Moonmed are pleased to bring you more in depth information on Sterilization and Infection Control.
All the following information can be found in the book titled “Sterilization of Medical Supplies by steam” by Jan Huys. For more information on Sterilization kindly send an e-mail to : firstname.lastname@example.org
It already has been almost 28 years since I left for Ghana, West Africa, as a technician, where I would stay for 7 years. I was responsible for the setting-up of a maintenance service for the hospitals within the healthcare system of the Catholic Church. Initially the work was focussing mainly on the actual repairs and maintenance of equipment in all its variety. In the later years the tasks moved to more organisational work and most of all training. I found out that for most equipment a wide range of training and study material was available. However for sterilization the information I could find was limited to often very brief instructions for use of equipment without further background information. After finishing the contract in Ghana I was asked to start preparing training material for hospital technicians. I thus choose sterilization as one of the first subjects to cover. It was in the early nineties, the time that in the Netherlands the world of sterilization was very much in motion. The Netherlands was in the forefront of the developments in this domain. The Guidelines on Sterilisation and Sterility were just formulated and became the basis for the first European Standards for sterilisation. The trade quickly professionalized.
I came to realize that I severely underestimated my efforts of writing a book on the topic! In order to be better prepared I attended a training with Mr. Machiel Jan Bot of Medithema, who introduced me with great enthusiasm into the world of micro-organisms, infection prevention and sterilization. For gathering information I got in touch with many sterilization-related companies and among others the RIVM: the Institute for Public Health and the Environment of the Netherlands. At that time the late Mr. Jack van Asten was pushing a scientific approach to sterile supply in hospitals throughout The Netherlands and through his department was enforcing improved quality control and validation of sterilization processes. From the information that was slowly but surely gathered, the first English edition was created which was published in 1996 under auspices of the ESH, the predecessor of the current WFHSS. In 2004 the second updated edition was published. During the past years I had the opportunity to present courses on sterile supplies in many countries, especially in Africa. It is a great experience to see the enthusiasm of all those people who want to make a difference in their own field. The book has been a tool to provide the basic information. With this 3rd edition I hope this contribution to improve sterile supply can continue.
Sterilization is a field where many exiting sciences and technologies meet: from microbiology, medicine, to mechanical and electrical engineering. A profession where life and death meet each other; in which life at micro-level is massively offered in order to protect ours. Through this sterilization almost gets a philosophical/ethical character.
This book wants to be an introduction for all those that get in touch with this fascinating field, which offers an essential contribution to the safe treatment of the many patients, who thus put their lives into our hands.
Cells: building blocks of life
Looking at any living creature more closely you will find out that they are built according to a well organised plan…
Cells, tissues, organs and organisms
We live together with many other people. But also with cows, dogs, goats, trees and grass and numerous other organisms. . Some of them are very big, like elephants or big trees. Others are small, like the tiny insects.
Houses are often built with bricks; very big houses can be built with small bricks. In the same way the bodies of most living things, are made of millions of very small cells. They are so small that they can only be seen with a microscope. There are many different types of cells, and they are all joined together in different ways to make the tissues of the body.
Cells are the basic unit of structure and function of any living thing.
Skin cells are joined together to make skin tissue. Muscle cells are joined together to make muscle tissue. A piece of muscle is muscle tissue. The whole muscle is called an organ. A whole eye is an organ; so is the whole heart or stomach. In this way cells make tissues, tissues make organs. Organs whose function is interlinked are forming an organ system, for example: the organs of
the circulatory system, the bones and joints, the digestive system, etc. And all these organ systems together make the body.
Cells -> tissues -> organs -> organ systems -> organism (body)
Cells have a very thin outer coat, called the cell membrane. Inside the cell membrane is a fluid called the cytoplasm. The cytoplasm is a mixture of many things, especially proteins in water and contains many small particles, the most important ones being the ribosomes, which in fact are small protein factories. In the middle of the cell there is a large ball or bag, called the nucleus which is usually round or egg-shaped. When we talk about more than one nucleus we say: nuclei. The nucleus contains one or more chromosomes: large molecules of DNA, which on their turn are the carriers of information about the structure and function of the complete organism. In other words: they hold the information to create the next generation of the organism. Together the genetic information in the chromosomes is known as the genome. Around the nucleus is another thin coat, the nuclear membrane. If you think the cell as a bag or sac (the cell membrane) full of cytoplasm, the nucleus is a smaller bag inside the cytoplasm. The cells of multi-celled organisms – but also many of single celled microorganisms – have such a nucleus. The group of organisms composed of cells with a nucleus are known as eukaryotes (“organisms with a true kernel”). Humans, animals, plants, fungi and various other groups are all eukaryotes. The parts of a typical (eukaryotic) cell are shown in the following drawing:
Some living beings are made only out of a few or even only one cell! All these organisms can live as independently as any other organism and as they are so small they are also called microorganisms. A major part of the tiny, multi- celled, and a group of single celled organisms consist of cells with a nucleus and thus belong to the eukaryotes. The single celled eukaryotic micro- organisms are known as protists. Another group of – only single celled – organisms do not have a nucleus; they are known as prokaryotes (“organisms that do not have a kernel yet”). The most important ones in this group are the bacteria. Another important group of micro-organisms are the viruses, which are even much smaller than the single-celled organisms. They need a host to survive and multiply. All these tiny organisms will be the subject of this book! Disease-causing microorganisms are also called germs.
How are cells made?
All cells are made from other cells. Cells divide (become two) in various ways. The usual way is for the nucleus to divide first to make two new nuclei. After this the cytoplasm divides to make two daughter cells with one nucleus in each of them.