Dressing material
Dressings include gauze balls, sponges, turundae, tampons, and bandages. The main raw materials are gauze and cotton wool. The material is used for hemostasis, wound drying, and drainage.
Critical properties of the material:
- High hygroscopicity.
- Biological and chemical inertness (no negative impact on healing).
- Softness and elasticity (to prevent tissue trauma).
- Resistance to sterilization methods.
- Minimal thread shedding (detached threads become foreign bodies in the wound).
To prevent fraying, the edges of the gauze are always tucked inward. For easy counting, sponges are tied in bundles of 10, and balls are packed in bags of 50–100. Used supplies must be incinerated.
Surgical linen
Surgical linen (gowns, sheets, masks, caps, towels) is made from cotton fabrics such as coarse calico (biyaz). Reusable items must have special markings and be washed separately.
Preparation features:
- Surgical gowns are sewn without belts and pockets.
- Sheets must be hemmed.
- Linen is folded into rolls — this allows it to be easily and aseptically unfolded before use.
Types of packing and drum handling algorithm
Materials are sterilized in special metal containers — drums (e.g., Schimmelbusch drum). There are three types of packing:
- Universal — a standard set for a typical minor surgery (e.g., appendectomy).
- Targeted — a specialized kit for a specific complex intervention (gastric resection, etc.).
- Procedure-specific — the drum is filled with only one type of item (gowns only, or sponges only).
Packing algorithm:
- Check the drum for operability.
- Line the bottom with an unfolded sheet so that its ends hang outside.
- Place the material vertically and loosely (so steam can freely penetrate inside).
- Place sterilization indicators inside (test microbes, thermometers, or melting substances).
- Fold the edges of the sheet over the contents, close the lid, and snap the lock.
- Attach an oilcloth tag with the date and the name of the responsible person.
Sterilization in bags and storage rules
In addition to drums, sterilization in cloth bags is permitted. The material is packed loosely. The bag is tied, placed inside a second similar bag, which is also tied.
Unpacking the bag: The orderly unties the outer bag and pulls its edges down. The scrub nurse, using sterile hands, unties the inner bag and removes the contents.
Storage of sterile material: After autoclaving, the drums are removed, the ventilation ports (grilles) are closed immediately, and they are transferred to a special table. Storage is permitted only in locked cabinets in a separate room. Joint storage of sterile and non-sterile items is strictly prohibited.
Briefly: answers to topical questions
What are the storage periods for sterile material in a drum with a filter and without a filter?
The shelf life of sterile material in an unopened drum is 48 hours. Information on specific shelf lives for drums with filters is not provided in the sources.
After removing the drums from the sterilization chamber, it is necessary to close their ventilation ports (grilles) immediately. Storage is carried out in special locked cabinets in a separate room, where the co-location of sterile and non-sterile materials is strictly prohibited. In soft cloth packaging placed inside drums, the shelf life can reach up to 3 days, whereas in bags outside the drum, it is no more than 24 hours.
What autoclaving modes are used for the sterilization of linen and dressings?
A rigorous steam sterilization (autoclaving) mode is used for the sterilization of surgical linen and dressings.
Parameters of this mode:
- Pressure — 2 atm
- Temperature — 130–132.9 °C
- Time — 20 minutes
The sterilization time countdown begins strictly from the moment the specified pressure is reached in the chamber. Packing the material into drums must be loose and free to ensure uniform distribution and access of steam to all items being sterilized.
What chemical and biological indicators are used to monitor sterilization in the drum?
Chemical substances with a specific melting point, thermal indicators, and biological tests are used to monitor sterilization in the drum.
- Chemical indicators — benzoic acid (120 °C), resorcinol (119 °C), and antipyrine (110 °C). The powder in ampoules is placed between the layers of material; upon reaching the required temperature, it melts into a solid mass.
- Single-use thermal indicators — paper-film strips that irreversibly change the color of the indicator mark.
- Mikulicz method — using a paper turned blue with iodine and starch paste, which decolorizes at high temperature.
- Biological indicators — test tubes with a known spore-forming non-pathogenic culture. They are placed deep inside the drum, and the absence of microbial growth confirms sterility.
Class and exam questions
Why are surgical gowns made without pockets and belts?
This is necessary to maintain strict asepsis: extra details complicate sterilization and can become a reservoir for infection or catch on non-sterile items.
Why are gauze edges folded inward when making surgical sponges?
To prevent thread shedding. Detached threads can get into the wound and become a foreign body, causing inflammation.
How should materials be packed into a sterilization drum (Schimmelbusch drum): tightly or loosely?
The material is packed loosely (fluffily) and vertically. This is necessary for the free passage of steam through the entire thickness of the pack during sterilization.
How long do materials remain sterile in an unopened sterilization drum?
If the drum has not been opened, its contents are considered sterile for 48 hours.
What else to study on this topic
- Types of sterilization indicators (thermometers, melting substances, test microbes)
- Organization of the sterilization room work
- Shelf life of syringes and blood transfusion sets
- Dressing material consumption for various types of surgery
Master the entire topic in the "General Surgery" course
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Other topics in the section "CHAPTER 2. ASEPSIS AND ANTISEPSIS"
Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.