Drastic performance improvement of hand-operated sterilizers

In a great number of low-income countries, hand-operated sterilizers are commonly used for the sterilization of medical supplies, including porous loads and hollow instruments. Due to the socio-economic situation in these countries the introduction of fully automatic sterilizers is not (yet) feasible. During a course on sterilization technology for hospital technicians at the Polytechnic in Mombasa, Kenya, some performance tests have been done with locally used sterilizers with standard test loads and loads as are common in the hospitals that were visited. The results for porous loads were alarming due to poor air-removal. Immediately, a number of modifications in the processes were made and tested, based on a method of steam pulsing. This resulted in a significant improvement of performance and can be introduced at a very low cost.