LOW TEMPERATURE

PLASMA STERILIZATION

By : Yara Safwat , demonstrator of microbiology Supervised by : Prof. Dr Amina Noureldin

INTRODUCTION

Plasma is an advanced technology for safe low-temperature sterilization. Plasma was first discovered by Irving Langmuir in 1928. This new sterilization technology was patented in 1987 and marketed in the United States in 1993.

PLASMA THE FOURTH STATE OF MATTER

* Plasma technology is based on a simple physical principle. Matter changes its state when energy is supplied to it: solids become liquid, and liquids become gaseous.

* If even more energy is supplied to a gas, it is ionized and goes into the energy-rich plasma state, the fourth state of matter.

HOW IT IS GENERATED?
* Gas plasmas are generated in an enclosed chamber under deep vacuum using radio frequency or microwave energy to excite the gas molecules and produce charged particles, many of which are in the form of free radicals.
* A free radical is an atom with an unpaired electron and is a highly reactive species.

HOW IT ACTS ?

Free

radicals are produced within a plasma field that are capable of interacting and destroying essential cell components (enzymes, nucleic acids) and thereby disrupt the metabolism of microorganisms.

AT THE MOLECULAR LEVEL

* Most of the research in plasma sterilization pertains to volume discharge. * E.g. spores are basically made up of simple atoms like C, O, N, H. The free radicals react with these atoms to form simple compounds like CO2, which can subsequently be flushed out. * When the organism loses such atoms that are intrinsic to its survival, it dies.

WHY PLASMA TECHNOLOGY?

o It

has been developed to be ideal for sterilization of delicate , heat sensitive , moisture sensitive reusable medical devices.

ADVANTAGES
Controlled

Hydrogen Peroxide dosing. Large chamber size with a choice of two sizes. Better versatility for different loads. High volume load. High sterilization capacity and flexibility. Large coloured multi language touch screen for constant critical multi-parameter monitoring. Suitable for delicate & Heat/Moisture sensitive. device like endoscopes, ophthalmic instruments and others.

ARRANGEMENT OF ARTICLES

The materials to be sterilized are wrapped and placed on the shelves in the chamber and processed through the sterilization cycle. They are typically placed into a tray covered with a double layer of nonwoven polypropylene fabric wrap. They must be thoroughly dried first. Excess moisture in the instrument load will prolong the evacuation phase because of continued evaporation of the moisture and can lead to cancellation of the cycle.

5 CYCLE PHASES
1- vacuum, 2- injection, 3- diffusion, 4- plasma, 5- vent cycles.

CYCLE

DETAILS

1- During the vacuum stage, the chamber is evacuated to 0.3 mmHg pressure. 2- A dose of liquid peroxide is then injected into the evacuated chamber through a heated injector nozzle, which both evaporates the aqueous hydrogen peroxide solution and disperses it into the chamber.

CYCLE
N.B.

DETAILS

2-a- The chamber temperature is controlled at a point somewhat warmer than room temperature, not exceeding 4045C, to reduce the chance of condensation. 2-b- The chamber pressure rises slightly during the injection phase as the hydrogen peroxide evaporates. The process can be considered fairly dry, since the relative humidity stays between 6 and 14%, and the equilibrium vapour pressure of water at 40C is about 60 mmHg.

CYCLE
3-

DETAILS

During the diffusion phase (approximately 50 minutes in duration), the hydrogen peroxide vapour is allowed to permeate the chamber and completely expose all surfaces of the load to the sterilizing agent. At the completion of the diffusion phase, the chamber pressure is reduced to 0.5 torr, and the radio-frequency plasma discharge is initiated, which lasts for 15 minutes.

N.B.

CYCLE

DETAILS

4- In the plasma state, the hydrogen peroxide(H2O2) vapour breaks apart into reactive species that include microbicidal free radicals {e.g., hydroxyl (HO) and hydroperoxyl (HOO) } are generated.

CYCLE
N.B.

DETAILS

The combined use of hydrogen peroxide vapour and plasma safely and rapidly sterilizes most medical instruments and materials without leaving toxic residues. Following the reaction, the activated components lose their high energy and recombine to form primarily oxygen, water, and other nontoxic by-products.

CYCLE

DETAILS

5- In the final phase, the chamber is vented to atmosphere through a high-efficiency particulate air (HEPA) filter re evacuated, and vented again.
N.B.

The vapour purged from the chamber is vented to the atmosphere through a catalytic filter to decompose all remaining traces of hydrogen peroxide into water and oxygen vapour.

CYCLE

GRAPH

1- Pre Vacuum 2- Deep Vacuum & Plasma 3Sterilization with Hydrogen Peroxide 4- Aeration 5- Vacuum & Plasma 6Sterilization with Hydrogen Peroxide 7- Aeration 8- Vacuum with Plasma for residual removal 9- Aeration

MONITORING CYCLE EFFICIENCY

o

Using a biological indicator with a population of 106 spores, we can certify the effective reduction of the bio-burden and the achievement of the sterile status of the load. The sterile status of the loads are protected by proper storage.

EFFICACY TESTS ARE PERFORMED WITH A STANDARD KIT OF SPORES OF GEOBACILLUS STEAROTHERMOPHILUS ATCC 7953, ON STRIPS
POPULATED WITH

106 SPORES.

COMPATIBLE MATERIALS
They

should possess hydrophobic character, chemically stable, and resist oxidation and moisture. e.g. * Metals Stainless steel 300 series, Aluminum 6000 series, Titanium * Non-metals Glass, Silica, Ceramic

OTHER COMPATIBLE MATERIALS

Plastics and Elastomers Polyethylene ,polypropylene copolymer, polymethylpentene, Tefzel, chlorinated polyvinyl chloride, polystyrene, polyethersulfone, polyvinylidene fluoride, polyetherketone, Viton, trifluorochloroethylene resins, fluoroelastomer, polypropylene, polyphenylene oxide, Teflon, polyvinyl chloride, polycarbonate, polysulfone, acrylonitrile butadiene styrene, polyetherimide, most silicones and fluorinated silicones, ethylenepropylene rubber

COMPARISON WITH OTHER LOW TEMPERATURE STERILIZATION PROCESS ( ETHYLENE OXIDE)

EO.

Toxic Posses environmental threat from chlorofluorocarbons, long aeration Longer total processing time High costs Custom facilities requirements( explosive) Residual EO in materials

hydro

OTHER GAS PLASMA SYSTEMS

Other

gas plasma systems can use other oxidizing agents e.g. ozone, peracetic acid, and chlorine dioxide, which differ from hydrogen peroxide gas plasma in several ways.

The

use of peracetic acid & acetic acid were removed from the marketplace because of reports of corneal destruction to patients when ophthalmic surgery instruments had been processed in these sterilizers.