Extending Instrument's Life with Proper Care and Maintenance

Pre-Cleaning

Here are general pre-cleaning guidelines that can help you with the subsequent cleaning of the surgical instruments.

• Keep your instruments moist, and do not allow contaminants to dry on them.
• Rinse the instrument thoroughly under water temperature below 110°F/43°C.
• Do not use chlorinated or saline solutions, as they can lead to corrosion.
• Open and disassemble the instruments to expose all surfaces to the cleaning process.
• Avoid mixing instruments of different metallic composition.
• Keep ebonized instruments separate from other stainless steel instruments to avoid scratching their coating.

Rinse

We recommend rinsing the instruments under distilled or demineralized water, as ordinary tap water has minerals that can cause staining or discoloration.

Cleaning Precautions

The following are the cleaning precautions you should keep in mind:

• Time, temperature, and agitation are essential for instrument cleaning.
• Avoid harshly soaking the tools in hot water, alcohol, disinfectants, or antiseptics, and do not soak the tools for more than two hours.
• Use soft materials or paper cloths, water spray guns, or soft plastic brushes made of nylon.
• Do not use steel wool, wire brushes, pipe cleaners, or abrasive detergents to remove residue.

Manual Cleaning and Soaking

Instruments should be cleaned immediately after use. When cleaning the instruments manually, be careful with the tips to avoid damage. Moreover, after rinsing the instruments with distilled or demineralized water, choose a cleaning and disinfecting solution suitable for the instruments. It is recommended to use neutral pH detergents to avoid corrosion, pitting, and breakage. Furthermore, you should use small, hand-held nylon (not steel) brushes to clean the instruments while immersed in the solution. This will remove the soil from the tools and enhance patient care.

Ultrasonic Cleaning

Ultrasonic cleaning is the most effective method for cleaning surgical instruments from deep surfaces. In this procedure, the sound waves from the ultrasonic device create bubbles in the solution that dislodge dirt and particles, even in tight spaces. Following are the guidelines we recommend during ultrasonic cleaning:

• Place the instruments in an open position to avoid sharp tools from touching other instruments, and do not pile them up.
• Use a free-rinsing, low-sudsing detergent with a neutral pH (6.0 - 8.5).
• Do not use this method for delicate and micro instruments to avoid damage.
• Never place dissimilar metals, such as stainless steel, copper, etc., in the same cleaning cycle.
• Follow the manufacturer’s specifications for automatic washer-sterilizers.

Rinse and Dry

When the ultrasonic cleaning process is completed, ensure that the instruments are cleaned with distilled, pyrogen-free water to remove all traces of debris and cleaning agents. After thoroughly rinsing the instruments, allow them to air-dry before storing. Additionally, use a soft, absorbent towel or cloth to dry the external surfaces.

Lubrication

After properly cleaning the instruments, lubricate all the joints and movable parts, such as boxlocks and hinges, regardless of their surface coatings. This lubrication should be done after the ultrasonic cleaning and before sterilization for complete care and maintenance of the tools. Furthermore, do not rinse the instruments after this step.

Sterilization - Autoclaving

Sterilization is an essential step in cleaning and maintaining surgical instruments. Autoclaving, also known as steam sterilization, is the most common method to sterilize instruments. In this method, the instruments are sterilized with steam that comes from distilled water and is free of all impurities. The instruments can be autocalved individually or in sets, but in the open and unlocked position. Instruments may be packaged in rigid containers or those cleared for use in sterilization. Packaging should ensure the sterility of instruments until they are opened for use at the sterile field and permit the removal of contents without contamination.

However, try not to put too many instruments in at once, as this may hinder steam penetration. We recommend placing a cloth or towel on the bottom of the pan to absorb moisture. Additionally, ensure that the close has no residue of detergents and is pH neutral.

Here are the recommended steam sterilization parameters to achieve a Sterility Assurance Level (SAL) of 10-6:

Instrument Checkup

After cleaning, lubricating, and sterilizing the instruments, check for any signs of irregularities, staining, or fractured and worn parts on the overall instrument surfaces. Moreover, you must discard any damaged and defective instruments and replace them.

Storage of Instruments

Once the instruments are thoroughly dried, they should be stored in a secure, closed, dry, and cool environment. We recommend you secure instruments with a lock in the first detent to prevent possible damage. Furthermore, keep the instruments with delicate working tips in suitable storage cases with tip protectors.