Clean tools save lives. In any medical setting, surgical instruments come into direct contact with the body. That makes sterilisation a non-negotiable. Whether it’s a routine skin biopsy or major surgery, sterile tools keep infections out of the operating room. And the go-to method for doing that? Autoclaves.
Steam sterilisation has been trusted for over a century. It’s simple, effective and compatible with most medical-grade instruments. But getting it right is more than just pressing a button. To fully sterilise tools, clinics and hospitals must follow the correct protocols—every time.
So let’s break it down. Here’s what best practice looks like, what the risks are when it’s done wrong and what the future might hold for autoclave use in modern healthcare.
Why Sterilisation Matters in Surgical Settings
When surgery happens, the skin—our natural barrier—is broken. That opens the door for pathogens. Even a tiny amount of bacteria can cause infections, delay healing or trigger serious complications. That’s why sterilisation is critical, not just important.
Instruments must be free from all microorganisms before they touch a patient. It’s not enough to rinse them off or use chemicals. Only high-pressure steam at the right temperature for the right time can guarantee full sterilisation.
Surgical tools often have joints, hinges or fine tips where bacteria can hide. Without proper cleaning and sterilising, these parts can carry pathogens from one patient to another.
Healthcare facilities that follow strict autoclave procedures lower infection risks, cut costs on post-surgery treatment and avoid liability. It also keeps them compliant with health standards, including AS/NZS 4187.
The importance of autoclave use in hospitals is only growing as procedures become more complex and patient safety expectations rise.
Cleaning Instruments Before Sterilisation
You can’t sterilise dirty tools. That might sound obvious, but it’s one of the most common mistakes. Instruments need to be thoroughly cleaned before they go into the autoclave.
This step removes blood, tissue and other organic matter that can block steam penetration. Leftover debris creates barriers that prevent sterilisation from working. Some bugs even form protective layers called biofilms, which are tough to kill.
Here’s the proper order:
- Rinse tools under cool water to remove visible debris
- Use enzymatic cleaners or ultrasonic baths to reach tiny parts
- Dry instruments completely to avoid moisture build-up
- Inspect tools for damage or wear before packing
Skipping or rushing this step compromises everything that follows. Autoclaving should only begin once instruments are visibly clean and dry.
Knowing the steps for proper autoclaving means understanding that sterilisation starts before you even load the chamber.
Wrapping, Packaging and Loading the Right Way
Once tools are clean, they must be packed in a way that lets steam do its job. Pouches, wraps and cassettes are used to maintain sterility after the cycle ends. But they must be sealed, spaced and loaded properly.
Use medical-grade paper or laminate pouches with built-in steam indicators. These change colour when exposed to the right temperature and pressure, confirming sterilisation.
Here are a few loading tips:
- Place pouches paper-side up
- Avoid overlapping packs
- Don’t overload trays
- Leave space for air and steam to circulate
Overloading the chamber or jamming tools too tightly prevents even steam flow. That means some tools might get sterilised, others might not. Instruments should be positioned so all surfaces are exposed.
Loading the chamber correctly is key to making sure how sterilisation helps stop disease isn’t just theory—it’s your everyday practice.
Running the Correct Cycle for the Load
Autoclaves aren’t one-size-fits-all. Different instruments require different cycle settings. Running the wrong cycle can either damage the tools or leave them unsterile.
There are two main types:
- Gravity cycles for solid, unwrapped tools
- Pre-vacuum cycles for wrapped instruments or hollow items
Check the manufacturer’s guidance for each item. Instruments with lumens (like suction tips or scopes) usually need longer cycles or special handling.
Also, consider the material. Stainless steel handles heat well. Plastic or rubber might warp if the temperature is too high or the drying phase is too long.
Modern autoclaves come with pre-set options. But you still need to select the right one and check the settings. Never assume the default will cover all loads.
Keeping a cycle logbook helps track what’s run, when and by whom. It also provides an audit trail for health authorities or internal reviews.
Drying, Cooling and Storage Procedures
Many users overlook the post-cycle steps. But drying and storage are just as critical as the cycle itself.
Wet packs can reabsorb contaminants from the environment. That means a sterile item becomes non-sterile within minutes of removal. Always wait until the drying phase is complete before opening the chamber.
Let packs cool completely on a clean surface. Use sterile gloves when handling them, and avoid stacking or compressing items while they cool.
Once dry and cool, store instruments in closed cupboards or containers, away from moisture or airborne particles. Each pack should have an expiry date, usually based on storage conditions and the type of wrap used.
If anything feels damp, discard or reprocess it. Taking shortcuts at this stage risks everything you’ve done up to this point.
