Sterilizing method and apparatus
10792602 ยท 2020-10-06
Assignee
Inventors
- Robert E. Turbett (Penfield, NY, US)
- Brian E. McGrath (Clarence, NY, US)
- Richard D. Richmond (Canandaigua, NY, US)
Cpc classification
B01D46/10
PERFORMING OPERATIONS; TRANSPORTING
B01D46/0002
PERFORMING OPERATIONS; TRANSPORTING
B01D46/0005
PERFORMING OPERATIONS; TRANSPORTING
B01D46/64
PERFORMING OPERATIONS; TRANSPORTING
A61L2202/24
HUMAN NECESSITIES
A61L2202/15
HUMAN NECESSITIES
Y10T29/49826
GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
A61L2202/23
HUMAN NECESSITIES
International classification
B01D29/54
PERFORMING OPERATIONS; TRANSPORTING
B01D25/02
PERFORMING OPERATIONS; TRANSPORTING
B01D46/00
PERFORMING OPERATIONS; TRANSPORTING
Abstract
A sterilization container for retaining surgical instruments in a sterilizer comprising a plurality of walls defining an interior volume sized to receive at least one instrument tray, least one of the walls defining a venting pass through area, and a filter occluding the venting passage area, wherein a ratio of the venting pass through area to the interior volume is at least 1 square inch:125 cubic inches.
Claims
1. A sterilization container for sterilizing instruments in a sterilizer using a sterilizing agent, the sterilization container comprising: (a) an enclosing wall and a door defining a total surface area and an interior volume sized to receive a plurality of instrument trays; (b) at least one of the surrounding wall and the door defining a venting pass through area; and (c) a filter occluding the venting pass through area, wherein the venting pass through area is at least 5.7% of the total surface area.
2. The sterilization container of claim 1, further comprising a second filter overlying the first filter.
3. The sterilization container of claim 1, wherein the venting pass through area is defined by only one vent.
4. The sterilization container of claim 1, wherein the venting pass through area is defined by only one vent port.
5. The sterilization container of claim 1, wherein the enclosing wall includes sidewalls, a top wall and a bottom wall and the venting pass through area is located in at least one of one of the sidewalls and the top wall.
6. The sterilization container of claim 5, further comprising a door moveable between an open position and a closed position, and wherein the venting pass through area is in the door.
7. The sterilization container of claim 6, further comprising an opening in the enclosing wall, the opening lying in a plane spaced from a rear wall of the enclosing wall, wherein the door is moveable between the open position permitting passage of the tray through the opening into the interior volume and the closed position precluding passage of the tray through the opening.
8. The sterilization container of claim 1, wherein the venting pass through area is defined by a fenestration in the enclosing wall, and the enclosing wall includes a plurality of walls.
9. The sterilization container of claim 1 wherein the enclosing wall includes sidewalls, a top wall and a bottom wall, and wherein the venting pass through area is located in the bottom wall.
10. The sterilization container of claim 1, wherein the interior volume is defined by three orthogonal dimensions, and wherein one of the three orthogonal dimensions is no more than twice the other orthogonal dimensions.
11. The sterilization container of claim 1, wherein the enclosing wall includes sidewalls, a top wall and a bottom wall, and wherein the venting pass through area is located in at least two of the sidewalls.
12. The sterilization container of claim 1, wherein the enclosing wall forms an opening sized to pass a plurality of instrument trays.
13. A method of drying contents in a sterilization container, the method comprising: (a) placing the contents in a sterilization container having an enclosing wall and at least one door, the enclosing wall and door defining (i) a total surface area; and (ii) an interior volume between approximately 2,900 cubic inches and 30,600 cubic inches for receiving a plurality of instrument trays for retaining the contents; (b) venting the sterilization container through a venting pass through area having a filter occluding the venting pass through area, wherein the venting pass through area is at least 5.7% of the total surface area; (c) sterilizing the contents in the sterilization container with a sterilizing agent; and (d) drying the contents in the sterilization container in less than 30 minutes.
14. The method of claim 13, wherein the enclosing wall forms an opening sized to pass a plurality of instrument trays and wherein the venting pass through area is between approximately 5.7% and 20% of the total surface area.
