Guidelines for Cleaning

Cleaning, Sterilizing and Maintaining,


The following guidelines for cleaning, sterilizing and maintaining your surgical instruments will ensure maximum functionality and lifespan. Distilled or deionized water and a neutral pH cleaning solution (7) is recommended for all of the procedures.
bubbles

1. Rinsing

Immediately after surgery, rinse instruments under warm – not hot – water. A nylon toothbrush is helpful to clean out lock boxes, joints and springs. Be sure to remove all blood, bodily fluids and tissue.

If you are not planning on cleaning the instruments immediately after rinsing, submerge them fully in a solution of water and neutral pH (7) detergent.

delicate

2. Cleaning

There are three methods of cleaning:  Ultra-sonic, Automatic Washer Sterilizing and Manual Cleaning.

We strongly recommend manual cleaning for micro and delicate instruments.

Ultrasonic

  • Do not place instruments of dissimilar metals in the same cleaning cycle, ie. stainless steel, copper, chrome plated, etc.
  • Process the instruments in the cleaner for the fully recommended cycle of time – 5 to 10 minutes.
  • Place instruments in an open position in the ultrasonic cleaner.  Make sure instruments do not touch each other.
  • All instruments must be fully submerged.
  • Change solution frequently, as often as recommended by the manufacturer.
  • Rinse instruments after ultrasonic cleaning with distilled or deionized water to remove any cleaning solution residue.

Automatic Washer Sterilizers

Follow the manufacturer’s recommendations. Make sure all instruments are lubricated after last rinse cycle and before sterilization cycle.

Most manufacturers recommend ultrasonic cleaning as the best, most effective way of cleaning surgical instruments, particularly those with hinges, locks and other moving parts,  However, if ultrasonic cleaning is not available, follow these steps:

  • Use stiff cleaning brushes made of nylon or a similar material. Do not use steel wool or wire brushes, unless they are specially recommended stainless steel wire brushes for instruments such as bone files or on stained areas in knurled handles.
  • Use only neutral pH (7) detergents and rinse properly after cleaning. Lower pH detergents break down the protective stainless surface of instruments and cause black staining. Higher pH detergents cause surface deposits of brown stain that may look like rust and will interfere with the smooth operation of the instrument.
  • Brush delicate instruments very carefully. Try to handle them separately from general instruments.
  • Examine instruments carefully to make sure all surfaces are visibly clean and free from stains and residue.
  • Finally, rinse instruments thoroughly under running water – distilled is best. While rinsing, open and close scissors, hemostats, needle holders and other hinged instruments to make sure both inside and outside surfaces are completely rinsed out.

Routine Inspection

Cleaning is a good time to check instruments for proper functionality and overall condition.
Check for the following:

  • Scissor blades should glide smoothly from open to closed positions. They shouldn’t be loose at all when closed. Test them by cutting them into a thin piece of gauze. Three-quarters of the length of the blade should cut easily straight to the scissor tips.
  • Forceps should have aligned tips.
  • Hemostats and needle holders should not allow any light to shine through between the jaws. They should lock and unlock easily, and the joints should not be loose. Check needle holders for signs of wear at the tips.
  • Suction tubes should be clean inside and out.
  • Retractors should open, close, and lock properly.
  • All cutting edge blades should be sharp and smooth.
storage

3. Storage

If the cleaned instruments are going into storage, let them air dry and store them in a clean and dry environment.

machine

4. Autoclaving

If instruments are to be reused or autoclaved:

  • Lubricate all instruments with metal-to-metal contacts, such as scissors, hemostats, needle holders and retractors.  Lubricants such as Instrument Milk are best.  Do not use WD-40 or other industrial lubricants.
  • Use disposable paper or plastic pouches to sterilize individual instruments.  Use a wider pouch (4” or wider) for instruments with ratchet locks, such as needle holders and hemostats, so the instrument can be sterilized in an open and unlocked position.
  • Never lock an instrument during autoclaving.  It will not be thoroughly sterilized if steam cannot reach all the surfaces. It might also develop cracks in hinged areas caused by heat expansion during the autoclave cycle.
  • Do not overload the autoclave chamber.  Pockets may form between instruments that do not permit steam penetration.  Place a towel on the  bottom of the pan to absorb excess moisture.  This reduces the chance of getting “wet packs.”  Towels used in the sterilization process must be free of detergent residue and be neutral pH (7) when immersed in water. The residue of high pH detergents pH (9 to 13) used by some commercial laundries could cause stains on some instruments.

CAUTION:  At the end of the autoclave cycle, before the drying cycle, unlock the door and open it about ¾” – then run the dry cycle according to the manufacturer’s instructions.  If the door is fully open during the drying cycle, cold room air will rush into the chamber, causing condensation on the instruments. This results in water stains and causes “wet packs.”

sterilization

5. Cold Sterilization

Most cold sterilization solutions render instruments sterile only after a 10-hour immersion. The prolonged chemical action can be more detrimental to surgical instruments than the usual 20-minute autoclave cycle.  If  instruments only need to be disinfected, cold sterilization is recommended as disinfection takes place after only 10 minutes.

What is the difference between sterilization and disinfection?

  • Sterilization means no living organism survives.  It is an absolute term.
  • Disinfection means the cleaning of an article of some or all of the pathogenic organisms that cause infection.

Always use the proper sterilization or cleaning technique required for the intended use of your instruments.

IMPORTANT:  For instruments with tungsten carbide inserts – such as needle holders, scissors and tissue forceps – we do not recommend the use of solutions containing Benzyl Ammonium Chloride. It destroys the tungsten carbide inserts.