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Sterilized water in Autoclaves?

Discussion in 'United Kingdom' started by C Bain, May 27, 2005.

  1. C Bain

    C Bain Active Member


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    Hi All,

    In another place sterilized water is being discussed regarding contaminated water, (Pathogens and the like!), and Autoclaves!

    Has anyone any views on the autoclaves from well respected companies in the UK. and there inability to sterilize their own water in the sterilization processes'?

    The use of Ionized/sterile water and the like was the norm to prevent damage to the Autoclave surfaces. If these autoclaves are now shown to be unable to sterilize their own water, what chance is there for sterilizing the instruments placed in them? I don't believe that I'm writing this here never mind the claims made in other places!!!

    Taking a leaf out of someone else's book here, "How say you?"

    Regards,

    Colin. (Do we believe this?).

    P.S. I am quite prepared to look foolish here, this is to important not to be discussed I think!
     
  2. summer

    summer Active Member

    Sterilized Water

    Actually, I don't know about not being able to sterilize their own water, but I do know this ....... At one time we used regular tap water in ours. Eventually it ruined the autoclave. With our new one we use the drinking water we bought in the cooler from the water company for the waiting room. Also good in theory, but a bad idea.......Learned our lesson well. Used deionized or sterilized water so as not to ruin the instrument!!!!!!!!!!!!!!!!!
     
  3. Robin Crawley

    Robin Crawley Active Member

    Hi Colin!

    I too have been thinking about this...

    Today I treated my Dentist's feet.
    I asked him about sterile water. He knew about it, but currently uses de-ionised water in his autoclaves.

    However, he did say that there is concern about CJD Prions not being killed. He also mentioned about endotoxins etc in the water, as the study we read elsewhere states.

    Interestingly he said that some companies are very soon going to sell a new type of steriliser that utilises ozone, and is supposed to be more effective than autoclaving. He wants to read more independent reserch before spending the money though, as they probably won't be cheap.

    The study about Sterile Water comes from the Society Website (I'm very reliably informed). I believe it. I don't yet do it though, however I will if it becomes the norm, and it becomes widespread in dentistry and podiatry.

    I DO know that they used sterile water in my local nhs Podiatry dept before they went on to using hsdu sterilisation.If this becomes the norm I think it would cost approx £1 a litre bottle. So basically £1 to sterilise a batch of instruments.

    This would not break the bank, but is another reason for people to stop charging stupid low fees.

    Cheers,

    Robin.
     
  4. C Bain

    C Bain Active Member

    Distiller!?

    Hi Robin

    My supplier Chiropody Express has just recently put a Rotajet Water Distiller into their Catalogue for £145.00, (Four litres/hour!). I was wondering why! I think you have the answer! Yet one more piece of expense to budget for as you say with a price rise?

    The Ozone sounds interesting? Never heard of that one before, usually expensive at first of course, but still interesting.

    I have been using de-ionised to date! think it might be time to move up one?

    Regards,

    Colin, (Four litres/hr. I wonder what it tastes like?).
     
    Last edited: May 28, 2005
  5. C Bain

    C Bain Active Member

    Thank-you Summer,

    Your experience sounds nasty! Proves the advice by Prestige regarding tap water etc. was right!

    Regards,

    Colin.
     
  6. dmdon

    dmdon Active Member

    I use purified (de-ionised) water which I purchase from my local chemist, about 2 quid for 5 litres, I put the required amount of water plus some, through for one cycle, then run it again with instruments....is this wrong?....I have no idea! :confused:

    Is it a sensible way of proceeding, taking 'all reasonable and practicable' ways of guarding against contamination taking into account the procedures I do....yes I think so. :rolleyes:

    Cheers

    David

    Now please excuse me while I run for my protective armour and hat. :eek:
     
  7. C Bain

    C Bain Active Member

    Deionized Water!

    Hi David,

    Yes exactly my present practice! Slight variation depending on pressure of work, laterly I use Battery top up water from Halfords. De-ionised water safe for Irons, Lava lamps and airconditioning units! It leaves perfectly clean smooth surfaces in the Autoclaves!

    This sterilization cleaning and just under 400 degrees Cent. on working surfaces immediately before use has always served me and the patients well up to now, (Plus the rest of the normal cleaning cycle of course!).