15. The method of claim 13, further comprising the step of occluding the venting pass through area with a second filter before sterilizing the contents in the sterilization container with a sterilizing agent.
16. The method of claim 13, wherein the drying is less than 15 minutes.
17. A sterilization container for sterilizing instruments in a sterilizer using a sterilizing agent, the sterilization container comprising: (a) an enclosing wall having a top wall, a bottom wall, sidewalls, and a door defining an interior volume between approximately 2,900 cubic inches and 30,600 cubic inches for receiving a plurality of instrument trays; (b) at least one of the side wall, the top wall and the door defining a venting pass through area; and (c) a filter occluding the venting pass through area, the sterilization container having a ratio of the venting pass through area to the interior volume that is (i) at least 2 square inches to 50 cubic inches; and (ii) configured to provide a drying time of less than 30 minutes.
18. The sterilization container of claim 17, wherein the drying time is approximately 15 minutes for 140 lbs or less of instruments.
19. The sterilization container of claim 17, wherein the ratio of the venting pass through area to the interior volume is at least 1 square inch to 5 cubic inches.
20. The sterilization container of claim 17, wherein the ratio of the venting pass through area to the interior volume is between 2 square inches to 50 cubic inches and 1 square inch to 5 cubic inches.
21. The sterilization container of claim 17, wherein the venting pass through area is located in the bottom wall.
22. The sterilization container of claim 17, wherein the venting pass through area is defined by only one vent.
23. The sterilization container of claim 17, wherein the venting pass through area is defined by only one vent port.
24. The sterilization container of claim 17, wherein the enclosing wall forms an opening sized to pass a plurality of instrument trays, and wherein the door is moveable between an open and a closed position, and wherein the venting pass through area is in the door.
Description
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING(S)
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DETAILED DESCRIPTION OF THE INVENTION
(47) In the medical field, it is of the utmost importance that medical instruments are sterilized prior to any medical procedure. This drastically helps prevent the spread of infectious materials. In the marketplace, there are a wide variety of devices that provide for sterilization of medical instruments through the use of a sterilizing agent, such as steam. Instrument trays can be wrapped in a cloth or paper that acts as a filter, allowing the tray to be sterilized, then delivered to the operating room. Alternatively, a rigid container can contain the instrument tray. The device (e.g., a rigid container, sterilization container or cabinet) contains at least one vent for venting the steam used to sterilize the contents of the device. A disposable filter usually covers these vents. The filters have two major purposes. First, the filters prevent extraneous materials from entering the sterilizing device during and after the sterilization cycle. Second, the filters allow sterilizing steam to enter and exit the sterilizing device (sterilization container). Thus, the sterilization container can retain the sterilized medical instruments within the container and protected from the environment by the filters sealing the vents. The filter can be made of any type of porous paper or cellulose type material. In other embodiments, the filter is made of polymeric substances, such as polypropylene or a combination such as plasticized paper as known in the art. The filter is required to be both porous and dense enough to allow the passage of a sterilizing agent, such as steam, through its membrane, but also resilient enough to not rip or tear during a sterilizing cycle or during insertion/clamping into operable position. Although the present description is set forth in terms of a paper-like filter, the filter can be a tortuous path or even a valve that acts as a check valve permitting the venting of the sterilization container without permitting passage of extraneous materials into the sterilization container.
(48) Referring to
(49) The term sterilization cabinet 100 encompasses any device capable of retaining the medical instruments subjected to the sterilization procedure, wherein the cabinet 100 can receive and retain at least one tray, with the tray retaining at least one medical instrument. The sterilization cabinet 100 can retain the medical instruments in the sterilized condition after the sterilization process. The term sterilization container also includes sterilizing cabinets for sterilizing medical instruments, surgical devices and the like. The term sterilizer includes, but is not limited to, a housing or device defining an interior retaining the sterilization container and in which a controlled environment is create to impart a desired sterilization. Sterilizers include autoclaves; hot air ovens; ethylene oxide; low temperature steam, steam, high pressure steam and formaldehyde; sporicidal chemicals; irradiation; chlorine dioxide (CD) gas sterilization; hydrogen peroxide; vaporized hydrogen peroxide; hydrogen peroxide plasma; electron beam and gas plasma devices.
