Unwrapped instruments: what to monitor and record

What “unwrapped” means on this page

An unwrapped cycle here is a sterilization cycle that runs without a wrap, pouch or closed container: the instruments sit open in the tray or container system. Everything on this page comes from four things only: two sentences about unwrapped cycles, the rule for monitoring each load, the list of fields to record, and this project’s own form design. Where those run out, this page says so instead of guessing.

Mechanical and chemical indicators, every unwrapped cycle

An unwrapped cycle is not an exception. Use mechanical and chemical indicators for each unwrapped sterilization cycle (CDC, 2003 dental infection-control guidelines).

The wider rule shows what that means: monitor each load with mechanical (e.g., time, temperature, and pressure) and chemical indicators (CDC, 2003 dental infection-control guidelines). Keep the guideline’s “e.g.” in mind — time, temperature and pressure are examples, not a fixed list.

Where the chemical indicator sits when there is no pack is not spelled out in the rows behind this page. That detail is a gap in the sources, not an oversight on your side. Your sterilizer’s own instructions are the place to settle it.

Implantables: never unwrapped

Do not sterilize implantable devices unwrapped (CDC, 2003 dental infection-control guidelines). This sentence carries no hedge: there is no “whenever possible” and no emergency clause inside it.

What an implant load needs instead sits outside the rows this page is built on. The guide implant loads: the spore test, quarantine and what to do in an emergency covers that ground.

What to record

An unwrapped cycle leaves the same paper trail as any other cycle. The 2008 guideline gives the list in one sentence: “For each sterilization cycle, record the type of sterilizer and cycle used; the load identification number; the load contents; the exposure parameters (e.g., time and temperature); the operator’s name or initials; and the results of mechanical, chemical, and biological monitoring” (CDC, 2008 disinfection and sterilization guideline).

• The sterilizer and the cycle type used.
• The load number, and what the load held.
• The exposure parameters (e.g., time and temperature).
• The operator’s name or initials.
• The mechanical, chemical and biological results.

One more field matters on this page. A good log marks each load wrapped or unwrapped, because that mark tells a reader which rules the load lived under. Dental Logbook will make the mark required on every load, and it will not let an unwrapped load be marked as containing an implantable device — that combination cannot exist.

A good log is also filled in at the end of the cycle, while the readings are still in front of you.

If you want the paper version first, the free dental sterilizer load log on this site gives each of these a column, the wrapped or unwrapped mark included.

How long unwrapped items keep: these sources do not say

Search the web for unwrapped cycles and most pages answer with minutes and temperatures. The rows behind this page hold no such numbers. The two unwrapped sentences, the per-load monitoring rule and the record list say nothing about how long an unwrapped item stays usable after the cycle ends.

So this page will not give you a time. A number lifted from another document is only as good as that document’s authority, and none of the rows cited here carries one.

Where an answer has to come from instead: your sterilizer’s manufacturer instructions, your office’s own written policy, and your state board’s current rules.

Wrapped and unwrapped, side by side

The exact words, with their row IDs

Everything above stands on four sentences. They are quoted exactly as the rule pack holds them, with the row IDs so you can check them.

• “Use mechanical and chemical indicators for each unwrapped sterilization cycle” — row C03-11, recommendation VI.E.2 (CDC, 2003 dental infection-control guidelines).
• “Do not sterilize implantable devices unwrapped” — row C03-11, recommendation VI.E.6 (CDC, 2003 dental infection-control guidelines).
• “Monitor each load with mechanical (e.g., time, temperature, and pressure) and chemical indicators” — row C03-7, recommendation VI.F.2 (CDC, 2003 dental infection-control guidelines).
• “For each sterilization cycle, record the type of sterilizer and cycle used; the load identification number; the load contents; the exposure parameters (e.g., time and temperature); the operator’s name or initials; and the results of mechanical, chemical, and biological monitoring” — row D08-6, recommendation 19.e (CDC, 2008 disinfection and sterilization guideline).

Common questions

Does an unwrapped cycle skip the indicators?

No. Use mechanical and chemical indicators for each unwrapped sterilization cycle (CDC, 2003 dental infection-control guidelines).

Can an implantable go through an unwrapped cycle in a hurry?

No. Do not sterilize implantable devices unwrapped (CDC, 2003 dental infection-control guidelines). The sentence leaves no room for a hurry.

Does the log entry change for an unwrapped cycle?

Only by the mark. The record list is the same for every sterilization cycle (CDC, 2008 disinfection and sterilization guideline), and a good log adds wrapped or unwrapped.