TABLE 3.

Prion Decontamination Protocols For Reusable Surgical Instruments and Surfaces

World Health Organization and Centers for Disease Control and Prevention recommended options
1. Immerse in 1 N or 2 N NaOH and heat in a gravity displacement autoclave at ≥121°C for 30 minutes in an appropriate container (see text, warnings, and references). Clean and sterilize by conventional means.
2. Immerse in 1 N NaOH or NaOCl 20,000 ppm for 1 hour. Transfer into water and autoclave (gravity displacement) at ≥121°C for 1 hour. Clean and sterilize by conventional means.
3. Immerse in 1N NaOH or NaOCl (20,000 ppm) for 1 hour. Rinse instruments with water, transfer to open pan, and autoclave at ≥121°C (gravity displacement) or at 134°C (porous load) for 1 hour. Clean and sterilize by conventional means.
Decontamination of surfaces
Surfaces can be treated with 2N NaOH or sodium hypochlorite (20,000 ppm) for 1 hour.
Ensure surfaces remain wet for entire time period and then rinse well with water.
Before chemical treatment, it is strongly recommended that gross contamination of surfaces be reduced because the presence of excess organic material will reduce the strength of either NaOH or sodium hypochlorite solutions.
Warnings
NaOH should not be autoclaved in aluminum containers or in contact with aluminum.
Some poor-quality stainless steel instruments may be corroded by exposures to NaOH solutions; many metal instruments are corroded by exposures to NaOCl solutions.
Autoclave containers should have rims and lids designed to allow NaOH condensates to collect and drip back into the pan.
NaOH solutions are very caustic when hot and should be allowed to cool close to ambient temperature before handling using appropriate precautions