(50) The sterilization cabinet 100 includes an enclosing wall which defines an interior volume, wherein the enclosing wall can include a plurality of sidewalls, a top wall and a bottom wall. The walls can be planar or curvilinear and can be oriented to define a rectilinear volume, cubic volume or round or curved volume. For purposes of the present disclosure, the enclosing wall is set forth as the plurality of sidewalls, the top wall and the bottom wall, along with a door. It is understood the enclosing wall can include or cooperate with a door to at least partially define the interior volume. In one configuration the sterilization cabinet 100 includes the enclosing wall having the plurality of sidewalls, the top wall and the bottom wall, along with a door or doors 102, vents 104, and in certain configurations filter holder 106, primary filter 108, secondary filter 110, sterilization cabinet frame 112 and legs 114. Door or doors 102 are able to open and close for access to the interior of sterilizing cabinet 100. Door or doors 102 are physically connected to sterilization cabinet frame 112. Door or doors 102 can be attached through the use of a hinge or hinges which allows the doors to swing open. Alternatively, door or doors 102 can be removable from sterilization cabinet 100 through the use of clamps (not shown in
(51) Sterilization cabinet 100 in one embodiment provides for four vents 104. However, it should be appreciated that exemplary embodiments of sterilizing cabinet 100 are not limited to four vents. The sterilization cabinet 100 may include a fewer number or a greater number of vents 104. The vents 104 can define a venting pass through area 140 of the sterilizing cabinet 100. It should be appreciated that vents 104 can provide numerous small openings for the passage of sterilizing steam or heat. The small openings in vents 104 can be holes or slits. Alternatively, vents 104 can be fenestrated. By venting pass through area it is meant to refer to the total available area for the ingress and egress of a gas to or from the interior volume of the sterilizing cabinet 100. Exemplary embodiments of sterilization cabinet 100 can include one or more vents so long as the venting pass through area to volume ratio is equal to or greater than 0.008 inch.sup.2 per inch.sup.3, or 1 inch.sup.2:125 inch.sup.3, and in select configurations between 0.02-0.2 inch.sup.2 per inch.sup.3, or between 1 inch:50 inch.sup.3 and 1 inch.sup.2:5 inch.sup.3, and in further configurations between 0.16-0.2 inch.sup.2 per inch.sup.3, or 4 inch:25 inch.sup.3 and 1 inch:5 inch.sup.3.
(52) The term dry time or drying time means the time required to provide no visible moisture in the sterilization container or on the sterilized medical instrument (or tray or wrapping, if used), as set forth in the governing regulations. For example, as set forth in AAMI ST79 Comprehensive guide to steam sterilization and sterility assurance in health care facilities (AAMI/CDV-2 ST79), visible moisture left in (interior) or on (exterior) a package or tray within the sterilization container after sterilization and the proper cooling (drying) period should be considered a wet pack. Further, if moisture is present on or in two or more packages the load should be considered a wet load. The moisture may be in the form of visible dampness, droplets, or puddles of water on or within a pack (or instrument or tray). If wet packs are observed in the processing area they should not be released. If wet packs are observed in the user area (e.g., in the OR) they should not be used.
(53) By venting pass through area to volume ratio, it is meant the ratio of the total venting pass through area 140 of a sterilizing cabinet 100 to the interior volume of the sterilization cabinet 100 ratio. Thus, for example, a sterilizing cabinet 100 as shown in
(54) The sterilization cabinet 100 can retain multiple trays holding medical instruments and, because of the high venting pass through area to volume ratio, has a drying time of less than 30 minutes, and more specifically, between 10-15 minutes, and even more specifically 10 minutes. In one configuration, the sterilizing cabinet 100 can hold up to 15 trays and each tray holds up to 25 lbs of material to be sterilized. In a configuration of the invention, the dry time of less than 30 minutes includes multiple trays loaded into the sterilization cabinet 100, the trays holding a total of 140 lbs or less of material to be sterilized, and in select configurations less than 15 minutes dry time.
