Question

Surgeons who operate in several facilities may bring their own instruments for use in surgery. Sometimes the instruments are brought in already wrapped and sterilized. However, rules for aseptic technique require that instruments brought in from outside be opened, re-wrapped, and re-sterilized in the facility where the surgery takes place. Provide the rationale for this rule of aseptic technique. Note that there are a number of different reasons for this.

Answer 1

Rationale: for Surgeons who bring their own instruments brought from outside be opened and,re- wrapped and sterilized.

The Association of Peri Operative Registered Nurses (AORN) recommended practice of maintaining a sterile field States “ Items used within the sterile field should be sterile. To ensure that only sterile items are presented to the sterile field,all items should be inspected immediately before presentation to the field for proper packaging, processing, seal, package container integrity,and inclusion of a sterilization indicator.The indicator should be inspected immediately to verify the appropriate color change for the sterilization Process selected”.

Off- site transportation guidelines: When sterile packages are transported between health care facilities,the vehicles used to transport these items must be able to completely separate clean and sterile items from contaminated items.In this situation,all external shipping cartons ( corrugated or otherwise) are to be considered contaminated,even if they contain wrapped sterile items.

“Transport vehicles must be completely enclosed and should be checked periodically,at least annually and more frequently as needed,to ensure that they do not leak. Carts containing sterile packages should be secured within the vehicle to prevent damage or contamination.Transport vehicles and handling practices should allow for ease of loading and unloading”

“When motor vehicles are used,environmental conditions should be assessed while the vehicles is in motion and when it is not in motion”.In areas of the country that frequently have high humidity,specific tests should be done to determine whether potential sterile items have the potential to become contaminated through absorption.Evaluation should be done to determine if there is potential for the contents of sterile packages to become wet through condensation.Condensate can occur on plastic or metal surfaces that are moved from air- conditioned environment to non- air- conditioned environments and then back to air- conditioned environments.

All transport vehicles (motorized or manual) should be constructed of materials that allow for proper decontamination process.Loaded transport vehicles should never be left unattended or in an unsecured location.

The instruments brought by surgeons from outside may compromised the above mentioned guidelines.