None of the 10 prevacuum high-pressure sterilizers of different makes tested was able to produce and maintain the conditions advocated by the Medical Research Council working party on high-pressure steam sterilizers (1959) or by Knox and Penikett (1958) with the result that steam did not penetrate adequately the single challenge load and it was not sterilized.
The sterilization of `group drums' of various sizes and contents was erratic and tended to give operators a false sense of security.
An alarming number of minor engineering faults were present in seven out of 10 machines tested and they require very much more skilled maintenance than is being given at the moment. The possibility of centralizing sterilizers to central sterile supply departments and placing them under the care of a regional engineer cannot be too highly recommended. The presence of undetected `leaks' and a failure to draw a prevacuum of 20 mm. even with a steam burst interferes with sterilization of a challenge load. A leak test should be performed twice daily and should not exceed more than 1 mm. in one minute at 20 mm. absolute. The centre of the load should be monitored by crossed tapes or Brownes tubes in each sterilizing cycle. Although the challenge load was sterilized when the chamber was filled to capacity, a more reliable cycle consisting of a double prevacuum of 20 mm. or more with intermediate steam burst to 10 lb. ensured the sterilizing of a single challenge load, which could be adequately controlled by the chamber drain temperature.
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