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(56) These high venting pass through area to volume ratios reduce the drying time required after the sterilization cycle. The sterilization cabinet 100 can hold multiple trays holding instruments and, because of the high venting pass through area to volume ratio, have a drying time of less than 30 minutes, and more specifically, between 10-15 minutes, and even more specifically 10 minutes. These trays can each hold up to 25 lbs of material to be sterilized. In a configuration of the invention, the dry time of less than 30 minutes includes multiple trays loaded into the sterilization cabinet 100, the trays holding a total of 140 lbs or less.
(57) In yet another exemplary embodiment, as shown in
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(59) In this embodiment, filter door 606 forms a seal with sterilization cabinet 100 at the edges of the open portion of the sterilization cabinet frame 112, such that any sterilizing steam that enters or exits sterilizing cabinet 100 during a sterilization cycle must pass through filter door 606 and primary filter 106. Likewise, filter door 610 forms a seal with filter door 606 such that any sterilizing steam that exits sterilizing cabinet 100 and primary filter 108 must pass through filter door 610 and secondary filter 110. As shown in
(60) Alternatively, for the sterilization container of
(61) Exemplary embodiments of sterilization cabinet 100 can include one or more vents so long as the venting pass through area to volume ratio is equal to or greater than 0.008 inch.sup.2 per inch.sup.3, or 1 square inch:125 cubic inches, and in select configurations between 0.02-0.2 inch.sup.2 per inch.sup.3, or between 1 square inch:50 cubic inches and 1 square inch:5 cubic inches, and in further configurations between 0.16-0.2 inch.sup.2 per inch.sup.3, or 4 square inches:25 cubic inches and 1 square inch:5 cubic inches.
(62) The high venting pass through area to volume ratio reduces the drying time required after the sterilization cycle. The sterilization cabinet 100 can hold multiple trays holding instruments and, because of the venting pass through area to volume ratio, have a drying time of less than 30 minutes, and more specifically, between 10-15 minutes, and even more specifically 10 minutes. In select configurations, the drying time can be as little as 5 minutes. In one configuration, the sterilization cabinet 100 holds up to 15 trays, each tray holding up to 25 lbs. In a configuration of the disclosure, the drying time of less than 30 minutes includes multiple trays loaded into the sterilization cabinet 100, the trays holding a total of 140 lbs or less.
(63) In another exemplary embodiment, as shown in
(64) The sterilization cabinet 2202, 2502, 2602 may have a fenestrated door 2506, 2612 holding a filter 2510, 2306, 1302, 1402,1502, 1602, 1700. In one configuration, the filter 2510, 2306, 1302, 1402, 1502, 1602, 1700 is a single-use filter. The sterilization cabinet 2202 2502, 2602 is designed to be used in a steam autoclave and may hold multiple open trays containing surgical instruments. Trays within the container 2202, 2502, 2602 may be separated by spacers 902 having dividers or lips 904 along the edges of spacer 902 and throughout the midsection of spacer 902 to ensure separation and maximum steam exposure. The sterilization cabinet 2202, 2502, and 2602 has been validated to sterilize 375 lbs. of instruments along with the spacers 902. The validation was conducted with 15 instrument trays at 25 lbs. Actual expected loads in hospital settings are likely to be less. For example, loads in a hospital setting are more typically 140 lbs or less, and even more typically approximately 110 lbs. It should be appreciated that sterilized instruments can be stored for up to 30 days within the closed (intact filters) sterilization container.
(65) The sterilization cabinet 2202, 2502, 2602 is loaded into the sterilizer, for example, an autoclave, with a transfer carriage (not shown).
(66) The use of a single-use disposable filter cartridge 1302, 1402, 1502, 1602, 1700 installed in the fenestrated door 2506, 2612 eliminates the need for a sealed gasket found on prior systems. The omission of a reusable gasket eliminates contamination risks due to failed reusable gaskets. It is understood the single use disposable filter can be used with a separate or integral cartridge.
(67) The sterilization cabinet 2202, 2502, 2602 is indicated for enclosing other medical devices that are to be sterilized by a healthcare provider. It is intended to allow sterilization of the enclosed materials and maintain sterility for up to 30 days until used. The sterilization cabinet 2202, 2502, 2602 is intended to be used in pre-vacuum steam sterilizers with a prevacuum cycle of 270 F. (132 C.) and exposure time of 4 minutes. The sterilization cabinet 2202, 2502, 2602 is intended to be used with Turbett Surgical filters.
