When ambulatory surgery centers flash or steam-sterilize instruments, they must now deliver the instruments to the sterile field in closed-container systems designed for rapid steam sterilization cycles. "Each newly sterilized instrument must be carefully protected to ensure that it is not re-contaminated," CMS said in a September letter clarifying flash steam-sterilization guidelines for ASC surveyors. The guidelines are effective for fiscal year 2010.

ASCs that flash will need closed sterilization trays or specifically designed "flash pans" for transport to prevent contamination during and after the steam process, said CMS. "There are no studies of increased contamination during transport, but we know it's a risk and it's our duty as patient advocates to remove all those risks," says Lee Anne Blackwell, RN, BSN, EMBA, CNOR, director of clinical resources and education for Surgical Care Affiliates. "Let's control and manage what we can control and manage. It's our responsibility."

CMS also made a point to say that flash sterilization should be used sparingly, "only in the event of an urgent and unpredicted need for a specific device, such as to clean an instrument that was dropped on the ground during a procedure."

"Flashing is fraught with all kinds of problems. CMS is not supporting flashing. What they're saying is, if you're going to flash, using a closed container is one way to minimize the risk of contamination," says Kathleen Kohut, RN, MS, CIC, CNOR, an independent infection prevention consultant.

CMS said that surveyors would observe the return of instruments to the sterile field and verify that they are being protected from recontamination. We invited manufacturers of closed-sterilization systems that allow for the safe flash sterilization and transportation of sterile instruments to showcase their products for you.

— Dan O'Connor

FlashPak from Symmetry Medical FlashPak is a hospital-proven mobile sterile field, says the company. It meets current guidelines for flash sterilization and is FDA 510(k) cleared for flash sterilization. FlashPak's patented valves automatically close at the end of the cycle, providing a truly closed system. Its unique appearance is easily differentiated from rigid filtered sterilization containers. www.flashpak.com

Flash-Guard from Sparco This closed-container flash sterilization and transport system was designed and patented to work in synchronization with gravity displacement (flash) sterilizers and pre-vac autoclaves, says the company. It's the only container system capable of sterilizing 16 lbs. of non-porous, non-cannulated instruments at 270 ?F for 3 minutes, according to Sparco. Available in 5 sizes, from 12" to 22". $895 to $1395, www.flash-guard.com

FlashTite from Case Medical The SteriTite container with FlashTite valve is a filterless, sealed-container system meeting all parameters for use in sealed flash sterilization, says the company. It replaces the current practice of flashing with an open pan or using a sealed container with its lid open. The valve automatically opens and closes in the autoclave. All components, including the valve plate, are designed to be easily disassembled for cleaning. Can be used for pre-vacuum flash. www.casemed.com