Table 2.1, Instrument processing - Safe Abortion

Method	Agent	Time	Notes
Sterilization	Pressurized steam (autoclave)	20 minutes at 121°C and 103.5–140 kPa pressure	Assumes the areas of equipment targeted for decontamination are accessible to steam. Time should be increased to 30 minutes for wrapped items.
	2% glutaraldehyde	5 hours contact at 20–25°C with a 2% activated alkaline formulation (pH = 7.5–9)	Some sources/manufacturers suggest 10 hours for sterilization.
High-level disinfection (HLD)	Chlorine (sodium hypochlorite)	5 minutes contact at 20–25°C with buffered hypochlorite (pH = 7–8) at a concentration of 5000 ppm available chlorine (approximately 10% dilution of household bleach – can be corrosive to metals)	Some sources recommend 20 minutes in a 5% dilution if made with tap water, or 1% dilution if made with boiled water.
	2% glutaraldehyde	30 minutes contact at 20–25°C with a 2% activated alkaline formulation (pH = 7.5–9)	Some sources/manufacturers suggest 20 minutes for HLD.
	Boiling	20 minutes at a “rolling boil”	The pot should be covered; items that float do not need to be fully immersed.

Method

Agent

Time

Notes

Sterilization

Pressurized steam (autoclave)

20 minutes at 121°C and 103.5–140 kPa pressure

Assumes the areas of equipment targeted for decontamination are accessible to steam. Time should be increased to 30 minutes for wrapped items.

2% glutaraldehyde

5 hours contact at 20–25°C with a 2% activated alkaline formulation (pH = 7.5–9)

Some sources/manufacturers suggest 10 hours for sterilization.

High-level disinfection (HLD)

Chlorine (sodium hypochlorite)

5 minutes contact at 20–25°C with buffered hypochlorite (pH = 7–8) at a concentration of 5000 ppm available chlorine (approximately 10% dilution of household bleach – can be corrosive to metals)

Some sources recommend 20 minutes in a 5% dilution if made with tap water, or 1% dilution if made with boiled water.

2% glutaraldehyde

30 minutes contact at 20–25°C with a 2% activated alkaline formulation (pH = 7.5–9)

Some sources/manufacturers suggest 20 minutes for HLD.

Boiling

20 minutes at a “rolling boil”

The pot should be covered; items that float do not need to be fully immersed.

From: 2, Clinical care for women undergoing abortion

Safe Abortion: Technical and Policy Guidance for Health Systems. 2nd edition.

Geneva: World Health Organization; 2012.

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Table 2.1Instrument processing