CARE OF SURGICAL INSTRUMENTS
Instruments represent a significant material asset within the overall investment of a hospital. The care and maintenance these instruments receive is critical to their performance during surgery and to the cost containment efforts of each hospital authority. Having made the investment in a quality product, the authority can expect several years of trouble free use if the operator utilises proper techniques during use, care and handling of its surgical instruments.
Did you know that all surgical instruments must be cleaned properly before first use?
A new instrument must undergo a full cleaning process prior to use to remove any remaining debris from the manufacturing process. It is the most vulnerable to poor conditions, as its passivity layer is at its thinnest. This layer builds up over time with exposure to water and air and repeated usage. If problems are identified with a new instrument, investigate and improve circumstances that your instruments are exposed to. It may not be a manufacturing issue.
Clean instruments are achieved through a combination of chemical (detergents) and mechanical (scrubbing or machine washing) means, both are required to achieve a clean instrument.
- Please note that instruments should never be left to soak in any fluids, unless stated otherwise by the instrument manufacturer. Never soak instruments in tap water.
- Whenever possible, do not expose instruments to salts, iodine, harsh acid or alkaline solutions or other chemicals.
- Use appropriate chemicals (active non-protein-fixing cleaners) for cleaning instruments; ensure they are measured in dilutions according to manufacturer’s instructions.
- All new instruments must be ultrasonic cleaned before normal cleaning. Ultrasonic cleaners assist in microscopic cleaning of instruments. Their use does not replace the normal cleaning process. Any item placed in an Ultrasonic cleaner is considered contaminated (water is dirty) and must undergo a full cleaning process afterwards.
- Ultrasonic cleaners remove all lubricants from the instruments. Any instruments with moving parts must be lubricated with appropriate instrument lubrication to reduce damage to the instruments.
- Do not use metal brushes on surgical instruments as they will scratch the surface. Use plastic or natural bristled brushes. Both external and channel brushes are required to make sure all aspects of the instruments are clean.
- Final rinsing of instruments should be done with demineralised and softened water. This reduces problems from salts and minerals during the sterilisation process and watermark deposits.
- Instruments must be dry prior to wrapping, packaging and sterilisation. Compressed air drying is commended. Nonlinting cloths would be a secondary option.
- Instruments must be taken apart whenever possible to maximise cleaning. Place all movable joint instruments in an open position to allow sterilisation of cutting surfaces such as clippers, scissors, artery forcesps, etc. and to prevent stress cracking of the joints.
- Please note: You cannot sterilise an instrument that is not CLEAN and DRY.