clean instruments before sterilization — biological material protects organisms from steam penetration.
Using chemical indicator results alone without periodic biological indicator validation.
Stacking sterilization packs tightly in the autoclave chamber, preventing adequate steam circulation.
Opening sterilized packs ahead of need and leaving them exposed in the prep room.
Sterilization failure is underreported because it is rarely identified. The instrument looks sterile; the pack looks intact. The biological indicator test that would catch a failed cycle sits in a drawer, run monthly rather than weekly. Most sterilization audit programs in veterinary practice are insufficient by the standards of human surgical facilities. Establishing a culture of rigorous, documented sterilization validation is foundational — everything downstream depends on it.