Release date: 2006-10-23 Application analysis of sterilized packaging materials in hospitals Sterilization packaging materials are essential supplies for hospitals. They are mainly used for packaging before sterilization of clinical diagnostic equipment. The purpose is to avoid the process of aseptic storage and aseptic transfer of the sterilized equipment. It is recontaminated by bacteria in the environment and remains sterile when opened for packaging. With the continuous development of sterilization and sterilization technology, the types of sterilization packaging materials are increasingly rich, and often a hospital uses several sterilization packaging materials at the same time. However, different types of sterilization packaging materials have great differences in technical indicators and cost of use. In practice, hospital infections or medical costs are often caused by improper selection. In this regard, we conducted a comparative analysis of several commonly used sterilization packaging materials for pressure steam and ethylene oxide sterilization in our hospital in a practical and economical manner. The main methods and results are reported below. Peer reference.
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1 packaging materials selection and use
1.1 cotton cloth
Made of domestic 140 yarns per square inch of pure cotton towels. The new cloth towel is washed, degreased and dried. After use, the equipment is folded and wrapped with a suitable cloth towel, and then a second cloth towel is used for the second staggered wrapping, and finally the cotton rope is cross-bundled or sterilized. The chemical indicating tape is wrapped around the dressing for waiting for sterilization; the old cloth towel is washed once and is limited to 15 times. Before each use, the integrity and cleanliness of the cloth towel are checked, and the unqualified cloth towel is removed, and the packaging method is the same as the new cloth towel.
1.2 rigid packaging container
It is made of domestically produced containers with hard lids and boxes with lids and open and closed screens. The material is stainless steel or aluminum, usually limited to 200 times. Clean and check the performance of the screen before each use. When using one or several pieces of equipment in a container of suitable specifications, close the lid; however, the non-automatic opening and closing type container should be opened before sterilization. The hole is closed immediately when it is sterilized.
1.3 paper / plastic bags
It adopts imported paper/plastic packaging roll bag, one side is 70g/m2 medical paper, which can filter air, and the other side is polyethylene plastic film with thickness of about 0.1mm. This packaging material is used at one time. When packaging, firstly, according to the size of the equipment, the corresponding independent bag is cut on the roll bag, and then the equipment is placed in a separate bag, and the two ends of the separate bag are sealed by a heat sealing machine (160 ° C ~ 200 ° C) to complete the packaging.
1.4 wrinkle wrapping paper
Table 14 Comparison of Sterilization and Antibacterial Effects of Sterilized Packaging Materials
Contrast project cotton cloth hard packaging container paper / plastic packaging bag wrinkle packaging paper sterilizing agent penetration effect excellent general excellent sterilization residue discharge effect excellent general excellent equipment sterilization period 7 ~ 14 days 7 ~ 14 days 90 ~180 days, about 30 days, the physical tolerance effect is excellent, generally the pollution level of the equipment is not slightly mild.
Imported medical wrinkle wrapper of more than 70g/m2 is used for one-time use. The packaging method is the same as cotton cloth.
2 sterilization and inhibition of bacteria
Any sterilized packaging material shall have the following conditions: Allow the sterilizing agent to penetrate all surfaces of the equipment directly in the bag, allow the air in the bag and the residual sterilizing agent and residue to be discharged, and have the ability to keep the bag out. The bacteria equipment is sterile before use (playing a bacterial barrier in a certain period of time), and has certain physical resistance characteristics such as stab resistance, tear resistance, moisture resistance and anti-friction ability, and basically does not constitute pollution to the equipment inside the bag. Based on these conditions, we compared the above four kinds of sterilization packaging materials. The result is: pure cotton cloth is good for the penetration and discharge of the sterilizing agent, and the physical resistance is also strong, but the bacterial barrier is poor. The maximum shelf life after sterilization is only 14 days, and there is more cotton dust on the cotton cloth, which can cause dust pollution on the surface of the packaged equipment. The rigid packaging container has strong physical tolerance and almost no pollution. However, the penetration and discharge of the sterilizing agent mainly depends on the mesh hole portion, and there is a certain incompleteness. The pressure steam sterilization may also cause local wet packing. In addition, the maximum shelf life after sterilization was only 14 days, due to the relatively poor sealing of the mesh and lid on the container. The paper/plastic packaging bag has a reliable bacterial barrier effect. The storage period after sterilization is 90-180 days, and the longest can be more than 1 year. Moreover, it has the advantages of easy sterilization, easy elimination of sterilization residue and almost no pollution. However, the performances such as stab resistance, tear resistance and moisture resistance are poor, and the equipment inside the bag is not easy to fix. Sharp and large pieces of equipment need to be protected or packaged with other materials before the final packaging can be completed with paper/plastic bags. The characteristics of wrinkle wrapping paper are similar to paper/plastic packaging bags, but the storage period after sterilization is not standardized in China, usually about 30 days.
