Surgical implant sterilization in the Asia–Pacific region: A survey of current practices

Abstract

Background

Healthcare-acquired infections are frequently linked to contaminated medical devices such as inadequately sterilized surgical devices, especially surgical implants. To prevent inadequate medical equipment sterilization, various health organizations (eg, World Health Organization) have provided guidance on best practices related to the sterilization monitoring practices of implant-containing loads.

Methods

A survey of sterilization practices, including practices related to monitoring implant-containing loads, at facilities from seven countries in the Western Pacific Region (WPR) and three countries in the Southeast Asia Region (SEAR) was conducted to assess alignment with health organization guidelines and to elucidate factors impacting sterilization practices.

Results

Workload distribution was selected by 47 % of respondents when asked what had changed over the past year. Overall, 21 % of respondents were not monitoring each implant-containing load with a PCD (Process Challenge Device) containing a BI (Biological Indicator) with a Type-5 Chemical Indicator (CI), and 27 % of respondents had seen an implant load released prior to receiving BI results. Twenty-nine percent (29 %) of respondents had no placement guide for CIs when used in multi-level trays. Lastly, 43 % of respondents routinely performed immediate use system sterilization (IUSS), which commonly involved loaner instruments.

Conclusions

The results of this survey study indicate that inappropriate PCD usage in implant loads and frequent IUSS are challenges for some facilities in SEAR and WPR countries. Regional collaboration to produce consensus documents and educational programs may help develop strategies to standardize practice of implant load monitoring and loaner instruments. Thus, a consortium to initiate education programs for SEAR and WPR countries would be worthwhile.