what are the sterilization rules?

Sterilizing medical equipment helps protect against the risks of contamination, says Christophe Lambert, pharmacist and honorary president of the French Society for the Science of Sterilization (SF2S).

A lack of sterilization on the equipment of a dental surgeon in Cherbourg, in Manche, led to the screening of more than a thousand people. These patients are exposed to a low risk of transmission of hepatitis B, C, as well as HIV. Enot last October, 5,000 patients at the Tarbes-Lourdes hospital, in the Hautes-Pyrénées, were also invited to be tested after a default dental sterilization. “When the reprocessing measures and hygiene practices implemented during treatment comply with the recommendations, we can completely protect ourselves from the risk of infection”estimated Christophe Lambert, pharmacist, head of central sterilization at the Chambéry hospital in Savoie and honorary president of the French Society for the Science of Sterilization (SF2S). With him, franceinfo returns to the importance of sterilizing medical equipment to avoid contamination.

Sterilization of medical equipment regulated by several texts

In France, the reprocessing of reusable medical devices, that is, the sterilization of medical equipment so that it can be reused, is regulated. The decree of June 22, 2001 states “good hospital pharmacy practices” And “is applicable in health establishments, whether public or private”, recalls Christophe Lambert. Health professionals can also refer to the guide to good sterilization practices which is published by the SF2S. “There are specificities depending on the field of activityunderlines Christophe Lambert. If these texts are scrupulously respected, the risk of contamination is greatly minimized, even if there is never the absence of total risk.”

Steam sterilization for at least 18 minutes

The so-called medical devices “invasive” Or “reviews” are subject to sterilization. This is any medical instrument or equipment that “will penetrate a cavity which is not sterile, such as the mouth, or which will create an intrusion, that is to say pass through the skin”, explains Christophe Lambert. At the dentist for example, “the mirror, the drill, the probe will have to be sterilized between two patients”.

“The material can therefore be used, or reused, provided that it undergoes all stages of reprocessing”, continues Christophe Lambert. These steps are first “pre-treatment which prevents dirt, such as blood or mucus, from drying on the instruments”. The instruments are then washed, “either manually, or in a kind of washing machine called a ‘washer disinfector’. Once washed, we will put the clean equipment in packaging which we will sterilize with steam at 134 degrees for a minimum of 18 minutes, these are the mandatory parameters in France.” The material is then stored in its sterile packaging until its next use.

A risk of “cross contamination” in the event of poor sterilization

The challenge of properly sterilizing medical equipment is above all to avoid what we call “cross contamination” that is to say, preventing microbes from being unintentionally transferred from patient A to patient B. “These transmission risks are specific to the type of surgeryunderlines Christophe Lambert. In the context of dental care, the risk of transmission of the hepatitis B virus is predominant. This is why patients of the Cherbourg dentist must be screened for this disease in particular.

In hospitals, there are also nosocomial infections. The risks of transmission are different depending on an appendicitis operation, a gynecological procedure or cataract surgery, lists Christophe Lambert, who explains: “When you have surgery for a hip prosthesis, there is a greater risk of being infected by staphylococcus aureus which will develop on the prosthesis.”

Little controlled sterilization in France

In the hospital environment, nosocomial infections are well monitored, according to Christophe Lambert. But for liberal medicine, “the process is much more complicated”, estimates the pharmacist. In the event of infection, a patient can contact the regional health agency (ARS) which has inspection services which audit the practitioners concerned. The ARS also carry out random checks. But “there are very few in France, compared to Switzerland, for exampleunderlines Christophe Lambert, where all dental practices are subject to review by the health services.”

It was after an inspection carried out by ARS Normandie that the dentist practicing in Cherbourg was suspended from his right to practice, and more than 1,100 patients in his practice are encouraged to be screened for hepatitis B and C. as well as HIV.