TY - JOUR
TI - Discovery of extra plateau period in hospital pressure steam sterilization and its impact on sterilization quality
AU - Yao Zhuoya
AU - Zhan Meng
AU - Li Manchun
AU - Geng Junhui
AU - Ding Lina
AU - He Zhirong
AU - Yu Zhang
AU - Yang Lei
JN - Thermal Science
PY - 2026
VL - 30
IS - 2
SP - 1097
EP - 1106
PT - Article
AB - 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.
DO - 10.2298/TSCI2602097Y
ER -