置入性器械不应使用快速消毒锅灭菌的出处

空紫

国手术室护士注册协会（AORN）
Recommended Practice for sterilization in the Perioperative Practice Setting-2006
手术室灭菌推荐性操作指南－2006年版
Recommended practice IV
Flash sterilization should be used only in selected clinical situations and in a controlled manner. Use of flash sterilization should be kept to minimum.
1, Flash sterilization should be used only when there is insufficient time to process by the preferred wrapped or container method. Flash sterilization should not be used as a substitute for sufficient instrument inventory.
6, Flash sterilization should not be used for implantable devices. Implants are foreign bodies, and they increase the risk of surgical site infection. Careful planning, appropriate packaging, and inventory management in cooperation with suppliers can minimize the need to flash sterilize implantable medical devices. When an implantable device is sterilized at a health care facility, a biological indicator should be run with the load and the implant should be quarantined until the results of the biological indicator are known. If an emergency situation makes flash sterilization unavoidable, a rapid-action biological monitoring device should be used along with a class V chemical integrator. The implant should not be released until the rapid-action indicator provides a negative result. After the rapid-action negative result is obtained, the implant can be released for use in the immediate situation. If the implant is not used, it cannot be saved as sterile for future use. Resterilization of the device is required. If the biological indicator is later determined to have a positive result, the surgeon should be notified as soon as the results are known.
推荐性操作IV
快速灭菌应该在严格控制的操作下，在某些特殊的情况和环境中使用。快速灭菌的使用应该尽量避免。
1，只有在推荐使用的常规打包或者硬质容器灭菌不能满足处理上时间的要求时，才考虑使用快速灭菌的方法。快速灭菌方法不能做为器械数量和库存不够的解决和替代方法。
6，快速灭菌不能使用于植入物的灭菌处理。植入物做为异物，可增加外科手术部位感染发生的可能性。细致的计划，合适的包装，与相关供应部门协调的库存管理可以最大限度的减少在植入物处理中使用快速灭菌的方法。当在医疗机构中进行植入物灭菌处理时，含有植入物的该装载必须进行生物监测，且植入物需等到生物监测结果得到后才能放行。如果特殊紧急情况发生，必须对植入物进行快速灭菌，必须使用快速型生物监测系统配合第5类化学指示物。植入物必须等到快速型生物指示物结果出来后且为阴性才能放行。在快速型生物指示物结果为阴性后，植入物可立即放行进行使用。如果该植入物此时没有使用，不能对其进行无菌保存以备将来使用。该植入物必须进行重新灭菌。（在提前放行的情况下，）如果生物指示物提供阳性结果，必须尽快告知外科医生。

珍爱生命

谢陈老师，以前只知道置入性器械不应使用快速消毒锅灭菌 ，但不知道为什么要这样做。现在明白了。