    I have seen somewhere that CJD requires 600 degrees Cent. to kill all. A very very low risk I believe was the conclusion. Just maybe this has been dustbinned now also?

    Regards,

    Colin.

    P.S. I run a water sterilization check first too, before instrument runs!
     
  8. dmdon

    dmdon Active Member

    400 degrees C :eek: ............YIKES! thats hot!

    126 here!

    Cheers

    David
     
  9. C Bain

    C Bain Active Member

    Hot-air Sterilization as point of Last Resort, The Patient!

    Hi David,

    Yes, sorry, my Autoclaves work at 126 to 129 degrees Cent. like yours! Silly me, 400 degrees Cent. refers to a hot air sterilizer used at the application of the whatever, to be used on the patient. Must remember to count while talking to the patient, however, and check physically for drop in temperature or the patient might just forget all about her corn! In fact you must stay awake with this form of sterilization or the end of the Blacks file might fall off, embarrassing, what!!!

    Regards,

    Colin.

    P.S. Have experimented with 2175 Butane Propane Mix Gas (New version of an old type paint stripper! Good on the lab. bench but I fear deeply worrying to the patient if applied on the front room carpet.)? Not practical I think except in the Sterilization chain when you have doubts of where you have had your contaminated instruments of course!

    Butane/Propane is operating at 1,200 degrees Cent. {Would you believe it I've never actually checked it, I must get the Thermometer out!}. One of the secondary draw backs to this one is if you are there for more than two or three seconds it just does not blunt the cutting edge it melts it, not to good you know on your instruments???).

    However, it is twice the killing temperature for CJD, (MRSA. I believe stands no chance)!!! I'm still working on it?
     
    Last edited: May 29, 2005
  10. DAVOhorn

    DAVOhorn Well-Known Member

    re sterile water

    Dear All,

    the article was put onto the SCP web site by Gordon Burrow.

    He has also put it onto the THATFOOTSITE web site.

    My PCT has used CSSD for about 6 weeks now.

    our autoclaves will be gone in the next 2 weeks.

    When i had a private practice i used CSSD for the last 2 years.

    It is not cheap but it saves so much time.

    We used in my PCT Sterile de ionised distilled water as per the article. We used it for the last 3-4 years.

    The SCP publish minimum standards for its members for Infection control and the Cleaning decontamination and sterilisation of instruments.

    I would imagine the other professional bodies would impose comparable minimum standards on their members.

    This is a very important part of our job in protecting not only ourselves but also our patients from potential infection, exposure to pathgogens.

    The reason for following the guidelines is not to prolong the life of your autoclave. This is a byproduct of the guidelines.

    If your autoclave is all crapped up then so are your instruments that you use on your patients.

    The autoclave must use a fresh load of the sterile water for each cycle and the previous water must be drained from the autoclave prior to refilling with fresh water for each cycle.

    The main benefit of using CSSD, apart form the patients really love it, is the time you no longer use cleaning and autoclaving your instruments .

    The time saving is marked, and leads to more of the appt time being used for the tt of the pt which is what the pt is there for.

    regards David :D
     
  11. C Bain

    C Bain Active Member

    Cssd???

    Hi David,

    Very useful article from you, as usual, but with one question? I cannot for the life of me work out CSSD? I can usually work something like this out by process of elimination but not this one? What is CSSD, before the little grey cells expire on me?

    Regards,

    Colin.
     
  12. DAVOhorn

    DAVOhorn Well-Known Member

    re sterile water

    Dear Colin,

    Sorry.

    CSSD = Central Sterile Services Department

    HSDU = Hospital Sterile Disinfection Unit

    These are the 2 names that Hospital instrument streilisation departments go under.

    Hope this helps.

    regards David
     
  13. C Bain

    C Bain Active Member

    Hi David,

    Thank you for that! It did not occur to me that you were referring to the Central Services Units. I assume by this that you will be getting sealed sterile packs of instruments now, Lucky fellow!!! Now that is an advantage of a large group like the NHS. isn't it!!!

    Regards,

    Colin.
     
  14. One Foot In The Grave

    One Foot In The Grave Active Member

    The autoclave manufacturers tell us the (distilled) water needs to be changed monthly....

    Must read the relevant sterilising standard on Monday to double check what they say...
     
  15. DAVOhorn

    DAVOhorn Well-Known Member

    re sterile water

    Dear Colin,

    For the last 2 years that i ran my private practice i used CSSD.