Monitoring Sterilisation Success
How do you know if sterilisation really worked? That’s where indicators come in. They’re not optional. They’re essential.
There are three main types:
- Chemical indicators: These change colour during the cycle
- Biological indicators: These use spores to test the full sterilisation process
- Mechanical indicators: These track time, temperature and pressure
Each load should have a chemical indicator inside at least one pouch. Weekly biological testing confirms your machine can kill even the toughest organisms.
Mechanical indicators are built into most digital autoclaves and should be reviewed after every cycle. If something’s off, investigate and reprocess the load.
Document all results. This protects your patients, your team and your clinic’s reputation.
Training Staff on Sterilisation Protocols
Even the best equipment fails without proper training. Staff must know how to clean, pack, load, run and monitor autoclaves properly.
New team members should receive hands-on training within their first week. Refresher training every six months keeps skills sharp and ensures protocols stay current.
Use visuals, cheat sheets or videos to make learning easy. Create a standard operating procedure manual that matches your equipment and workflow.
Include common troubleshooting steps and emergency contacts. If something goes wrong, staff should know what to do without guessing.
Ongoing education is a low-cost, high-impact way to improve sterilisation quality across your whole team.
Case Study: Improving Autoclave Outcomes in a Busy Clinic
A regional surgical clinic in New South Wales faced regular failed indicator tests. Staff often blamed the autoclave or packing materials. But after a third-party audit, it became clear the real issue was rushed loading and poor pre-cleaning.
The solution? A two-day training session, new checklists and weekly team reviews. Within one month, failed tests dropped to zero. Instrument life improved, and staff gained confidence in their process.
This wasn’t a tech problem. It was a people problem. Fixing it didn’t require new equipment—just better practice.
FAQs
1. What’s the ideal cycle for sterilising surgical instruments?
Most wrapped surgical instruments are best sterilised using a pre-vacuum cycle at 134°C for 3–5 minutes, depending on the load and autoclave model. This cycle removes air pockets and ensures steam penetrates all surfaces. For unwrapped solid items, a gravity cycle at 121°C for 15–30 minutes may be enough. However, always follow the instrument manufacturer’s guidelines. Using the wrong cycle can leave tools unsterile or damage them over time. It’s also important to monitor the drying time, as removing packs too early can compromise the result.
2. How often should we test autoclave performance?
Daily cycle monitoring is essential. Use chemical indicators in every load. Biological indicators should be used at least weekly, especially in surgical settings. Many facilities also run a control test after equipment servicing or when using a new pack type. Mechanical printouts should be reviewed after every cycle to check temperature, pressure and time. If there’s a failure, investigate immediately and reprocess affected items. Keeping a consistent testing schedule builds confidence and keeps your team compliant.
3. Can you reuse sterilisation pouches or wraps?
No. Sterilisation pouches and wraps are single-use. Reusing them breaks the seal, weakens the material and risks contamination. Even if a pouch looks clean or unused, it’s not guaranteed to be sterile-safe a second time. Reusing wraps also makes indicator results unreliable. Always use fresh, intact packaging materials for each cycle. The cost of reprocessing with new supplies is low compared to the risk of infection or compliance breaches.
4. What are the risks of improper sterilisation?
Improper sterilisation can cause serious harm. Patients may develop infections that delay healing, require extra treatment or even result in hospitalisation. Clinics risk malpractice claims, reputation loss and regulatory penalties. Failed sterilisation also means wasted time, resources and money. Some pathogens, like hepatitis B or MRSA, can survive mild cleaning and only die under strict conditions. Relying on visual inspection or skipped cycles is never safe. Proper sterilisation is a professional obligation.
5. Do all surgical instruments require the same cycle?
Not always. Instruments vary in shape, material and complexity. Items with hinges, lumens or heat-sensitive parts may need longer cycles or special wrapping. For example, a rigid retractor can handle higher heat, while a plastic suction tip may warp if overheated. Consult the manufacturer’s instructions for each tool. Keep a chart near the autoclave with recommended cycles for different items. This prevents guesswork and helps staff choose the correct settings every time.
Keep It Clean, Keep It Safe
Sterilising surgical instruments isn’t just another box to tick. It’s the backbone of patient safety and clinical success. From cleaning to drying to testing, every step matters. And every staff member plays a role in getting it right.
With growing pressure on healthcare providers to meet strict safety standards, now’s the time to review and upgrade your protocols.
If you need reliable tools to support your sterilisation process, check out the full range of autoclaves at MES Australia. Quality equipment paired with best practice keeps your patients safe and your clinic running strong.
For all your autoclave requirements, please call us today on 1300 342 013 or leave an enquiry.