3 packaging use cost analysis
Sterilized packaging materials are a kind of medical consumables, which are part of the medical cost and are also used in hospitals. Therefore, when using sterilized packaging materials, in addition to their quality requirements, they should also be considered. The cost. At present, the most used in our hospital is pure cotton cloth. We use pure cotton cloth as a reference to analyze the cost of using the above sterilized packaging materials (for commercial reasons, it is not convenient to list the specific purchase cost). Yes: Two sets of 600mm × 600mm cotton cloth packaged as the standard, and then determine the specifications and quantity of other sterilization packaging materials that can also achieve the same packaging effect, respectively, ф240mm × 160mm stainless steel 1 sterilized storage tank, 1 paper/plastic bag of 250mm×350mm size, 2 sheets of wrinkle wrapping paper of 600mm×600mm size. After determining the sterilized packaging materials that are comparable, combined with the actual packaging consumption (such as: chemical indicators outside the package, packaging tying rope, cleaning costs of pure cotton cloth and rigid packaging containers, etc.) and the effective period of sterilization, etc. The difference in the cost of using several sterilized packaging materials can be calculated.
Hard packaging containers have the highest cost of purchase, followed by pure cotton cloth, but both types of packaging materials can be reused, diluted and added to the cost of cleaning each time the packaging costs are lower; paper / plastic bags and wrinkles The purchase cost of wrapping paper is relatively low, but because it is a one-time use, the actual packaging cost is relatively high; if considering the shelf life and sterilization cost after sterilization, paper/plastic bags and wrinkle wrappers have a validity period. Long, effective to avoid the advantages of repeated sterilization, the overall packaging cost is lower than pure cotton cloth and rigid packaging containers.
4 comprehensive application analysis
The above four kinds of sterilization packaging materials have their own advantages and defects, and the hospital has certain difficulty in selection. Pure cotton cloth has the defects of poor cotton dust pollution and bacterial barrier. It has certain risk of nosocomial infection. It has been basically eliminated in foreign hospitals, but pure cotton cloth is mainly produced in China, and has the unique advantage of low packaging cost. Moreover, the cleaning costs are usually digested inside the hospital, so domestic hospitals will be used in large quantities in the near future. Hard packaging containers have the same advantages as pure cotton cloths, and are widely used in hospitals at home and abroad. However, the rigid packaging containers used in China are relatively poor in structure and function, sterilization effect and aseptic storage effect. It is not ideal, and the hard packaging containers used in hospitals in some developed countries have excellent performance. The sterile storage period of the packaged equipment after sterilization is 3 to 4 years, but the price is expensive. It is rarely used in domestic hospitals. Therefore, it is hard. Packaging containers are not eliminated in domestic hospitals, but they need to be continuously improved. Paper/plastic bags are widely used in foreign hospitals. In recent years, they have been used in large and medium-sized hospitals in China. The advantages of packaging cost and bacterial barrier are obvious. It is an efficient new sterilization packaging material, just A special heat sealing machine is required to press and seal. At present, some domestic manufacturers have produced self-sealing paper/plastic bags, which can meet the needs of some small and medium-sized hospitals without heat sealing machine. However, the physical resistance of paper/plastic bags is relatively poor, and it is necessary to pay attention to the method of packaging and sterilization when using. Medical wrinkle wrappers have been widely used in foreign hospitals, and their packaging effect is obviously superior to that of pure cotton wraps. It has a tendency to replace pure cotton wraps. However, the current domestic hospitals use less, mainly because of the current packaging costs. It is too high, and there is no manufacturer in China. In addition, there is no uniform standard for its use and sterilization period, which limits its scope of use.
In summary, we believe that based on reducing the risk of hospital infection of sterilized packaging materials and controlling the cost of sterilization packaging, it is currently possible to flexibly use sterilized packaging materials, such as pure cotton cloth and rigid packaging containers for routine use only. And fast-moving equipment packaging, equipment that is not commonly used but long-term spare equipment is to use paper/plastic packaging bags as much as possible, while medical wrinkle packaging paper is mainly used for packaging of important equipment such as transplanting, precision, and microscopy. In addition, the medical wrinkle wrapper can be used in the inner layer of the device, and the outer layer is covered with pure cotton cloth, which not only effectively prevents dust pollution, but also controls the packaging cost. (Southwest Hospital, Third Military Medical University) 