How to Use an Autoclave Safely

brandon llewellyn | 21 August, 2023

            How to Use an Autoclave Safely

In the realms of surgical suites, dental offices, laboratories, and even tattoo studios, a vital ally stands at the forefront of maintaining a clean and germ-free environment – the autoclave. Used by various professionals, autoclaves play a crucial role in ensuring the safety and well-being of both patients and practitioners. 


When it comes to surgical procedures, dental treatments, laboratory experiments, hormone pellet therapy, or the artistry of tattoos, cleanliness, and sterility are of paramount importance. Contamination by bacteria, fungi, viruses, or other harmful organisms can lead to severe complications, infections, and even life-threatening consequences. This is where the vital role of an autoclave comes into play. An autoclave is a powerful tool, much like a medical pressure cooker, designed to eliminate these microorganisms, ensuring that the instruments used in these fields are free from potential risks. By subjecting the equipment to high-pressure steam and heat, autoclaves effectively neutralize and eradicate any lurking threats, ensuring the safety of both patients and practitioners alike.


Autoclaves are a vital component of sterile offices and are used every day. 


Autoclave Training


There is a well-developed procedure for sterilizing surgical instruments in the autoclave. Operating room assistants assigned to use the autoclave need to be familiar with all of these steps even before they first use the machine on their own.


First, Treat Instruments Even While They Are Still in the OR


It is important not to allow blood, tissue, or bodily fluids to dry onto surgical instruments. The person assigned with the responsibility of operating the autoclave will usually apply an enzymatic foam to surgical instruments at their point of use to prevent surgical soil from drying.


Preparation for the Autoclave


It is important to place used surgical instruments in the autoclave as soon as possible after they are used. The nurse or surgical technician sterilizing the instruments typically will not disassemble them, unless specifically directed by the manufacturer. Tools for disassembly are provided by manufacturers for these cases.


Automated Cleaning


In the next step, the technician uses CE-validated washer-disinfectant machines to wash instruments automatically. Detergents must be non-ionizing and low-foaming. The technician follows the manufacturer's recommendations for use, especially the recommended concentrations of detergent and the recommended number of cycles.


Loading the washer, it is important to remember to:


  • Open any instruments with hinges or box joints before loading, so any windows in the instrument can drain.
  • Place heavier instruments in the bottom of the wash basket.
  • Avoid overloading.
  • Place instruments with concave instruments facing downward to avoid pooling of water.
  • Use appropriate devices to flush out reamers, lumens, and cannulas.
  • Make sure that soft, microbe-free water is used for the wash cycle.



The nurse or technician visually inspects each instrument for complete cleaning. This requires looking at all instrument surfaces, including joints, ratchets, and cannulas. Any instrument with visible signs of soiling is sent back for another cleaning cycle.




Once the washed instruments are dried, they are sterilized. The nurse or technician follows the instructions of the autoclave manufacturer, but sterilization usually involves heating to 134 to 137° C at a pressure of 2.25 to 2.5 atmospheres for at least 3 minutes.


Now, let's take a closer look at these steps:


Prepping the Instruments

Loading the Materials

Time & Cycle Selection

Unloading Materials

Autoclave Safety Procedures

How can nurses and technicians know when something has gone wrong with the cleaning process?


There are two kinds of common problems with autoclave sterilization. One is broken and cracked box joints. The other is discoloration. Fortunately, there are relatively straightforward ways to prevent these common problems.


Broken and Cracked Box Joints


Broken and cracked box joints can result from forced stress, tension stress, and general stress.


  • Forced stress results from overloading instruments. It is a particular [problem with tweezers, forceps, and needle holders. Using the correct washer and the right attachments prevents this kind of instrument failure.
  • Tension stress occurs during heating and cooling. The way to prevent this problem is to make sure not to close the instrument past the first notch during sterilization.
  • General stress is caused by the accumulation of blood, debris, and surgical soil in a box joint. Making sure the instrument is open when it is washed prevents this problem.


Discoloration is a problem when surgical instruments are not properly rinsed. It can occur when the water used for cleaning is heavily chlorinated. Discoloration also occurs when drops of water are allowed to dry slowly on the surface of a surgical instrument.


Other kinds of discoloration include:


  • Brown (yellowish-brown to dark-brown) spots. These occur when blood, tissue, or surgical soil are not removed before the instrument is sterilized.
  • Oxidation spots. These lightly colored spots with faint edges occur when the water is high in chlorides or iron. They can be prevented by using demineralized water.
  • Water spots. Hard water or water with a high concentration of iron or other minerals leaves water spots. They can be prevented by using demineralized water for rinsing.



Wrappers and containers keep surgical instruments germ-free after they have been sterilized. Typically, the surgical instrument is sterilized in its packaging. It is not placed in the packaging after it has been sterilized.


  • Aluminum foil, paper bags, poly-film plastic tubes, and wrapped perforated cassettes are used when instruments are sterilized with dry heat. It is important to choose a material that will not catch fire in the autoclave.
  • Cloth, paper, plastic, and peel-back packaging are used for steam autoclaves. The packaging allows steam to reach the surgical instrument.
  • Paper bags, paper, and plastic peel-back packages, and wrapped perforated cassettes are used for fumigating surgical instruments with low concentrations of germ-killing vapors. It is important that the disinfectant does not chemically react with the packaging.


Once surgical instruments have been cleaned, sterilized, and packaged, they should be stored in a cabinet, never under a sink.


Recordkeeping & Logbook

Many hospitals and surgical centers still keep paper records of use and sterilization of surgical instruments. Paper records create an audit trail that can be used to track down problems with sterilization procedures.


Even where records are digitized, it is essential to keep track of each instrument. If the autoclave malfunctions or fails, then the operating room staff will know which instruments should be recalled. These recalls protect patients from infection and the doctors, hospital, or surgical center from regulatory or legal liability.


Autoclave Maintenance


Every manufacturer publishes a manual detailing weekly, monthly, and annual maintenance schedules for every autoclave. Carefully following the manufacturer's maintenance schedule extends the life of the autoclave and reduces the risk of failure.


Consider Autoclavable Trocars and Other Equipment


When surgeons use disposable surgical tools, of course, the risk of contamination is eliminated.

Trocar Supplies offers an extension selection oftrocars of every FDA-approveddevice material. We offerdisposable trocar andautoclavable trocar as well as trocar tray kits. For everything you need to know about trocars includingreusable trocars and the engineering and manufacture of a trocar, please send us your questions online or call us at (937) 478-0469 for more information.