The effects of multiple sterilisations on titanium and stainless steel plates and screws

Abstract

The way in which health care facilities store surgical plates and screws in Australia varies from state to state and even hospital to hospital. The prostheses are either obtained as individually packaged, pre-sterilised implants or stored in a screw caddy in an instrument tray, which is sterilised for multiple surgeries. The repeated exposure of the plates and screws to sterilisation methods may have the potential to negatively affect their strength or corrosion potential. A systematic review of the literature was conducted to identify any impact from repeated sterilisation on stainless steel and titanium prostheses. Detrimental effects to either the oxide layer, which protects the metal from corrosion, or the overall strength of the metal were found in both metals after repeated sterilisations. Stainless steel was more affected than titanium. While no clear evidence about the clinical implications of these changes was able to be derived, it is recommended that further studies are performed relating to the clinical implications of these changes in order to guide best practice in the clinical setting.