(68) Validation was done using three trays per level and a maximum instrument load of 25 lbs. per tray. The validation load included six 1 mm500 mm lumens and six 3 mm400 mm lumens. The total weight of instruments and trays validated is 375 lbs. The trays holding instruments within the sterilizing cabinet 100 were uncovered, perforated or wire mesh general delivery trays.
(69) The principal material of construction of the sterilization cabinet 2202, 2502, 2602 may be stainless steel and aluminum. However, it should be appreciated that other materials may be used. In one configuration, the overall size is 342422. The empty container 210 weighs approximately 136 lbs. It is thus a relatively large container, typically associated with a transfer cart. In this configuration, the venting pass through area includes 905 holes, each having a diameter of approximately 0.74 inches, thus providing a venting pass through area of 398.2 (approximately 400) square inches. Thus, in an exemplary embodiment, the where the volume is approximately 17,952, cubic inches based on the overall size, the venting pass through area to volume ratio is approximately 0.022 inch.sup.2 per inch.sup.3 or 11 square inches:500 cubic inches. If internal dimensions provide a volume of approximately 14,846 cubic inches, the venting pass through area to volume ratio is approximately 0.027 inch.sup.2 per inch.sup.3 or 27 square inches:1000 cubic inches. It should be appreciated that exemplary embodiments of the sterilization cabinet can be other dimensions, shapes and sizes that provide similar vent to volume ratios, wherein the ratio is at least approximately 0.022 inch.sup.2 per inch.sup.3 or 11 square inches:500 cubic inches, and in select configurations between 0.008-0.21 inch.sup.2 per inch.sup.3, (1 square inch:125 cubic inches and 21 square inches:100 cubic inches) and in further configurations, between 0.16-0.2 inch.sup.2 per inch.sup.3 (4 square inches:25 cubic inches and 1 square inch:5 cubic inches). That is, the sterilization container, such as the cabinet may be configured of any shape or size so long as the venting pass through area has dimensions corresponding to the volume to provide the desired vent area to volume ratio. Similarly, the venting area may have many shapes, sizes and/or locations on the sterilization cabinet, so long as the venting area and volume meet the vent pass through area to volume ratios.
(70) Technological Characteristics:
(71) The sterilization cabinet 2202, 2502, 2602 has been validated to sterilize 375 lbs. of instruments along with the spacers 902. The validation was conducted with 15 instrument trays at 25 lbs. each to represent the most challenging case. The validations included thermal profile, sterilization efficacy, and drying in a pre-vacuum steam sterilizer. Sterilized instruments can be stored for up to 30 days within the closed container.
(72) The sterilization cabinet 2202, 2502, 2602 is constructed of 304 stainless steel sheet metal on a rigid stainless steel frame. The sterilization container, such as the cabinet opens from the side for easy placement and retrieval of surgical trays. In one configuration, a sidewall is omitted to define a door way or opening to the cabinet for inserting and removing trays (medical instruments). A filter 1700 comprised of 1 or 2 layers of filter paper 1704, 1706 and a compressible gasket 1702 is placed between the door and the cabinet, such that a portion of the filter or gasket is disposed between the door and the cabinet to form a sealed interface. After use (the sterilization process and removal of the trays (the sterilized medical instruments), the filter 1700 having the compressible gasket 1702 is discarded.
(73) The following testing was conducted to establish substantial equivalence and efficacy: ANS/AAMI ST77: Containment Devices for Reusable Medical Device Sterilization testing: Pre-vacuum thermal profile Steam pre-vacuum sterilization efficacy Pre-vacuum dry time Microbial aerosol challenge 30 day shelf-life study AAMI TIR 30: A Compendium of Processes, Materials, Test Methods and Acceptance Criteria for Cleaning Reusable Medical Devices testing: Protein analysis and Total Organic Carbon Manual cleaning methods ANSI/AAMI HE75: Human Factors EngineeringDesign of Medical Devices testing: Human factors usability study
(74) Turning now to
(75) Exemplary embodiments of sterilization cabinet 2202 can include a single vent or a plurality of vents to define the venting pass through area, so long as the venting pass through area to volume ratio between 0.008-0.21 inch.sup.2 per inch.sup.3 (or 1 square inch:125 cubic inches and 21 square inches:1000 cubic inches) and in select configurations between 0.16-0.21 inch.sup.2 per inch.sup.3 (or 4 square inches:25 cubic inches and 21 square inches:1000 cubic inches), or in further configurations equal to or greater than 0.021 inch.sup.2 per inch.sup.3 or 21 square inches:1000 cubic inches.
