Hello Fellow Workers,

I am a lead hand in a SPD in Canada. I would like to know what to do when I have a wet load. I have been told to do some problem solving of the load. However I have been told not to pull the full load. I have a problem with this. My training in sterilization tells me to pull the full load. Please I need help in this area because I cannot work in this area with this type of standard.

Thanks
Barb

Hello Barb,

A wet load problem is often an under estimated problem. It is very complicated to determine the reason that causes the wet loads. It is certainly not correct that you should not load the steriliser complete. In the EN 554, one of the validation tests is with a full load, this means that the loading area of the steriliser is filled (100%) with a production load. This could be instrument trays, garments or other combinations. (Preferably however you should try not to mix many varieties within one load.) All these loads should pass the validation correctly, which means that the temperature profile within the load has to be according to the standard but the final result should also be a dry load. If the validation engineer will notice that the load is not completely dry, but the temperature profile was according to the standard, the steriliser should be considered as "did not pass validation".

Reasons causing a wet load can be:

1. Loading pattern or system not correct
2. Steam supply piping or steam generator
3. Wrapping material
4. Chemical residue on instrumentation (washer chemical dosing not correct)
5. Steriliser design not correct (Steriliser chamber or P&ID)

Do not think you are the only one with this problem because I believe the "wet load problem" is the most common problem at all CSSD's worldwide. If the problem is new than it is important to trace changes in all the procedures from the date the problem occurred. This is often very helpful to eliminate a few possible causes.

It is close to impossible to advise you about this problem from distance because there are to many possibilities that can cause the problem. However I hope that my remarks are helpful to solve your problem. If you have particular questions please do not hesitate to contact me directly.

Best Regards,
Henk Ras

Henk Ras - Export Manager

Sanamij B.V. - Rotterdam, The Netherlands
www.sanamij.com

My answer to this question would depend upon the extent of the "wetness". If the problem is that one of the packs was not set up properly, i.e., too much metal, too heavy, too dense, etc. and it is the only wet pack, then there is no need to pull the full load. However, if most of the packs in the load show water damage, have beads of water on their surfaces, etc. then this indicates a problem with the steam supply and the full load should be pulled and the supply problem solved.
As is almost always the case in question like this, common sense should prevail. It has always been my message to substitute common sense for common practice when the reason for the common practice no longer exist or are unknown. For example, it makes little sense to pull perfectly good packages when only the ones that could not be properly sterilized or have the potential for contamination due to visible moisture are the problem. On the other hand wet packs are a symptom of poor steam quality or poor pack preparation and the cause should be resolved.

Hope this helps,
Dan Mayworm

Addition from Josy Holdener:
For more information read "How to Prevent Wet Packs" written by Dan Mayworm, Contributing Editor, Journal; Outpatient Surgery, No.8 August 2001, www.outpatientsurgery.net