Sterile Technique: Concept and Practices

Sterile technique is a method of eliminating microscopic organisms that can contaminate a surface and potentially cause illness. The term “sterile” literally means “free from germs.” More broadly, the concept of sterile technique encompasses any procedures used to completely remove all life forms and biological organisms present on a given surface. Such procedures may involve the application of heat, irradiation, filtration, high pressure, or chemical treatment. Sterile technique and sterilization are primarily associated with the medical field. Surgical instruments and other medical equipment often require careful sterilization before use to prevent the transmission of bacteria and viruses, as well as other potentially dangerous pathogens. Sterile technique is also sometimes used as a means of preserving and maintaining the safety of various food products, especially canned foods. Whatever the purpose, sterile technique is the most effective and reliable method of preventing the spread of disease by eradicating microscopic organisms.

Background

Sterile technique is ultimately aimed at eliminating all microscopic organisms—or microbes—from surfaces. Microbes are found in all parts of the biosphere where water is present and inside living things. In fact, more microbes are actually inside the human body than cells that make up the body itself. Although many microbes are harmless and some are even essential for good health, others are potentially dangerous. Harmful microbes that can cause infections and other forms of disease are known as pathogens.

The human body has a number of built-in defenses against common pathogens. Some of these include physical barriers such as the skin, the immune system, and helpful bacteria that normally exist within the body. Despite being able to keep many pathogens at bay under normal circumstances, the body’s natural defenses may not be effective in certain situations. This is especially true in hospital settings where numerous people are sick or undergoing surgical procedures. In these instances, the body’s natural defenses need to be supported by other supplemental methods of preventing the spread of harmful pathogens. This means ensuring the cleanliness of medical equipment, surgical implements, and operating rooms at large. Sterilization is the most effective way to accomplish this goal.

Sterilization is a broad term that refers to any procedure that eliminates all viable organisms present in a given area. That specific area may be a surface, an entire instrument, a quantity of fluid, or a medication. Sterilization is especially important for surgical instruments and medications that will enter a germ-free part of the body, including anywhere under the skin or within the bloodstream. Without proper sterilization, these objects or drugs could introduce potentially dangerous microbial contaminants into the body and ultimately encourage the spread of disease. As a result, sterilization and sterile technique are essential practices that must be vigorously observed and maintained by healthcare providers at every level in hospitals and other medical facilities. In modern healthcare in the United States and many other places around the world, sterile technique is therefore also a major component of medical training for doctors, nurses, and many other healthcare providers.

Overview

The easiest way to understand sterile technique is by comparing it to similar processes such as clean technique and aseptic technique. Clean technique represents the most basic level of infection prevention. It essentially means taking basic precautions like washing one’s hands, using hand sanitizer, and wearing clean gloves. A step up from clean technique, aseptic technique is a more advanced method of ensuring that surfaces and instruments are clean and safe for use. In essence, aseptic technique is aimed at eliminating potentially harmful microbes and taking steps to prevent pathogens from spreading disease. There are several accepted types of aseptic technique. These include using barriers like sterile gloves, gowns, masks, and drapes; using sterile equipment and instruments; maintaining a sterile environment; and observing contact guidelines governing how many people are allowed in an operating room and the avoidance of contact with nonsterile surfaces. Sterile technique goes one step beyond aseptic technique. Where aseptic technique only focuses on eliminating harmful microbes, sterile technique is aimed at eliminating all microbes, harmful and otherwise. This means that sterilization is the most effective means of disinfecting a specific area, a surface, or an instrument to prevent the spread of disease.

There are a number of different sterilization techniques. Specifically, sterilization can be achieved through the application of heat, irradiation, filtration, high pressure, or chemical treatment. These methods, whether used individually or in some combination, can all effectively eliminate all microbes and other potential pathogens. For any space or object to be considered sterile, all existing microbes—including bacteria, fungi, and their spores—must be completely and entirely eliminated. As such, only the methods and materials capable of doing this can truly be capable of producing sterility. The application of heat is perhaps the most common method of sterile technique in fields where sterilization is a necessity.

In healthcare facilities, sterilization is often achieved with the help of a device known as an autoclave, a machine that uses pressurized steam to kill microbes. Items that need to be sterilized, such as instruments, drapes, and linens, are placed inside the autoclave pressure vessel and heated to a specified sterilization temperature for a set period of time. In effect, the moisture in the steam produced by the autoclave transfers intense heat to the items inside to destroy the protein structure of any microbes that might be present. The autoclave process has three phases: the conditioning phase, exposure phase, and exhaust phase. In the conditioning phase, air is removed from the chamber so that it will not inhibit sterilization. In the exposure phase, steam is introduced into the chamber to raise the pressure and temperature to a pre-set level. Items in the chamber are subsequently held at that pressure and temperature level for as long as is required to sterilize them. Finally, the steam is released and the vessel is allowed to depressurize in the exhaust phase. At the end of the cycle, the items remain inside the autoclave until they have dried. Then they are considered fully sterilized and may be removed from the autoclave.

Bibliography

Cherney, Kristeen and Rachel Nall. “Aseptic Technique.” Healthline, 23 June 2017, www.healthline.com/health/aseptic-technique. Accessed 11 Mar. 2020.

“Difference between Aseptic and Sterile.” Difference.guru, 5 Dec. 2017, difference.guru/difference-between-aseptic-and-sterile. Accessed 11 Mar. 2020.

Eske, Jamie. “What Is Aseptic Technique?” Medical News Todau, 8 Nov. 2018, www.medicalnewstoday.com/articles/323615. Accessed 11 Mar. 2020.

“Everything about Autoclaves.” Steris Healthcare, 2020, www.steris.com/healthcare/knowledge-center/sterile-processing/everything-about-autoclaves. Accessed 11 Mar. 2020.

“Sterile Technique.” MedlinePlus, 12 July 2018, medlineplus.gov/ency/patientinstructions/000119.htm. Accessed 11 Mar. 2020.

“Sterile Technique.” Penn State Hershey, 2020, pennstatehershey.adam.com/content.aspx?productid=117&pid=60&gid=000119. Accessed 11 Mar. 2020.

“What Is Sterility and Why Is It So Important?” Sterile Barrier Association, 2020, www.sterilebarrier.org/general-public/what-is-sterility-and-why-is-it-so-important. Accessed 11 Mar. 2020.

“What’s the Difference between Sterile and Aseptic Technique?” Production Automation Corporation, 27 June 2018, blog.gotopac.com/2018/06/27/whats-the-difference-between-sterile-and-aseptic-technique. Accessed 11 Mar. 2020.