What is really Sterile?

My dear colleague I do respect you very much and appreciate your contributions, you are indeed a reference between medical play british and global communities but may I ask where do you get "metal disposable speculum's"? Never heard of such thing...

Off course I agree that using disable speculum's reduce cross contamination to zero level ( at least coming from the speculum...). We all real and play doctors want to reduce at minimum the possibilty of cross contamination at play or real offices and the most "wanted public enemy number one " is the Papova Vìrus; HPV with all its variations ( because on the contrary to HIV virus it can stay "alive" outside the human bodie at "fomites" - inanymate objects ).

Studies indicate that the correct cleaning/ brushing procedure followed by an adequate "Autoclave" procedement is adequate to kill all types of bacteria, virus and other microorganisms.

A metalic instrument coming from an autoclave comes packed like a disposable plastic speculum so both are totally sterile until the pack is open.

A vaginal exam even specular doesn't need the object to be sterile needs only that it had been sterelized after the contact with the last patient.

A Pressure coocker if properly used will have a very similar action to a real autoclave so I really don't see any "messing around with pressure cookers."

here goes the link :

http://www.chaseunion.com/documents/safety/sterile1.htm

.......but may I ask where do you get "metal disposable speculum's"? Never heard of such thing... .... A vaginal exam even specular doesn't need the object to be sterile needs only that it had been sterelized after the contact with the last patient.

Disposable stainless steel speculums can be obtained in the UK for £18 ($US27) for 10. They are individually sterile packed.

It is true that speculums do not need to be sterile provided they are sterilised after use with a previous patient. After all no one boils their penis before intercourse. However, there is so much more confidence to be gained by a patient in seeing the sterile wrapper torn open.

"there is so much more confidence to be gained by a patient in seeing the sterile wrapper torn open." _ I totally agree BigK,

I wish rhere were those dispodable metalic in Portugal ( I really do prefer metalic ), are they similar to the non disposable? in weight and model? Graves? Cusco?

I only use pre-packeged sterile disposables. I don't play frequently enough to invest in the equipment needed to sterile all things.

And for the room. I try to work only in rooms that are clean, have no pets in them, or people smoking. I tend to clean it before hand and afterwards. Ofcourse I can't accomplish the same cleanliness as in a medical institute, but usually I'm not working with people with low immune systems or cutting people open. (Also, I don't use catheters, so that's eliminating a big source of infection too).

So, I try to use as clean as possible, with sterile disposables in case I can get my hands on them 😃

When I was piercing, I either had an autoclave which was kept in proper condition by regular spore tests or access to a hospital's sterilization department. The problem was the things that could not handle the heat involved in the process. For these I used Mar-V-Cide. Read the label - it kills all known bacteria, viruses and fungi. This stuff is cheap and very good. All it lacks is the certification for health uses. It is the basis for the blue solution used on combs and other things by barbers and hair stylists.

Speed

When I was piercing, I either had an autoclave which was kept in proper condition by regular spore tests or access to a hospital's sterilization department. The problem was the things that could not handle the heat involved in the process. For these I used Mar-V-Cide. Read the label - it kills all known bacteria, viruses and fungi. This stuff is cheap and very good. All it lacks is the certification for health uses. It is the basis for the blue solution used on combs and other things by barbers and hair stylists.

Speed

The label/msds sheet does NOT say that it kills all known bacteria, viruses and fungi. In fact it lists several bacteria that it kills, including HIV virus, but just about everything kills HIV.

Part of the reason it isn't certified for health care is among other things not certified to kill hepatitis or tubercle bacilli.

Not being a toxicologist I can't say more about it, but the benzalkonium chloride/quaternary ammonium salts are NOT sterilants.

To kill what it does kill, the instruments must be CLEANED, then immersed and kept wet for at least ten minutes and allowed to air dry.

Chemical sterilants take on the order of TEN HOURS to sterilize non-porous surfaces.

In fact, in their instructions, it states: "It is a violation of Federal Law to use this product in a manner inconsistent with its labeling. This product is not to be used as a terminal sterilant/high-level disinfectant on any surface or instrument that (1) is introduced directly into the human body, either into or in contact with the bloodstream or normally sterile areas of the body, or (2) contacts intact mucous membranes but which does not ordinarily penetrate the blood barrier or otherwise enter normally sterile areas of the body.This product may be used to preclean or decontaminate critical or semi-critical medical devices prior to sterilization or high- level disinfection.For disinfecting, a precleaning step is required."

Http://www.cdc.gov/hicpac/Disinfection_Sterilization/toc.html

http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/ReprocessingofSingle-UseDevices/ucm133514.htm

The transmission of microbials isn't a laughing matter. Even hospitals can have a difficult time sterilizing equipment between patients. In our genre, colon tubes and other long channel devices are particularly difficult to sterilize. These documents cover a wide range of sterilization techniques, but are critical if you are the Dominant or partner in charge of 'toys' that go between people.

