From Steve Johnston
Does any one have any research based evidence on whether instruments such as Artery forceps should be left open or closed onto the first clip for steam sterilisation at 134degrees centigrade

Good day Stephan,

Stress fractures in the box lock region of hinged instruments that are caused by autoclaving instruments with the ratchet closed are seen by virtually every instrument repair technician. These instruments are unrepairable and must be thrown away. Your instrument repair service will probably be glad to supply you with as many samples of this sort of damaged instrument as you like.
The sterilant will not be effective if it is not able to reach the surface to be sterilized. Metal clamped against metal prevents steam penetration to all the surfaces. This principle has been demonstrated many times. Topic Q00058 is also related to this topic and might be of use to you.

Regards, Pete Bobb

Dear Steve,

In Flanders we recommend to close the instruments in the first ratchet (most open position) in order to avoid stress corrosion. This recommendation is also inserted in "Proper maintenance of instruments" of the working group: Instrument preparation 5th edition and in the French AFNOR norms. The closure of the instruments facilitates the arrangement of the instruments in a tray and prevents the perforation of the sterilization wrap. But I agree with Pete: it is preferable to not close any clip, for the reasons he gave.

Kind regards,
Wim Renders.

your question on sterilising artery forceps, in New Zealand at the hospital i work at, we have a two pronged stand that we put all the scissors and artery forceps, towel clips, needle holders onto which hold open the instrument for sterilising.this was designed by the local cssd department. each of our sets have one of these prongs so all the forceps are kept ;together. hope this is some help.

regards.
lyn craven. royston private hospital
New Zealand.

Standards Association of Australia is to my knowledge the first country which clarifies that Instrument (clamps, hemostats etc) no longer can be sterilized if closed on the first ratchet, that they must be fully open.
The new edition of AS4187-2002 says "instruments with ratchets should not be 'closed' and that they be sterilized in the 'open' position. When the ratchet is 'closed' rapid heating and cooling creates stress and can cause metal fatigue over a period of time."

Kind regards
Josy Holdener