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A Method for Storing Sterile Renal Catheters
A METHOD FOR STORING STERILE RENAL CATHETERS NORMAN E. TANNENBAUM Hospital for the Women of Maryland, Baltimore, Maryland
Received for publication October 22, 1923
By far the safest and most satisfactory method of rendering ureteral catheters aseptic is by boiling them just before they are to be used. Many other methods have been employed and various antiseptic solutions (bichloride, formalin, carbolic acid and others) have been found efficacious, but all these procedures are far more tedious and by no means more sure. Nevertheless, it is sometimes of great importance to have all these appliances ready for use without any previous sterilization at the time, and hence not a few of us have been looking for some method by which we could safely store the sterilized catheters so that they would be strictly aseptic and yet available at a moment's notice. Up to the present time the method suggested in Kelly and Burnam 's "Diseases of the kidneys, ureters and bladder" has been generally employed. Several ureteral catheters of various sizes (or of one size) are sterilized by boiling or by immersion in antiseptic solutions, and in tp.e latter case are washed in sterile distilled water. The stylets are then introduced, and the catheters are placed in a sterile towel which is folded and pinned. Finally, the whole package is autoclaved, after which it is stored away. The objections to this method are: (1) The temperature to which the catheters are subjected in the autoclave materially shortens their term of service; (2) it is injurious to the catheter to sterilize it with the stylet in situ, and besides, the stylets may adhere to the wall of the catheter, rendering its removal difficult; (3) the catheters may be subjected to bending; (4) there is 431
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NORMAN E. TANNENBAUM
always the possibility that the inside of the towel and its contents may become contaminated if particles of dust get into the towel, or if subjected to any accidental moisture; (5) when only one catheter is withdrawn for use the others may become contaminated. Some months ago I devised and have since employed the following method: Soft glass tubing, commonly used in the laboratory, with an inside diameter of ¾inch, is cut into 26-inch lengths and one end carefully sealed by melting in a flame. Eight tubes are then wrapped in a large surgical dressing cover so that they are not in contact with each other. A small piece of absorbent cotton and a wooden applicator are included in the package, which is provided with an outside cover and autoclaved for forty-five minutes at 15 pounds of pressure. zc:------
FIG. 1
The above sketch shows the assembled sterile unit . The renal catheter with its stylet in place and rubber sleeve adjusted is r eady for immediate ureteral catheterization.
The practical application of the method is about as follows: A nurse who has previously prepared herself, in the usual manner with sterile gloves and gown, for work in the morning's operative schedule receives the sterile package on the sterile covered instrument table. The glass tubes are removed and the cotton and applicator put to one side. The renal catheters after being boiled for three minutes, and the stylets and rubber sleeves for five minutes, are deposited on the table on sterile absorbent towels where they drain dry. The stylet is inserted into its catheter and the rubber sleeve slipped over it. Each unit is then put into its tube, the end of which is plugged with a small piece of cotton, the wooden applicator being employed for this purpose. The tubes are then ready for use, and the contents may be kept sterile -indefinitely. Such a tube is shown in the accompanying sketch.
STORING STERILE RENAL CATHETERS
433
This method offers the following advantages: 1. An efficient container which insures sterile contents. 2. A transparent container through which the operator may select the suitable catheter and examine without contaminating it. 3. The catheters are not subjected to bending. 4. A single catheter is stored in a single tube, preventing contamination, which might result when more than one catheter is included in the container. 5. Renal catheters are always assembled and ready for immediate use.
Received for publication October 22, 1923
By far the safest and most satisfactory method of rendering ureteral catheters aseptic is by boiling them just before they are to be used. Many other methods have been employed and various antiseptic solutions (bichloride, formalin, carbolic acid and others) have been found efficacious, but all these procedures are far more tedious and by no means more sure. Nevertheless, it is sometimes of great importance to have all these appliances ready for use without any previous sterilization at the time, and hence not a few of us have been looking for some method by which we could safely store the sterilized catheters so that they would be strictly aseptic and yet available at a moment's notice. Up to the present time the method suggested in Kelly and Burnam 's "Diseases of the kidneys, ureters and bladder" has been generally employed. Several ureteral catheters of various sizes (or of one size) are sterilized by boiling or by immersion in antiseptic solutions, and in tp.e latter case are washed in sterile distilled water. The stylets are then introduced, and the catheters are placed in a sterile towel which is folded and pinned. Finally, the whole package is autoclaved, after which it is stored away. The objections to this method are: (1) The temperature to which the catheters are subjected in the autoclave materially shortens their term of service; (2) it is injurious to the catheter to sterilize it with the stylet in situ, and besides, the stylets may adhere to the wall of the catheter, rendering its removal difficult; (3) the catheters may be subjected to bending; (4) there is 431
432
NORMAN E. TANNENBAUM
always the possibility that the inside of the towel and its contents may become contaminated if particles of dust get into the towel, or if subjected to any accidental moisture; (5) when only one catheter is withdrawn for use the others may become contaminated. Some months ago I devised and have since employed the following method: Soft glass tubing, commonly used in the laboratory, with an inside diameter of ¾inch, is cut into 26-inch lengths and one end carefully sealed by melting in a flame. Eight tubes are then wrapped in a large surgical dressing cover so that they are not in contact with each other. A small piece of absorbent cotton and a wooden applicator are included in the package, which is provided with an outside cover and autoclaved for forty-five minutes at 15 pounds of pressure. zc:------
FIG. 1
The above sketch shows the assembled sterile unit . The renal catheter with its stylet in place and rubber sleeve adjusted is r eady for immediate ureteral catheterization.
The practical application of the method is about as follows: A nurse who has previously prepared herself, in the usual manner with sterile gloves and gown, for work in the morning's operative schedule receives the sterile package on the sterile covered instrument table. The glass tubes are removed and the cotton and applicator put to one side. The renal catheters after being boiled for three minutes, and the stylets and rubber sleeves for five minutes, are deposited on the table on sterile absorbent towels where they drain dry. The stylet is inserted into its catheter and the rubber sleeve slipped over it. Each unit is then put into its tube, the end of which is plugged with a small piece of cotton, the wooden applicator being employed for this purpose. The tubes are then ready for use, and the contents may be kept sterile -indefinitely. Such a tube is shown in the accompanying sketch.
STORING STERILE RENAL CATHETERS
433
This method offers the following advantages: 1. An efficient container which insures sterile contents. 2. A transparent container through which the operator may select the suitable catheter and examine without contaminating it. 3. The catheters are not subjected to bending. 4. A single catheter is stored in a single tube, preventing contamination, which might result when more than one catheter is included in the container. 5. Renal catheters are always assembled and ready for immediate use.