From Volume 40, Issue 7, September 2013 | Pages 543-548
HTM 01-05 guidelines state that decontamination of handpieces remains a challenge, in particular the lumen, due to oil impeding access for steam sterilization. This paper discusses important aspects of cleaning and sterilization of the handpiece lumen and critically appraises the literature found on this topic. The paper is not intended to cover precleaning methods in detail.
The aim of the cleaning process is to ensure a surface free of tissue debris to allow sterilization to be effective. If the surface is not clean then sterilization is not possible. The presence of tissue debris and body fluids will impede access of steam to the surface which needs to be sterilized, particularly if baked on as a consequence of multiple exposures to steam sterilization without removal.
Different components make up the total tissue debris, which includes oil and prions and, together with the complex internal surface, makes the decontamination of handpieces particularly challenging. HTM 01-05 guidance recognizes that sterilization of handpieces remains a challenge and states ‘whilst steam sterilization alone will provide a small log reduction in infectivity, the most effective method of decontamination is rigorous cleaning to remove all proteinaceous material from surfaces.’
Whilst the cleaning phase will normally deal with most tissue debris, oil coating has caused controversy in the literature. The use of oil after the cleaning phase results in the internal surface of the handpiece becoming coated in hydrophobic material, which impedes the contact of saturated steam on the surface.
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