(76) The high venting pass through area to volume ratio reduces the drying time required after the sterilization cycle. That is, assuming multiple trays of medical instruments in a sterilization cabinet 100, for example, up to 15 trays, are placed in a sterilizer device, such as an autoclave, the sterilization cabinet 2202, with the venting pass through area to volume ratio of 0.021 per inch, would require a dry time of less than 30 minutes, and more specifically approximately 10-15 minutes, and even more specifically, 10 minutes. In one configuration, a dry time of less than 15 minutes is provided when a ratio of the venting pass through area to the interior volume of the sterilization cabinet 2202 is between 0.008-0.21 inch.sup.2 per inch.sup.3 (or 1 square inch:125 cubic inches and 21 square inches:1000 cubic inches). In another configuration, the drying time is approximately 10 minutes for up to 140 lbs of medical instruments arranged in the sterilization cabinet 2202 on multiple trays.
(77) In one configuration, the sterilization container has dimensions of approximately 34 inch by 22 inch by 24 inch and the door has 869 holes at 0.766 diameter and 32 holes at 0.5 diameter. Thus, the vented pass through area is 400 inch.sup.2 plus approximately 6 inch.sup.2. Thus, the ratio of the venting pass through area to the interior volume of the sterilization cabinet is approximately 406 inch.sup.2 to 17952 inch.sup.3 or 0.0226 inch.sup.2 per inch.sup.3.
(78) As shown in
(79) In one configuration, the total venting pass through area 3008 of the sidewalls 3002 and top wall 3006 to the interior volume of the sterilization cabinet 3000 ratio is greater than 0.008 inch.sup.2 per inch.sup.3. The high venting pass through area to volume ratio is sufficient to provide a dry time of 30 minutes or less, and more preferably 15 minutes, and even more preferably 10 minutes. In one configuration, these drying times are achieved when 140 lbs of medical instruments are loaded on trays in the sterilization cabinet 3000. The venting pass through areas 3008 of the sterilization cabinet 3000 may be smaller or larger, of a different shape, or provided on a different location of the sidewalls, top wall, bottom wall, and/or door, or include a plurality of holes or a fenestrated grid throughout its center, provided, however, that the venting pass through area to volume ratio is greater than 0.008 inch.sup.2 per inch.sup.3 (or 1 square inch:125 cubic inches).
(80) The present system is distinguished from prior trays which were wrapped with filter media, then disposed in an autoclave and transported to the surgical field after the sterilization process, in that there is no sterilizing container having a plurality of sidewalls and an opening for receiving an instrument tray, with a filter occluding a venting pass through area and the ratio of venting pass through area to volume of the sterilizing container being at least 0.008 inch.sup.2 per inch.sup.3 (or 1 square inch:125 cubic inches) and in further configurations the ratio being from 0.16 to 6 inch.sup.2 per inch.sup.3 (or 4 square inches:25 cubic inches to 6 square inches:1 cubic inch).
(81) Further, the sterilization container of the present system can accommodate trays with instruments or devices in the tray, wherein the instruments or devices may or may not be wrapped with filter paper and the tray may or may not be wrapped with filter paper. Thus, it is contemplated the sterilization container can retain unwrapped trays with instruments or devices, wrapped trays with instruments or devices, unwrapped instruments or devices as well as wrapped instruments or devices wherein the ratio of the venting pass through area to volume of the sterilization container provides drying times less than 30 minutes and in select configurations less than 15 minutes after the sterilization cycle.
(82) While select configurations may include a drain for passing condensate from the interior of the sterilization container, it is contemplated that other configurations having the present ratio of venting pass through area to volume can provide the reduced drying time (such as 10 minutes) without draining the condensation. In a further configuration, the floor of the sterilization container can be configured to collect or pool condensation within the container.