    I loved it .

    It cost about £2.17 per instrument pack as a cycle charge. I did not own the instruments so it was a rental and cycle charge that i paid. It also covered replacement of worn or damaged instruments.

    I would recommend it to any one in PP.

    regards David
     
  16. C Bain

    C Bain Active Member

    Hi David,

    Thank you for the information! It is something to look into up here? It will take a lot of preparation time out of the Early morning start up each day!!!

    Regards,

    Colin.
     
  17. David Smith

    David Smith Well-Known Member

    sterilisation /sterile water

    I just wondered how many out there regularly or ever have patients return with infections that were the result of poor sterilisation of instruments.
    There are many ways in and beyond our control that a wound can become infected and I think worrying about the tiny risk of infection due to pathogens that may be left in the 'sterile' water in the autoclave borders on paranoia. Manufacturers and retailers would love us to keep replacing our current equipment with ever more expensive stuff. Risk assessment means just that not risk elimination. Mrs Jones who wants her nails cut won't be prepared to pay £50 a go just because you have to keep up the payments on your unneccessary equpiment. So she will be down the road at the nearest Foot Health Proffesional's clinic who takes a more sensible view and only charges 20 quid.

    Just my view Dave Smith
     
  18. C Bain

    C Bain Active Member

    An Open Mind!

    Hi Dave,

    Hear, hear to that! I wonder whether 'paranoia' is a general symptom of our society, (The English Society I find myself living in today?).

    Vigilance should always be the NORM, and great care should be taken with instruments! So what has changed over the years? A shown pattern of infection in my patients after treatment, perhaps? No not in my case and that includes patients who have disappeared after the first treatment only to return years later! The reason for their disappearance was, because they were healed!!!

    Quote, "Risk assessment means just that not risk elimination." Enlightened thinking perhaps, I trust that the majority of us carry out safety with maturity brought about by experience as well as by the art and science of sterilization.

    For example after cleaning out an infected corn cavity with something as simple as Hydrogen Peroxide and sometimes a 1v gouge, a drop of Lavender/Tea Tree/Lemon, all Essential oils, into the cavity followed by layerings of,

    1. Betadine.

    2. Acriflex/Anaflex.

    3. Zinc and Caster Oil etc.?

    And the like where appropriate, (Old fashioned remedies!), on the dressings and the skin! Confuse whatever is there to death, whatever it is? No not the toe, the pathogens and the like! Because I find that they work much better than some of the more modern poisons! It keeps the patient away from the doctor and anti-biotics, in most cases! The doctor being the point of last resort!

    Of course I haven't got the pressure of high patient turn over that exists in such places as the NHS. For example, follow up is expected by my patients as part of the normal treatment without due expense being incurred. They are not left on their lonesomes with the effects of the pain in the foot still persisting occasionally as the tissues repair themselves!?!

    On going care as you have pointed out Dave without pricing yourself out of the market. I've gone slightly off the subject, perhaps, so whats new!!!

    Regards,

    Colin.

    PS. My training was as you might have guessed, normal but private chiropody with a leaning towards Alternative therapies thrown in and taught by experienced staff. I know that this might upset some people but these therapies, (Granted not all!), have always been used by my people to supplement the short comings of Orthodox Medication!
     
    Last edited: Jun 25, 2005
  19. DAVOhorn

    DAVOhorn Well-Known Member

    re sterilised water

    Dear Colin,

    Today in the world of Medicine and Professions Allied to Medicine we have evidence based practice.

    We also have peer review.

    If anyone is using medicaments and complimentary therapies in the treatment of infections wound care then GOD HELP you.

    Many of the potions used when i trained have been found to be toxic and or just down right bloody dangerous.

    Here i am with a mouth full of Mercury Amalgum.

    That is a throny subject in the world of Dentistry and yet for years this was considered good practice.

    Hydrogen Peroxide i thought nobody used this today to clear wounds. or irrigate a pocket of pus.

    Most today use Sterile saline. Believe it or not there are arguments over this and even a what temperature the saline is used at.

    The use of essential oils is one i still have problems with. Especially the source of these products.

    What is Anaflex licensed for? Do you use it as it has been licensed. As you can tell i do not use it .

    Poultices ?????

    A friend does use Larval Therapy on his diabetic ulcers, but this is now evidence based and considered an excellent modality.

