Which Is Better: Wrapped Instrument Trays or Sealed Containers?

Exacerbating the problem, sealed containers take up a great deal more space than sterile wrap — about 11???2 times as much, by the time you get everything assembled. And as technology advances, surgeons are only going to require more instrumentation. This doesn’t just create a storage issue; it creates a decontamination backlog every time several surgeries finish at once. Sealed containers each add 4 relatively large pieces to a washer: the container itself, which can be as big as 30-by-18 inches, the lid, and a square or circular filter retention plate, which varies in size, depending on brand, and consists of 2 pieces.

It gets worse: Once a washing is complete and you’ve reassembled and inspected that container, the better part of an hour has gone by. Compare this to the 3 or so minutes it takes to wrap a tray of instruments, and the amount of manpower saved by sterile wrap is clear.

As for price, I have seen many ROIs arguing for containers and against them, and for sterile wrap and against it. Sealed containers have a higher upfront cost and additional preventative maintenance costs. Still, some people insist you’ll end up paying more for sterile wrap over the course of many years. The bottom line is this: A price is only as good as the product itself, its implementation and the people who oversee those procedures.

Maintaining sterilityWhile all of these points are matters of efficiency, the real argument is one of safety. A study conducted by Harry Shaffer, MS, and published in the December 2015 American Journal of Infection Control (osmag.net/xvok6b) found sterilization wrap provided greater protection against airborne bacterial ingress, compared with rigid containers. The study, which was funded by Halyard Health, found bacterial contamination in 87% of rigid containers, some of which had never even been used. Of 161 wrapped trays tested, none demonstrated bacterial ingress into the tray.

In the study, Dr. Shaffer calls rigid containers “complex devices with multiple seals and filters held by retention plates or valves that can be damaged, and demonstrate loss of performance with age and use. Our results indicate that the barrier efficacy of rigid containers may diminish over time.”