Publicaciones

El Grupo de trabajo Tratamiento del Instrumental (AKI) fue fundado en 1976 con el objetivo de elaborar y publicar el conocimiento existente y la información orientada a la práctica sobre la preparación de instrumental del ámbito sanitario que garantice su seguridad y conservación. Con sus cuatro décadas de existencia, en 2016 el AKI no solo forma parte de la historia de la «preparación del instrumental», sino que también personifica el presente y constituye una inspiración para el futuro de nuestra especialidad en calidad de modelo para una cooperación interactiva y multidisciplinar.

Antes de la Segunda Guerra Mundial, la Central de Esterilización era el “apéndice” de Sala de Cirugía, el vestuario donde las mujeres auxiliares se reunían para doblar gasas y hacer vendajes. En la era de la posguerra, se levantó la necesidad de una Central de Esterilización Médica y Quirúrgica en todos los hospitales. Su responsabilidad primaria fue la esterilización de instrumentos y equipos, pero con el tiempo, le fueron agregadas otras funciones. (Wenzel, R. 1993)
Hacia fines de los ’70 se propuso la siguiente meta: la Central de Esterilización tendría el objetivo de proveer un servicio para mejorar el cuidado del paciente y mantener altos estándares en la práctica médica. También colaboraría con la administración hospitalaria protegiendo al personal de infecciones o accidentes, proveyendo un ambiente seguro para el empleado. (Wenzel, R. 1993)

All hospitals need to sterilize their equipment and supplies. Even the smallest hospital requires sterile surgical instruments for minor procedures, and sterile dressing materials. If a hospital has a full surgical unit, the sterilization of surgical instruments and linen, together with dressing materials for the wards and operating theatre, plays a key role in infection control.
In medical facilities supported by the ICRC, care must therefore be taken to provide safe, sterile surgical material and safe blood for transfusion. This is all the more important when the ICRC is working in a general hospital setting where elective or semi‑elective surgery is a routine part of the workload.

The Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008, presents evidencebased recommendations on the preferred methods for cleaning, disinfection and sterilization of patientcare medical devices and for cleaning and disinfecting the healthcare environment. This document supercedes the relevant sections contained in the 1985 Centers for Disease Control (CDC) Guideline for Handwashing and Environmental Control.

New disinfection methods include a persistent antimicrobial coating that can be applied to inanimate and animate objects (Surfacine), a high-level disinfectant with reduced exposure time (orthophthalaldehyde), and an antimicrobial agent that can be applied to animate and inanimate objects (superoxidized water). New sterilization methods include a chemical sterilization process for endoscopes that integrates cleaning (Endoclens), a rapid (4-hour) readout biological indicator for ethylene oxide sterilization (Attest), and a hydrogen peroxide plasma sterilizer that has a shorter cycle time and improved efficacy (Sterrad 50).

Ethylene oxide (EO) is a well-known sterilizing agent. However, only recently has its use significantly emerged, based on its range of applications in the field of new medical device development and sterilization. This paper describes the progress in terms of EO sterilization and concludes that it remains a promising field to explore and develop. The EO action mechanism and toxicity are analyzed, and a critical analysis is made on how it is possible to use EO sterilization for medical devices advantageously, with emphasis on cycle design and validation.

Health care-associated infections (HAI) are acquired by patients while receiving care and represent the most frequent adverse event affecting patient safety worldwide.
Recent work by the World Health Organization (WHO) shows that surgical site infection (SSI) is the most surveyed and frequent type of HAI in low- and middle-income countries and affects up to one third of patients who have undergone a surgical procedure. Although SSI incidence is lower in high-income countries, it remains the second most frequent type of HAI in Europe and the United States of America (USA).

Globally, hundreds of millions of people are affected every year by avoidable infections in health care (health care-associated infections, HAIs). The determinants of HAI are influenced by a complex combination of gaps in policies, infrastructure, organization and knowledge, defects in health care workers’ behavior, and patientrelated factors. Through knowledge, best practices and infrastructures improvement, infection prevention and control (IPC) aims to prevent harm due to HAI to patients and health workers.