    So we have to be careful with what we slap on our patients feet, and must be aware of the risks and potential complications of using potions for which there is little or no evidence to support thir use for that condition.

    This week my PCT will be entirely AUTOCLAVE FREE.

    They have all gone to the big scrap yard in the sky. We are now HSDU CSSD fully compliant.

    I am very happy with this, as running an autoclave safely and responsibly is extremely time consuming.

    So more of our clinical time is now spent on just that, treating our patients.

    regards David :)
     
  20. Nikki

    Nikki Active Member

    Our Trust has been using sterile water in the autoclaves for about 2 years now. We have to empty the chambers at the end of every working day (or session) and leave empty. We are planning on changing to CSSD within the next 2-3 years.
    Regarding sterility of instruments and cross infection, it doesn't matter which method of sterilization is used, the instruments only remain sterile so long as the autoclave door stays shut, or the CSSD pack stays unopened. As soon as the door or pack is opened the instruments are now only disinfected, unless you are in a totally sterile environment. At the end of the day it is down to minimising risk as much as practically possible.

    Nikki
     
  21. C Bain

    C Bain Active Member

    Reply to DAVOhorn Post No.1.

    Hi David,

    I was in the last para.'s of a rather long reply to you when the whole thing vanished? Definitely Peaked to the nth. degree!!! I think it is important to me, as I hope relevant to you to try to post it to you again! I intend unless it offends you or Admin. to give you it in parts providing your forbearance can hold out that long of course? I'm not going to risk getting so far down the Page again! This was offline at that???

    Regards,

    Colin. (It makes you sick doesn't it!).
     
  22. C Bain

    C Bain Active Member

    DAVOhorn Post No.2, (2nd. Attempt).

    Hi David,

    Yes in the main I use normal ointments like everybody else!

    There are a small number of exceptions such as Hydrogen Peroxide (HP.10vols.), Nurses have to deal with 2"ulcers, the practice of pouring HP. into these I believe ceased a few years ago? It would make me very nervous if I started pouring HP. into or onto anything! However, one drop onto or into a corn cavity followed by one drop of,

    1. Lavender.

    2 Tea Tree.

    3. Lemon.

    Thus reducing 10vol. to about 3 or 4vols. this is under visual control and does not concern me in the least, (It's about the same as HP. in honey!). It should go without saying that if you have not a trained working knowledge of the dangers of Essential oils DO NOT DO IT! My training allows me to use a certain restricted group of oils. It does not make me an Aromatherapist!

    The book explaining the part of that which I was trained to do is found in,

    Aromatherapy for Health Professionals.

    Shirley and Len. Price.

    Churchill Livingstone.

    London. 1995.

    Regards,

    Colin.

    PS. Well lets see what happens this time? When I press Spell Check last time a new Yahoo Screen appeared identical to Google, strange???

    PPS. In respect of Essential Oils.

    Only the purist maybe bought and used in wound treatment. I use Gerard House Products and also Holland & Barrett with Gerard sometimes for Tea Tree, [Herbal Authority 100% Pharmaceutical Grade, Straight from Australian Company looking at the Tea Tree bush on the box!).

    The same standard applies to oils and herbs that applies to normal pharmaceuticals, my stuff found in the local chemist and up to standards always.
     
    Last edited: Jun 26, 2005
  23. C Bain

    C Bain Active Member

    DAVOhorn Post No.3. (Now there is a miracle!).

    Hi David,

    SALINE.

    Saline, why waste your time with salt when you can have Magnesium Sulphate or even Epsom Salts with a spoon full of sugar.

    Or even Sugar and Soap? The miners wives up here can clear an infection in twenty-four hours flat with it! I daren't use it, I cannot find a sterile soap - Anyone?

    Saline good for washing and cleaning but no good for me in getting control of a cavity or the like!

    MERCURY!

    Yes your quite right about Mercury, I once knew a Detective Chief Inspector who you had to be very careful what you said to him and the like? We reckoned that it was twenty years throwing Mercury Fingerprint Powder about in all kinds of weather! Of course all his hair may not have fallen out because of this, (I wonder whether that is why my hair is thinning?). It might have been his daily whiskeys and rum that really did it!

    Following on from this, I had a Station Inspector in the early 1980's who travelled at 30,000 feet and 70mph. around the Station.

