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A mobile container from Rice University sterilizes surgical instruments in low-resource settings. The "Sterile Box," built into a standard 20-foot steel shipping container, houses a water system for decontamination and a solar-powered autoclave for steam sterilization.

The Rice researchers cited studies that show about a third of patients in low-resource settings suffer surgical-site infections, a number nine times higher than in developed countries. The infections are frequently the result of care providers using medical instruments that carry traces of microorganisms or biological material from previous patients.

The university engineers built the Sterile Box by first adding solar panels and electrical storage to the container. Water is distributed from two tanks, including one on the ground that has a hand pump. The interior has two rooms: a foyer that separates the sterile processing area from outsiders and the elements and a main area with a small window to pass instruments in and out.

Processing is divided into four stations. At the first station, technicians decontaminate instruments in a three-basin sink, removing debris and then soaking them in an enzymatic detergent and scrubbing with nylon brushes before a final rinse. The second station's electric hotplate heats the steam autoclave that sterilizes the instruments. In the third station, the instruments are dried on wire racks and then moved to the fourth, a storage cabinet where they await the next surgery.

To keep technicians comfortable, the team incorporated radiant barrier insulation and reflective paint outside and maximized air flow inside with mesh screens over the door and windows, floor vents, and two wind-powered turbine fans in the ceiling. A battery pack tied to the solar panels powers outlets for fans and cellphone charging.

The next step will be to test the Sterile Box in a clinical setting. According to Douglas Schuler, an associate professor of business and public policy in Rice’s Jones Graduate School of Business, the Sterile Box may be suitable for other medical situations, including maternal and neonatal care, oral health care, and postdisaster relief.

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