THERMAL SCIENCE
International Scientific Journal
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DISCOVERY OF EXTRA PLATEAU PERIOD IN HOSPITAL PRESSURE STEAM STERILIZATION AND ITS IMPACT ON STERILIZATION QUALITY
ABSTRACT
This study identifies and investigates the extra plateau period (EPP), a previously unreported phenomenon in hospital pressure steam sterilization, where temperature and pressure stabilize at elevated levels before entering the sterilization stage. Utilizing digital temperature-pressure detectors and standard test packs, a comprehensive analysis of 58 sterilizers across 31 hospitals was conducted under small-load (Bowie-Dick test) and full-load (sterilization program) conditions, in accordance with the Chinese standard Technical Requirements for Large Steam Sterilizers (GB 8599) or the European standard Sterilization - Steam Sterilizers - Large Sterilizers (EN 285). The findings revealed that 39.66% of the sterilizers (23 out of 58), all of which were older cross-atmospheric pulsating models, exhibited EPP. The Bowie-Dick test program revealed that all affected sterilizers exhibited EPP, with plateau times averaging 462.5 seconds - a 118.88% increase over the established values. A similar trend was observed in 73.91% of sterilization programs, which exhibited EPP, resulting in a 39.91% increase in plateau times (749.9 seconds vs. 536 seconds). The consequences of EPP manifested in substantial delays in temperature penetration within test packs, leading to Bowie-Dick test false negatives and rendering physical monitoring ineffective despite apparent compliance with traditional quality checks. These findings underscore critical risks to sterilization quality, including undetected equipment malfunctions and compromised infection control. The study underscores the necessity for enhanced parameter monitoring in older sterilizers and advocates for precision quality control strategies to ensure patient safety.
KEYWORDS
pressure steam sterilization, extra plateau period, digital monitoring, sterilization quality control, hospital infection prevention, Bowie-Dick test failure
PAPER SUBMITTED: 2024-11-14
PAPER REVISED: 2025-04-16
PAPER ACCEPTED: 2025-04-17
PUBLISHED ONLINE: 2026-04-12
DOI REFERENCE: https://doi.org/10.2298/TSCI2602097Y
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REFERENCES
[1] Ding, L. N., et al., Application of a Temperature and Pressure Detector to the Preventive Maintenance of Hospital Autoclaves, Thermal Science, 28 (2024), 3A, pp. 2201-2210
[2] Zhan, Y., et al., Study on Temperature Delay of Non-Metallic Medical Instruments in Pressure Steam Sterilization, Thermal Science, 27 (2023), 3A, pp. 1921-1926
[3] Nazhat, S. N., et al., Sterility and Infection, in: Biomedical Materials, (Narayan, R. ed.) Springer, Cham., New York, USA, 2021
[4] He, J.-H., Transforming Frontiers: The Next Decade of Differential Equations and Control Processes, Advances in Differential Equations and Control Processes, 32 (2025), 1, 2589
[5] Lei, X. H., et al., Frontiers in Thermal Science Driven by Artificial Intelligence, Thermal Science, 29 (2025), 3A, pp. 1671-1677
© 2026 Society of Thermal Engineers of Serbia. Published by the VinĨa Institute of Nuclear Sciences, National Institute of the Republic of Serbia, Belgrade, Serbia. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International licence


