Careful handling and care of your precious general surgery instruments can improve their lifespan and performance. Select a method appropriate to your specific environment.
After use, wash instruments immediately with warm or cool running water to eliminate any body fluids, blood, and tissues. Dry soils can cause damage to the instrument’s surface and cause a lot of difficulty cleaning. Don’t use hot water since it can cause proteinous substances to coagulate.
Temperature, time, and agitation are crucial in the cleaning process.
Timing — The efficacy of cleaning chemical products is typically dependent on time.
Temperature — higher temperatures are cleaning solutions that will result in more effective cleaning.
Agitation — either ultrasonic or manual– helps loosen the soil on the instrument’s surface.
This can be the most efficient cleaning technique. Ultrasonic cleaning results in cavitation. Sound waves that vibrate create microscopic bubbles that form in solution and grow as the pressure is alternating. Once they reach a resonance size, the bubbles explode, producing a force that lifts dirt and particles even in the tiniest of crevices. Ultrasonic detergents greatly increase the rate of cavitation compared to ordinary water.
1. Mix with enzymatic or any other neutral pH and mild alkaline cleaners according to the manufacturer’s specifications.
2. Use deionized water, if available.
3. Ultrasonic cleaner is run for several minutes to help degas the solution and achieve the proper temperature.
4. Put the instruments in an open position in the cleaner’s ultrasonics. Don’t allow instruments with sharp blades to get in contact with other instruments. All instruments should be completely submerged.
5. Don’t mix different metals (stainless or copper or chrome plated.) within the same cleaning process.
6. Instruments must be cleaned for 5 to 10 minutes.
7. Rinse the instruments with water to eliminate the ultrasonic cleaning solution and remaining soil.
8. Dry the instruments completely with an untidy towel. This reduces the chance of corrosion and the formation in the form of spots.
9. Spray out lubricant within the hinges to enhance the instrument’s functionality.
Automatic washer Sterilizers
Follow the manufacturer’s guidelines. Lubricate the instruments following your last rinse cycle and before sterilization.
1. Make use of plastic brushes that are stiff. Don’t use wire brushes or steel wool.
2. Make sure you use only low pH soaps. If they are not properly rinsed, low pH detergents can cause corrosion of the stainless surface, causing black stains. The high pH of detergents can create brown stains on the surface that can impede the ease of functioning of the instrument.
3. Take care when brushing delicate instruments and, if possible, take them apart from general instruments.
4. Examine all instrument surfaces to make sure they are clear of stains and tissues. Examine each instrument to ensure it is in good functionality and state of repair. The scissor blades should move effortlessly, and the blades should not be loose in the closed position. Verify that the forceps tips are correctly aligned. Needles holders and thermostats should not have any light between the jaws. They must be able to lock and unlock easily, and joints shouldn’t be too tight. Check needle holder jaws for wear. Check cutting tools and knives to ensure the blades are in good shape and not damaged.
5. Clean instruments thoroughly with running water. The hinge areas are cleaned when you rinse cut-off and closing hemostats, scissors, needle holders, hemostats, and other instruments with hinges.
6. Dry your instruments thoroughly using an untidy towel. This reduces the chance of corrosion and the formation in the form of spots. Spray the lubricant on the hinges to increase the instrument’s functionality.
If other cleaning methods aren’t feasible, large, non-delicate instruments may be treated with a detergent that inhibits corrosion. Drying and washing after soaking is suggested.
1. Lubricate all instruments that feature metal-to-metal action, like hemostats, scissors and needle holders, self-retaining retractors, etc. Lubricants for surgical instruments are to be use. NOTE Don’t use oil, WD-40, or any other industrial greases.
2. Instruments can be autoclave in sets as well as in groups.
- Individual instruments–Disposable paper or plastic pouches are ideal. Make sure you have a large enough pouch (4″ or more) to accommodate instruments with lock ratchets (such as hemostats and needle holders) to allow the instrument to be clean in an unlock place.
- Instrument Sets–Unlock all instruments and sterilize them with their open positions—set heavy instruments on the top of the sets (when two layers of instruments are need).
3. Don’t lock any instrument while autoclaving. This can prevent steam from reaching metal-to-metal surfaces. In addition, heat expansion during autoclaving may cause cracks to hinge areas.
4. Do not overburden the autoclave chamber, which could also affect the steam’s penetration.
5. Place a towel over the bottom of the pan to soak up excess moisture during autoclaving.
6. Then, at the end of the autoclave’s cycle (before the dry cycle), unlock the autoclave door and close it with just a little (about 1/4″). The dry cycle should be run according to the period suggest by the autoclave manufacturer. If the autoclave door is completely open before the drying process begins, cold room air can enter the chamber and cause an accumulation of condensation over the instrument. This could cause staining of instruments with water and result in wet packs forming.
Most cold sterilization methods require a 10-hour immersion to make instruments sterile. However, this lengthy chemical process could be more harmful to surgical equipment than a 20-minute autoclave process. Cold sterilization is fine if the general surgery instruments only need to be clean (basically clean) because disinfection can be complete in just 10 minutes.
Autoclaving is recommend to make the instruments sterilize (with absolutely no live organisms remaining).
For instruments equipped with tungsten carbide inserts (needle holders or scissors, tissue forceps, etc.) Do not use solutions containing benzyl ammonium chloride, which can destroy inserts of tungsten carbide.
General surgery instruments should be kept in a dry and clean area until need.