PrepperMed 101: Sterile Instruments

“The operation was a success, but the patient died.” That was a common theme in pre-20th century medicine. People had figured out what to do in the way of surgical repair for many injuries, but in using instruments that were not sterile they were sowing the seeds of the patient’s destruction even while they stopped the bleeding and knitted the tissues back together.

Even the simplest surgical interventions, such as lancing boils or doing a cut-down to remove an embedded splinter bit, can literally be fatal if you introduce infection. How can a prepper avoid this kind of problem? By knowing how to make tools sterile.

Choose instruments that don’t fight being sterile

I have a love/hate relationship with the surgical instruments I see in a lot of historical displays. They can be beautiful: High quality, well crafted surgical steel, with lovely polished wood handles. I look at those handles and see a million little hiding places for bacteria, so hard to get sterile.

Boring as it may be, plain steel instruments are best. Fewer crevices to harbor bacteria.

The high quality, well crafted surgical steel part still works today. It can stand up to repeated rounds of any sterilization method. Rubberized handles can melt the tool together when exposed to heat, or get gummy or crumbly after exposure to alcohol. Any porous material is harder to make sterile than smooth surfaces. Cheap steel can dull or get cranky in its movements under the harsh treatments needed to create a sterile tool.

The whiskey method does have some value

High alcohol solutions do a pretty good job of making a tool or surface sterile. 70% ethanol (140 proof) is a common wipe-down solutions in labs; we’re taught that the wiped surface can’t be considered really sterile but it has a really reduced microbe population. Letting an instrument soak in 95% alcohol (180 proof) for 10 min was considered sufficient to make it actually sterile. The soak time is to let the solution slip into all the little crevices.

I still remember how horrified one of my very straight-laced chemistry professors was when I needed some very pure ethanol for this purpose and the only quick source was a bottle of Everclear. One of his cub scouts saw him leaving the liquor store with the tell-tale bottle in a brown paper bag…

190 proof grain alcohol, off the shelf, is 95% ethanol; the same as we used in the lab to make things sterile. (We also had to lock it away from the med students.)

We were also taught to get most of the alcohol off before touching live cells. The subject’s cells don’t like the alcohol any more than the microbes do. A quick run through a flame (followed by a few seconds of cooling time before touching the patient!) was the preferred method.

Pressure cookers can make things sterile

An autoclave, the lab instrument most often used to make sterile tools and solutions, is essentially a pressure cooker. Below is a guideline on what it takes to create sterile instruments, from the Journal of the American Dental Association:

Autoclave Temperature and Time Pressure Chart

It shows a 15 psi will take the temperature to 121 F, and 15 min of that provides reliable sterilization. I note my stove-top pressure cooker can run at 15 min; and would work even over a wood fire if necessary.

Stove top pressure cookers that use weighted rockers instead of gauges will likely work for years without power.

I already have used my pressure cooker to sterilize water, and I keep a bit of that sterile water on hand should I need it for wound cleaning or some such. Any time I’m running the canner and have space for an extra jar or two, it’s almost no extra work to can a jar of water.

Keeping the instruments sterile until use

Since surgical-type instruments may need to be used without much warning, you might want to sterilze them ahead of time. Since our world is teeming with microbes, things don’t stay sterile unless you really work at it. 

The usual lab method, and one that would work very well for pressure-cooked instruments, is to do the sterilzation in a sealed bag. They’re essentially little paper bags sealed with a tape that’s heat sensitive. The indicator on the tape changes color when sterilization conditions are met, so you can look at the bag and assure it’s still sealed and had been made sterile. They’re readily available for purchase; I don’t recommend any particular brand but here’s the sort of thing I mean: https://www.net32.com/ec/house-brand-350-x-10-selfsealing-paper-d-101050?utm_source=Windfall&utm_medium=productfeed&utm_content=dental&utm_campaign=googleshopping&utm_source=google&utm_medium=cpc&adpos=1o1&scid=scplp101050&sc_intid=101050&gclid=EAIaIQobChMI9_bbtaq43gIVWYGzCh08jgwdEAQYASABEgIFSfD_BwE

Autoclave bags go through the sterilization procedure with the tools already sealed inside.

This method would work for syringes and needles too, so long as the components were autoclave-safe.

Are home measures to make everything sterile likely to be 100% effective? Based on early practices in medicine, no … but they did reduce infection rates a lot, and that’s a big deal. If your operation is successful, you definitely also want the patient to live.

Cleaning wounds themselves is a whole other can of worms. You can read some about it here.