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STERILE PROCESSING INSIGHTS Dirty silicone mats & DIN trays by Stephen M. Kovach


going through the medical automatic washer, and some people don’t. Also, some of our mats are very dirty. What advice do you have?”


Q A


I have captured two pictures that will help highlight your concerns about the proper way to use silicone mats (right).


Your question indicates that dirty silicone mats are cleaned incon-


sistently and without a standardized practice at your facility. Silicone mats are purchased with a purpose that they can add an


extra level of protection (a “cushion”) to instruments in the tray or basket and are often used for delicate instruments. Silicone mats (or pads) come in many sizes and shapes. Some are:


• On rolls or sheets that can be cut. • Precut to the DIN tray size. • In diff erent colors. • With specifi c trays designed to fi t snugly in the tray. In my view, all departments have silicone mats, and I have seen


exactly what you are talking about—the inconsistency in cleaning silicone mats, which can cause them to look dirty. Thus, how can you reduce having dirty silicone mats in any department? As in almost all my responses, you need critical thinking. This entails fi nding the instructions for use (IFU) for the silicone mats you are using. Dove tail that with research to put in a “Best Prac- tice” in your Standard Operating Procedure (SOP). Ensure your SOP includes information on inspecting, cleaning, sterilizing, and any other relevant information. As per your questions, it seems your department does not


have any SOP. Here is a very generic SOP you can use as a guideline and adjust based on the specifi c type of mat your department uses.


SAMPLE SOP FOR SILCONE FINGER MATS1-3 .


1. When received, the silicone fi nger mat should be cleaned prior to fi rst use in accordance with the cleaning instructions found in the IFU.


2. Confi gure the mat properly to where the fi ngers point upward to accommodate the instruments that will be sterilized. The mat should be used to help hold, organize, and protect instruments.


“We have silicone mats in my department. Some people leave them in trays with instruments when


Figure 1- Dirty Silicone Mat


Figure 2- Improper loading of instruments


(with silicone mat in bottom of tray).


7. Review the IFU for specifi c sterilization instructions (types/methods/ cycles) for the silicone mat.


8. It is the processor’s responsibility to ensure processing using equipment, materials, and personnel in the processing facility to achieve the desired result. This could require routine verifi cation monitoring of their process.


9. All staff will be trained in this policy by demonstrating how to properly use, clean, and inspect silicone mats.


10. The silicone fi nger mat has a life span and will require replacing if there are any signs of deterioration or loss of functionality. Dispose of product following the facility’s policy. This should give you a start on resolving your concern and get cleaner silicone mats. I used the term “DIN tray” in my response, and I am not sure everyone knows what this means; so, here is an explanation of the term DIN. DIN stands for Deutsches Institut für Normung meaning German Institute for Standardization. The most common sizes of sterilization trays are DIN sizes. DIN sizing refers to a German Standard (DIN EN 285: 2016), which specifi es requirements and the relevant tests for large steam sterilizers primarily used in health care for the sterilization of medical devices and their accessories. HPN


DIN Reference Size – Width Full DIN ¾ DIN ½ DIN ¼ DIN


480 mm (sometimes also known as 500 mm / 515 mm / 540 mm) 360 mm (sometimes also known as 400 mm / 405 mm) 240 mm 120 mm


The trays can be any length and depth/height, but the most common length referred to is 250 mm. Common DIN tray sizes would be (length x width x height): 480- x 250- x 50 mm, 240- x 250- x 50 mm


3. Instruments should be arranged in a single-layer with adequate spacing to prevent them from contacting each other.


4. The silicone fi nger mat is reusable and should be cleaned and decon- taminated prior to reuse according to the IFU for the mat.


a. Mats can be manually cleaned (preferred method) or can go through medical automatic washer.


b. Mats should not be washed (or placed inside) with the tray of instru- ments because they could prevent exposure of the cleaning solutions and rinsing of the instruments by blocking impingement.


5. Visually inspect the mat before placement in a tray or storage to ensure the complete removal of soil. Inspection should verify cleanliness, lack of damage (e.g., cracking in the mat, missing fi nger points), and proper function.


6. Mats should be dry before being placed in a tray with instruments. References:


1. Chobin, Nancy (RN, AAS, ACSP, CSPM, CFER). (August 29, 2019). Surgical Instrument De- contamination: A Multistep Process. AORN Journal, September 2019, 110(3), 253-262. https:// doi.org/10.1002/aorn.12784. (PDF on https://www.cbspd.net/wp-content/uploads/2019/10/ Chobin-2019-AORN_Journal.pdf).


2. Griffi n, Ava (BSN, RN, CNOR); Koncur, Patti (CRCST, CHMMC, ACE). (2015). CIS Self-Study Lesson Plan Lesson No. CIS 261 (Instrument Continuing Education - ICE): Human Factors That Impact Sterilization. Communiqué, May/June 2017, 34-38. MyHSPA (formally www. iahcsmm.org). Retrieved December 6, 2022, from https://myhspa.org/images/Lesson_Plans/ CIS_Plans/CIS261.pdf.


3. Wood, John (BAAS, CIS, CRCST). (2015). CIS Self-Study Lesson Plan Lesson No. CIS 277 (Instrument Continuing Education - ICE): Instrumentation Assembly, Inspection & Protection. Process, January/February 2020, 48-52. MyHSPA (formally www.iahcsmm.org). Retrieved December 6, 2022, from https://myhspa.org/images/Lesson_Plans/CIS_Plans/CIS277.pdf.


4. © National Surgical Corporation. (n.d.). Understanding sterilisation trays for CSSDs. Retrieved December 6, 2022, from https://nationalsurgical.com.au/understanding-sterilisation-trays- for-cssds/.


hpnonline.com • HEALTHCARE PURCHASING NEWS • February 2023 31


Combining DIN sizes together as width and length: 480- x 360- x 50 mm, 240- x 120- x 50 mm.4


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