    He was very thin! We considered total insanity as a diagnosis? The local dentistry came to a conclusion one day and removed all the Mercury Amalgam from his teeth! You know he really had a lot of it! After that we concluded that he was only half-mad!

    David, how is your speed down the middle of the Department? Maybe it might be time for a change in fillings?

    Regards,

    Colin. (Half way there!).
     
  24. C Bain

    C Bain Active Member

    DAVOhorn Post No.4.

    Hi David,

    ANAFLEX.

    Main use is into the nailgrooves of nails or where infection maybe lurking.

    Anaflex is POLYNOXYLIN 10% concentrate.

    Others in formula,

    1. Polyethylene glycol 4000.

    2. Polyethylene glycol 400.

    3. Goldrose (Perfume).

    Polynoxylin is an antimicrobial agent which is active against a wide range of bacteria and fungi.

    The activity helps to keep minor cuts and scrapes clean - helps to heal.

    Manufactured by Geistlich Pharma,CH-6110, Wolhusen, Switzerland.
    UK. Geistlich Sons Limited, Long Lane, Chester.
    (It is in most of the Private Chiropody Catalogues!).

    Regards,

    Colin.

    PS. Information for Anaflex from it's information sheet, A notable Contra. It is not to be used in deep wounds!
     
  25. C Bain

    C Bain Active Member

    DAVOhorn Post No.5. (Last one hopefully?).

    Hi David,

    When I first started, maybe over ten years now? I followed my training to the letter. It soon became apparent that I was in danger of getting a reputation with the local doctors.

    I cleaned out the minor skin infections on toes. Used the treatment in my original Post above and sent the patient to his/her doctor. When she got there after a day or two and the doctor examine the patient there was nothing there. Patient back with me telling me the doctor with question, "Where is it?" That is mainly why I resolve my own problems before sending the resistant ones to doctor for antibiotic.

    One last practice case in a residential home where a nurse was doing her best with a toe full of pus and white blood cell residue passed it on to me with the patients blessing,. Nurse had intimated that the toe might have to come off. The treatment repeated twice more within three days over the bank holiday. Have you noticed it's always a bank holiday! Nurse returns, nothing to see, toe normal as though there has never been a problem! Very gratful she was!

    But that doesn't mean that there will ever be a time when such as I will never need the help of the doctor and his nurse plus anti-biotics!!!

    Regards,

    Colin. (I hope our journey has really been necessary.).

    PS. Admin. Sorry but I've only used sterile twice and it had nothing at all to do with sterilization, or had it?
     
  26. C Bain

    C Bain Active Member

    Reply to Nikki.

    Hi Nikki,

    A perfect post. Could not agree more with you on your understanding of,

    Sterilization - Disinfection.

    That is why I use a converted Bosch paint stripper at 400 degrees C.

    7 to 10 seconds depending on the volume of metal.

    I would like to think sterile but a High State of Disinfection I suspect.

    Must not give more than 10sec., however, or the end of the Blacks File will fall off and set fire to the front room carpet!!!

    Regards,

    Colin.

    PS. Appologies for appearing to ignore you on what is a very lucid point.
     
    Last edited: Jun 26, 2005
  27. DAVOhorn

    DAVOhorn Well-Known Member

    re paint stripper

    Dear Colin,

    Do you really use hot air as a disinfection agent??????

    I could understand it if you used a flame to burn the crap off an instrument but that would leave ash and residue as products of combustion.

    I cannot believe that that is what you use on your instruments.

    ALL PROFESSIONAL BODIES HAVE MINMUM STANDARDS and to knowlingly and deliberately work outside those guidelines and protocols means that your professional indemnity insurance is null and void.

    I can imagine what my NHS infection control team would make of your conduct.

    It is because of them and Govt guidelines that the professional bodies have minimum standards. For us in my PCT that means CSSD HSDU and tracing of instruments from the patient on which they were used right through the whole system of :

    Washing Rinsing Ultrasonic Cleaning Rinsing Autoclave at 134C 36psi 3 minutes holding time If i remember correctly. The instruments are supplied in a pouch so sterility is guaranteed for up to approx 3 months provided seal on pouch not damaged.

    If you have a bottle of a medicament as soon as the bottle is opened the contents are no longer sterile. This is why nearly everything used today is for single use only.

    Innoculating an infected wound with contaminated medicaments, denatured preservatives and active ingredients is not what is done.

