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Surgical Instruments Packaged In Linen-Wraps Versus Plastic-Paper Bags

      138 Faculty of Medicine Ramathibodi Hospital SHELF LIFE OF STEAM STERILLIZED SURGICAL INSTRUMENTS PACKAGED IN LINEN-WRAPS VERSUS PLASTIC-PAPER BAGS Srisiri S, Phummisirikul P, Pongchailerk P, Duangsomkit V, Phummisirikul P Department of Surgery, Ramathibodi Hospital, Bangkok, Thailand.

                    Background: In our institution surgical instruments are sterilized by steam sterilization (Autoclave) wrapped in two layered linen packaging. Unused items must be resterilized every 2 weeks. However they has been recommendation in various textbook that this method of sterilization has a reliable shelf life of 7 weeks. Meanwhile, it has been quoted that plastic-paper combination packaging of surgical instrument has an expired date of 1 year for instruments that are seldom used.

It is tempting to know whether sterilizing in linen versus plastic-paper packing is more cost effective                     Objective: To compare the duration whereby surgical instruments remained sterile after autoclaving between two-layered linen packaging and disposable plastic-paper packaging.                     Material and method: Orthopedic screws were used in this experiment to represent surgical instrument. Seven hundred and thirty eight screws were divided into 3 groups. 1 consisted of 360 screws which were individually wrapped in a two-layered linen packaging.

Group 2 also consisted of 360 screws individually contained in a disposable, heat-sealed, plastic-paper bag. Group 3 was the control and consisted of 18 screws which would not undergo any process of packaging and sterilization. All specimens in Group 1 and 2 were sterilized simultaneously by steam sterilization. All specimens were kept on open-shelf in the operative room without special treatment.

Twently sterilized screws were take from each of groups 1 and 2 for culture of both aerobic and anaerobic organisms every 2 weeks for the first 20 weeks and then every 4 weeks from the 20th to the 52nd week. One non-sterilized screw in group 3 was also cultured at the same time.                     Result: From the day of sterilization up to the 52nd week, not even a single screw in Group 1 and 2 showed any growth of organisms in either aerobic and anaerobic cultures. On the other hand, all screws in group 3, which were not sterilized, showed positive growth in aerobic culture.

                    Conclusion: Small surgical instruments sterilized in two layered linen packaging as well as in disposble plastic paper bag could remain sterile for at least 52 weeks. Whether either of these two means of packaging could last any loner beyond this period of time was to be found out by further experimentation. TWO METHODS OF TENDON REPAIR : AN IN VITRO EVALUATION OF TENSILE STRENGTH AND GAP FORMATION Wattanawong K. Division of Plastic and Maxillofacial, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Bangkok 10400, Thailand                     A comparative study of two method of tendon repair was performed on fresh cadaveric tendons.

The cross stitch epitenndinal suture technique with mokified Kessler core suture and the conventional epitendinal suture technique with mokified Kessler core suture were tested biomechani
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