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How to Manage Linen Wrappers During a Single Use Shortage

I started my career using muslin sterilization wrappers. With the shortage of disposable polypropylene wrappers, muslin wrappers are coming back into favor, albeit most likely for just a short period of time. I have some good memories of using muslin wrappers. One of them is that they have no fabric memory, unlike disposable wrappers. The muslin wrappers are much easier to work with because they stay where you place them. However, there are many issues when it comes to managing them.

Laundry Services

First of all, muslin wrappers, because they are reusable, must be laundered between each use. One of the reasons is that they dry out during the sterilization process and must be re-humidified. Other reasons, such as contamination, etc., should be fairly obvious. With the laundry service comes a host of issues. Wrappers come back with holes in them, heat damage by the laundry presses, and a multitude of contamination (e.g., lint, suture, stains).

Cleaning & Inspecting Linen Wrappers

Muslin wrappers must be inspected for damage and contamination each time they are used. Cleaning should occur in a separate enclosed area other than prep & pack to limit contamination within Sterile Processing. The area should also have a downdraft HVAC system to help remove particles from the air. Increased linting in Sterile Processing can cause lint to contaminate surgical instrument trays, which in turn can become a retained foreign body during surgical cases. Cleaning should occur using a de-linting device such as a lint roller.

Linen wrappers must be inspected with the use of a light table. Textile wrappers often develop holes due to use and laundering. The light from the table penetrates the wrapper from below and helps the staff locate areas needing repair.

Repair of Linen Wrappers

Linen wrappers can be patched with heal-seal patches; sewing is not recommended. A limited number of patches can be placed per square inch of space, especially if gravity sterilization is being employed. The manufacturer's instructions for use should be followed to ensure you use the proper patching material when mending the wrappers.

Shelf Life

Shelf life for muslin wrappers is a little more ambiguous than disposable sterilization wrappers. The CDC states that supplies wrapped in double thickness muslin comprising four layers remain sterile for at least 30 days. Other options are to add a dust cover to the wrapped package to extend shelf life. Refer to the manufacturer's IFU to see how long you can extend the shelf life. As always, event-related issues come into play which can shorten shelf life.

In conclusion, I recommend reviewing the references below if you consider moving to reusable textile wrappers, even for a short time. There are many more facets to managing textiles.



Comprehensive guidel to steam sterilization and sterility assurance in health care facilities

Effects of patching on sterilization of surgical textiles

AORN Journal

Choosing a Sterilization Wrap for SurgicalPacks

William A. Rutala, Ph.D., MPH, and David J. Weber, MD, MPH are from Division of Infectious Diseases, University of North Carolina (UNC) School of Medicine and the Department of Hospital Epidemiology, UNC Health Care System (Chapel Hill, NC).

May 1, 2000, Infection Control Today

Center for Disease Control and Infection

Sterilizing Practices

Guideline for Disinfection and Sterilization in Healthcare Facilities (2008)

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