    I find a lot of what you say you do interesting.

    Why do you keep saying MY TRAINING WAS IN PRIVATE CHIROPODY.

    I do not understand the inference in that statement.

    Instrument sterilisation and infection control should ALWAYS BE THE SAME regardless of the organisation that provided the training.

    I have always been told that SMAE was rigorous in its training in these extremely important matters.

    Certainly when i trained At Plymouth School Of Podiatry IT WAS EXTREMELY IMPORTANT.

    In fact when i qualified and joined the NHS it was about 18 months after qualifying that the orgainsation i worked for adopted Autoclaves. WE had been using disinfection of instruments only. So Plymouth in its training was years ahead of the NHS in its infection control policies.

    Saline at the same salt concentration as the fluids in the body is supposed to have a minimal impact on the body fluids salt concentration hence minimal impact on tissues. Or so the theory goes.

    regards David
     
  28. C Bain

    C Bain Active Member

    Continuous Sterilization for a High State of Disinfection!

    Hi David,

    The use of hot air sterilization is at the point of contact with the patient! This is after,

    1. Washing and physically cleaning.

    2. Ultrasonic.

    3. Autoclaving.

    One two and three have already taken place and happened to my instruments before they are transported to where the patient is. I assumed that you would have understood this, I didn't think I had to spell it out?

    So the use of hot air at this time at 400 degrees is on already clean and sterilized instruments. Hot air is the point of last resort in the system. As Nikki has pointed out open the pack and the instruments are no longer sterile on their working surfaces before use! Hot air is yet a last resort before use. I am confidant that this is an insurance against possible last minute contamination and it works. Not all working areas and floors are as clean as a hospital clinic's floor.

    Is there a problem in this?

    Regards,

    Colin.
     
  29. Where?
     
  30. Sean Millar

    Sean Millar Active Member

  31. C Bain

    C Bain Active Member

    Mark!

    Hi Mark,

    You need your crystal ball again! The PPS. was added almost immediately? It was missed out of the original Post because of difficulty Posting from this end yesterday. Somebody may have been performing maintenance on one of my search engine's???

    Regards,

    Colin.

    What Post No. was it on?
     
    Last edited: Jun 27, 2005
  32. DAVOhorn

    DAVOhorn Well-Known Member

    re hot air

    Dear Colin,

    I did miss understand what you meant.

    regards David
     
  33. DTT

    DTT Well-Known Member

    Hi All

    I have a Prestige century 3 vacuum autoclave which I use in conjunction with an ultrawave ultrasonic cleaner (including cleaning fluid) the method is as David described above .

    I have enough instrumentation to last through a weeks work so today (Sunday) is my instrument cleaning day and yes everything is numbered with the printer read out and if not used in 3 months is re sterilised.

    Do I use sterile water ? no just deionised . The manufacturer told me at the installation instruction it was practitioner choice as nothing at the time was clinically proven . The autoclave goes through its own test cycle (printed) everytime it is used so if a fault occurs the cycle is aborted.

    I believe I am taking all reasonable measures to protect my patients unless in the passing of time research proves otherwise . It does not however protect the patient from post operative infections from bacteria filled shoes , bad personal hygiene , going into hospital and picking up some infection there or a total disregard of any instructions I gave !!

    The cost per pack ?? I don't know I have never bothered to work it out my way is , if I need it I do it myself then I know it is done properly and there is no one else to blame should a problem occur and the cost is built in to my fee anyway ( IPP = profit and loss business rules).

    But there again perhaps thats why my patients are happy to pay my fee ??

    Cheers

    Derek ;)
     
  34. betafeet

    betafeet Active Member

    David looks like the only way forward is CSSD for instrument tracabilty, I think the time taken up with the new guide lines will out way the cost. So would like to know of available commersial companies who will supply private practioners, and could anyone tell me of there experiences. (spell check would be helpful on this site).

    Jude
     
  35. jeffcole

    jeffcole Welcome New Poster

    hi
    I also use a Prestige Autoclave & Ultrasonic cleaner. I use de ionised water, what would I use sterile water for when its heated to 134C.
    CJD is an unknown quantity as yet I'm not sure any autoclave can sterilize against it.I'm not even sure there is a method of sterilization that wo't destroy the instrument, hence the instrument tracking in hospitals.
    Jeff
     
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