Rationale

CSSD was generally looked upon as an essential part of an OT as the use of sterile supplies in a
hospital is maximum to the OT. However, all that has changed. CSSD is considered today, integral
to the function of Out Patient Department (OPDs), wards and other departments.

To maintain good workflow, sterilization process implies proper functioning and co-ordination
between four zones: dirty area, which is also called as washing area, assembly area or packing
area, sterile area and finally the sterile goods storing area.

Problem

CSSD requires technical competency, which implies that the department controls all the activities
of asset management pertaining to selective procurement of general and specialized surgical
instruments and other inventory. CSSD in Indian hospitals imply quality service with scarce
resources. An alarming rate of Hospital Acquired Infections (HAI) in Indian hospitals has
highlighted the importance of CSSD. If the CSSD is not in place, there is a definite surge in HAI.

The rise in incidence of nosocomial infection with corresponding increase in mortality, length of
stay and cost can be brought down by establishing a good CSSD set-up

Future

Indian hospitals are generally known to clean, disinfect or sterilizing SUDs. “This practice should
be adopted only very judiciously to reduce disposable medical waste and costs, without
compromising on patient safety.”

Today, the upcoming advanced sterilizers are all computer controlled with a backup that leaves no
margin for error. Achieving cent per cent sterilization is the biggest challenge. “Theoretically, one
can achieve 100 per cent sterilization, but practically achievement of true sterilization is a factor
that follows the law of chance. Hence, achieving 99.99 per cent log kill of bacterial spores is
considered good enough to pronounce the material as sterile. There is a specific protocol called
the Spaulding classification, which is followed for sterilizing or disinfecting critical and semi-
critical items,”