After cleaning and washing, the instruments should be inspected, organized into sets, wrapped or packaged, and placed into the container for sterilization. Hinged instruments should be processed open or unlocked.

An indicator to determine sterility should be attached to the package as a way of verifying the sterilization status.

For unwrapped loads, at a minimum, an internal chemical indicator should be placed in the tray or cassette with items to be sterilized. Refer to manufacturer’s instructions regarding the use and correct placement of sterilization indicators. Packaging materials should be designed for the type of sterilization process being used.

RECOMMENDATIONS:

1. Use an internal chemical indicator in each package. If the internal indicator cannot be seen from outside the package, also use an external indicator.
2. Use a container system or wrapping compatible with the type of sterilization process used and that has received FDA clearance.
3. Before sterilization of critical and semi-critical instruments, inspect instruments for cleanliness, then wrap or place them in containers designed to maintain sterility during storage (eg, cassettes and organizing trays).