On my previous article, I discussed how to seal pouches correctly, but did you know you must date them as well? When I mention this during my infection control classes, I get a quizzical look and “why”? We are going to use them again either right away because we have a limited number of instruments, or at least before the spore test comes back. Both are legimate questions. According to the CDC guidelines, all pouches/wrapped instruments must have the date and which autoclave they were removed from on the wrapping or pouch.
1. If your spore test comes back as “positive” or did not pass that all of the bacteria in the test was not killed, then those instruments need to be repackaged and re-autoclaved after verifying that the autoclave is working properly with another spore test. By dating them, it is easy to track which instruments need to be reprocessed. It is the same reason that it is necessary to label which autoclave it was removed from.
2. All instruments should be “first-in, first-out”. Without a date on them, that is impossible to know. According to the manufacturers, sterility lasts in the pouches for 9 months to three years (check the IFU for the brand you are using). If I have an instrument that is not used routinely, it may be necessary to re-autoclave before use.
Remember that implant parts/instruments are to be immediate use after autoclaving. Again, check the manufacturer instructions for use.
If you are wrapping cassettes, it is necessary to have a internal strip inside the cassette to verify time/temperature/pressure was achieved inside the cassette. Tape that is used for wrapping only tells you what happened on the outside. If your office pouches cassettes, then this is not necessary as the internal indicator is part of the pouch.
No matter what process you are using, it is best practice to open the instruments in front of the patient.