For all but the most aggressive, meticulous, perhaps professionally employed player, disposible is the way to go (or have each partner have their own equipment not to be shared).

This trhead keeps being very important in my opinion!thank you for last contributions

I use disposable (sealed packaged) speculum although I do also have a large selection of stainless steal speculum, which in most cases is prefered by both myself and patient (I only use plastic if the scenario calls for it)

All speculum are thoroughly cleaned after use with antibacterial spray, and I then use a vegetable steamer (the type you can buy from all good electrical retailers) with a mix of water and dettol and st team the speculum for 30 minutes, I know this isn't the same as an autoclave but with half an hour of steam any bacteria would be killed, I then remove them and clean them, off again with anti bacterial cleaner, prior to an exam I warm them in a very mild warm water and dettol solution and then rinse them off in clean warm, water before use.

So far in all the years I have been doing this, I have had no issues with cleanliness or hygiene

SJ

A home pressure cooker serves as a suitable substitute for an autoclave. A home cooker will never give the pressure of an autoclave to achieve 121C so prolonged time in the cooker is necessary. I won't even try to give an estimate of time needed but an hour sounds reasonable. (I take no responsibility for these figures).

How do you know the pressure cooker reaches 121C or 250F?

When Cooks Illustrated Magazine recently did their tests of pressure cookers, they didn't get that hot.

If there is a pressure gauge, then when it reaches 15psi, you are at approximately 121C. It takes a full 15 minutes at that temperature/pressure to achieve sterilization.

If the item being sterilized is metal that can be heated in an oven (dry heat), then 60 minutes at 170C or 30 minutes at 180C will do it. 170C = 338F. 180C = 356F. The item being sterilized needs direct access to this heat. Putting the item on an open, clean sheet of aluminum foil that can be closed after sterilization is a good way to do this short of buying an autoclave.

@switchablesus... If I read the same article you did, those were ELECTRIC pressure cookers, not stove tops. My stove top gets to 121C..

A pressure gauge does NOT tell all. Why are you assuming the pressure gauge is accurate? If the pressure gauge reads 15 psi when it is only 10 psi, you do NOT have 121C or 250F.

When Cooks Illustrated Magazine recently did their tests of STOVETOP not electric pressure cookers ONLY ONE pressure cooker reached 15 psi and 250F, and that was the Fissler Vitaquick at about $280. NONE of the others ever reached temperature or pressure. NONE of them has a psi pressure gauge, so you never know what's going on inside the pot. Relying on a pressure cooker isn't good for sterilization unless you run it for a full hour.

The very large canning pressure cookers sometimes have a psi gauge.

The Emirl by TFal was the best electric and they really DON'T like the eletcric models.

All the temperature and pressure info has been covered in earlier posts in this thread regarding real sterility.

My pressure cooker is about 25 years old and it does have a pressure gauge

Is it accurate? There aren't any medical devices for sterilization that go 25 years without calibration or inspection.

Sterilizers are routinely tested for spore sterilization by specialized laboratories.

Susie, If you re-read my original post you will read that I clearly stated that I would not expect a home cooker to reach 121C and I recommended an hours cooking time.

For those of you with pressure cookers that have a pressure gauge, good, but don't rely on it for sterilization.

There is a tape used to close paper wrapped instruments which has an indicator that shows if sterilization temperature has been achieved.

As I mentioned last year on this thread I switched over to disposable single use metal speculums a couple of years ago. I purchase metal speculums that come individually sterile packed from a reputable medical supplier here in the UK. By buying in bulk, even the better quality polished stainless steel ones are not expensive, and the standard stainless steel ones are very cheap. They are all genuine medical quality instruments that would be used by real doctors in real life examinations. The main cost of most play exam appointments is the hotel room followed by travel expenses, the cost of the speculums is just a small percentage.

To my mind, if it is the woman's first play exam experience, or her first examination with a new play doctor, then the fact that the speculum is sterile packed might go some way to giving her a bit of reassurance.

I can understand if play doctors have an expensive or special instrument they wish to keep and use again, but for me I like an easy life and prefer to go for disposable as much as possible than mess around with the uncertainty of pressure cookers and the like.

It works well for me.

Dr Philip.

Sure, Methylated Spirits can be used to cleanse instruments. But there is a clue in the name Methylated. It is denatured alcohol which most often has around 10% Methanol, which is poisonous.

It is also likely to contain various amounts and mixes of isopropyl alcohol, acetone, methyl ethyl ketone, methyl isobutyl ketone and frequently an analine dye to give it a blue or purple colour.

Of course most of it will evaporate but there will be chemical traces left after the alcohol has gone. Those traces will very likely not harm you but, if you don't fancy being part of a chemistry set, then why not use Surgical Spirit? Yes, it also contains methyl's, and ethyl's too, but at least it's approved for use on humans, like Vodka is, lol.