Aseptic Presentation Protecting the Sterile Barrier of Peel Packs


A sterile barrier system, or peel pack, is used to maintain the sterility of, and present a product to the sterile field in an aseptic manner. The pack must maintain its full integrity throughout the continuum to ensure sterility.


Factors that adversely affect sterile barrier integrity are crushing, dropping, stacking, compression, tears, holes, ruptures of seals, etc.


Even though we may see a sterilization indicator within a pouch does not mean the pack is sterile. It means that pack was processed by a method that met conditions sufficient enough to achieve microbial inactivation. However, the path the pack takes after sterilization determines whether or not that instrument is fit to use.


Repetitive handling is frequently cited as causing a negative impact on the sterile barrier. Creases, folds, and pinholes may be created and render the instrument unsterile. What can your facility do to minimize the effects of handling on the sterile barrier?


1. Use a sterilization card within the pouch to secure the instrument and prevent it from moving around. Instruments placed loosely in a pouch are more difficult to transport, store, handle, or grab without crushing. Also, moving instruments within a pouch has a tendency to place stress on the sides of the pack, risking seal integrity.


2. Backer cards are easier to retrieve from the pack during transfer of the instrument to the sterile field. Retrieval of loose instruments can compromise the sterility of the scrub person. Dumping of product onto the field may result in dropping of the instrument onto the floor or contamination of the sterile field. Give your Surgical Technologist something to grab.


Sterilization cards act like a semi-rigid container within a plastic pouch, holding things together and preventing movement, so that the pack may be presented “aseptically” to the O.R.