灭菌方法I：物理方法

Steam sterilization, or autoclaving, uses non-toxic, dry saturated steam under pressure to destroy all microorganisms. The process is both microbicidal and sporicidal, quickly warming and penetrating fabrics. Moist heat destroys microorganisms through irreversible coagulation and denaturation of enzymes and structural proteins, making it ideal for sterilizing surgical instruments and linens.

Steam sterilization depends on steam quality, pressure, temperature, and time. Ideal steam must be dry saturated with a dryness fraction of at least 97%. Pressure generates high temperatures needed to destroy microorganisms quickly. Standard temperatures range from 121°C to 132°C, with minimum exposure times of 30 minutes at 121°C or 4 minutes at 132°C for wrapped medical supplies.

Dry heat sterilization uses moisture-free heat to kill microorganisms and is non-toxic with no adverse environmental effects. It is non-corrosive to metal objects and sharps, making it ideal for moisture-sensitive materials. Metal instruments are typically sterilized using dry heat because it penetrates materials effectively without causing corrosion or damage.

Boiling water is an easy and affordable sterilization method commonly used at home for tools like scissors and tweezers. However, it has significant limitations: it does not eliminate bacterial spores or some viruses. Therefore, boiling water is suitable only for controlling or killing most microorganisms but cannot achieve complete sterilization.

Non-ionizing radiation, in the form of ultraviolet rays, is typically used only for surface sterilization of aseptic work areas. Ionizing radiation, such as gamma rays or X-rays, is a very effective but expensive sterilization method suitable for temperature-sensitive materials like pharmaceuticals. Ionizing radiation can utilize cobalt 60 gamma rays or electron accelerators for sterilization.

All critical and semi-critical items that are heat- and moisture-resistant can be steam-sterilized. These include surgical instruments, linens, and other medical supplies that can withstand direct contact with saturated steam at prescribed temperatures and pressures. Steam sterilization's ability to quickly penetrate fabrics makes it ideal for wrapped medical supplies in healthcare settings.

Ionizing radiation, including gamma rays and electron accelerators, can sterilize temperature-sensitive materials without exposing them to heat or moisture. Pharmaceuticals often cannot tolerate high temperatures required by steam or dry heat sterilization. Although ionizing radiation is expensive, its ability to effectively destroy all microorganisms while preserving drug integrity makes it valuable for medical product sterilization.