Miller C H
Department of Oral Microbiology, Indiana University School of Dentistry, Indianapolis.
Dent Clin North Am. 1991 Apr;35(2):339-55.
The goal of instrument processing is to protect patients by preventing cross-contamination from instruments. The processing involves a series of sequential steps aimed at removing and killing microbes on contaminated instruments and maintaining those instruments in an aseptic state until they are reused. These steps must be conducted carefully to assure success and to reduce chances of disease spread or physical injury to those handling the contaminated instruments. Presoaking begins the cleaning process and facilitates terminal cleaning by ultrasonic or manual scrubbing. If instruments are not properly cleaned, subsequent sterilization may be jeopardized by insulation of blood- or saliva-coated microbes from the sterilizing agent. Items that would be destroyed by heat should be cleaned and sterilized in a properly prepared glutaraldehyde solution. Cleaned instruments must be packaged prior to heat sterilization to protect them from recontamination after sterilization and before reuse. Sterilization of cleaned, packaged instruments in steam, chemical vapor, or dry heat sterilizers must involve proper loading, processing, drying, and cooling. Routine use of spore tests and chemical indicators will provide quality assessment of packaging procedures and operation of the sterilizer, as well as assist in identifying processed packages during distribution. Using the results of sterilization monitoring to adjust procedures as a means of assuring sterilization provides quality assurance to the office staff and to the patients that the instruments have been properly processed. Carefully handling storage and distribution of the sterilized instrument packs or trays reduces the chances for recontamination until the instruments are reused. Instrument processing is a major part of the office infection control program. It must be performed in a controlled manner with proper monitoring to achieve the desired outcome of patient protection.
器械处理的目标是通过防止器械交叉污染来保护患者。该处理过程包括一系列连续步骤，旨在清除并杀死受污染器械上的微生物，并使这些器械保持无菌状态直至再次使用。必须谨慎执行这些步骤，以确保成功并减少疾病传播或对处理受污染器械人员造成身体伤害的可能性。预浸泡开启清洁过程，并通过超声或手工刷洗促进终末清洁。如果器械未得到妥善清洁，后续的灭菌可能会因血液或唾液包裹的微生物与灭菌剂隔离而受到影响。不耐热的物品应在适当配制的戊二醛溶液中进行清洁和灭菌。清洁后的器械在热灭菌前必须进行包装，以防止灭菌后及再次使用前受到重新污染。在蒸汽、化学蒸汽或干热灭菌器中对清洁、包装好的器械进行灭菌时，必须进行正确的装载、处理、干燥和冷却。定期使用芽孢测试和化学指示剂将对包装程序和灭菌器操作进行质量评估，并有助于在分发过程中识别已处理的包装。利用灭菌监测结果调整程序，以此确保灭菌，这为办公室工作人员和患者提供了质量保证，即器械已得到妥善处理。小心处理已灭菌器械包或托盘的储存和分发，可减少再次污染的可能性，直至器械再次使用。器械处理是办公室感染控制计划的重要组成部分。必须在适当监测下以可控方式进行，以实现保护患者的预期结果。
