A Tray's Journey Through Processing

In practice

The laparotomy finishes at noon. At the field, the scrub person wipes visible blood from the instruments, opens every hinged instrument, removes blades and sharps into the sharps container, and keeps the instruments moist so that blood does not dry on them. The tray goes to the decontamination area of central processing, where staff wearing heavy gloves, eye protection and gowns take it apart, clean every piece with an enzymatic cleaner and a mechanical washer, and brush the jaws and hinges by hand, because residue hides in joints and grooves. In the clean packaging area, a technician inspects each instrument, checks that it works, and assembles the set according to its written list: hinged instruments open, heavy retractors placed so they will not crush the fine scissors, basins positioned to drain. A chemical indicator goes inside the tray. The set is wrapped in two sheets without gaps, taped with an external indicator, and labelled with the load information. It is loaded flat on a shelf in a prevacuum steam sterilizer that passed its air-removal test that morning, and the cycle runs to the temperature and time the manufacturers specify. Afterward the tray cools and dries completely before it is handled, then goes to sterile storage on a shelf off the floor and away from the sink. Two days later it is opened for a new patient, and the scrub person checks the package and the internal indicator before anything touches the field.