Sterilization is a composite process that requires pre-cleaning and decontamination of surgical instruments. If instruments are not pre-cleaned, they cannot be sterilized through the autoclave. Proper care and maintenance are essential to ensure sterility, longevity, and performance of instruments. Even a small residue on the surface of the used instrument can lead to contamination and compromise the quality of autoclaving.

As a professional, you don’t want your instruments to carry germs that can affect your dental procedures. In this guide, you will learn why pre-cleaning is essential and how to clean surgical instruments before autoclave.

Why Pre-cleaning of Surgical Instruments is Essential?

Patients have the right to be treated in safe surgical environments. Professionals strive to maintain standards that minimize the risk of contamination on surgical instruments. Decontamination is the only process to achieve this goal. It reduces the risks of cross-infections that can be spread by handling used instruments.

The Centers for Disease Control and Prevention (CDC) emphasizes following strict protocols to clean surgical instruments before autoclaving. It is essential to use best practices and quality requirements while performing sterile procedures.

Segregate Surgical Instruments Before Autoclave

The first and foremost step is to segregate instruments based on their usage. Some instruments are manufactured for one-time use only. You can read the manufacturer’s guidelines to separate these instruments from those that can be sterilized.

• Single-use items cannot be reprocessed, so you need to dispose of them in clinic waste.
• Once you have segregated the instruments, it is time to begin the pre-autoclave instrument cleaning.

Pre-autoclave Instrument Cleaning Methods

Pre-autoclave instrument cleaning is effective in preventing the risk of disease transmission. Manufacturers must provide instrument care guidelines for professionals to follow. The team of dental professionals should be aware of the delicacy and precision required in cleaning surgical instruments.

Manual Cleaning Methods

Step 1: Dismantling Instruments

Before cleaning, instruments with multiple parts (e.g., surgical clamps or scissors) should be disassembled to ensure access to all surfaces. This is critical for effective cleaning, especially in areas like hinges or grooves.

Step 2: Selecting the Right Cleaning Solutions

• Neutral pH Cleaners : Use a neutral pH detergent designed specifically for surgical instruments. Products with high or low pH can damage the instrument's surface.
• Mixing Cleaning Solutions : Ensure powdered cleaning solutions are fully dissolved before use. Regularly change solutions to avoid a buildup of organic material or excessive chemical concentration that could cause corrosion.

Step 3: Cleaning with Soft Brushes

• Brush and Wipe: Use soft lint-free cloths or plastic brushes to scrub instruments, paying attention to intricate areas. Avoid using abrasive brushes that could scratch the instrument's surface.
• Rinse: Perform two rinses – one with tap water to remove debris, and a second with demineralized water to prevent contamination from mineral deposits.
• Dry Thoroughly: Dry the instruments completely using forced air drying, or by gently shaking off excess water and placing them on a clean lint-free towel.

Additional Tip: It is highly recommended to use salt-free, distilled water for cleaning surgical instruments. Avoid tap water that contains foreign ions, such as chlorides, which can cause staining, pitting, and corrosion.

Ultrasonic Cleaning

Ultrasonic cleaning is one of the most efficient ways to clean excessive debris from surgical instruments. Follow these guidelines:

• Clean promptly: Remove any rust-like buildup, especially around the box lock of needle holders, hemostats, or on the screws of scissors using a soft toothbrush.
• Prevent contact between sharp instruments : Ensure sharp blades (e.g., scissors, knives, and osteotomes) do not touch other instruments during cleaning.
• Fully submerge instruments : Ensure all instruments are completely submerged during the cleaning process.
• Avoid mixing metals : Do not mix dissimilar metals (e.g., stainless steel, copper, chrome-plated) in the same ultrasonic cleaning cycle to prevent chemical reactions or damage.
• Rinse thoroughly : After cleaning, rinse the instruments with distilled or deionized water to remove any residue from the cleaning solution.

Automatic Washer Sterilizers

Strictly adhere to the manufacturer’s instructions for using automatic washer sterilizers. A typical disinfector cycle includes:

• Flush
• Wash
• Rinse
• Thermal disinfection
• Drying

It is recommended to lubricate the dental instruments thoroughly before or after the cycle.

Pre-autoclave Lubrication

Instruments with moving parts (e.g., scissors or needle holders) should be regularly lubricated to prevent wear and maintain smooth operation. High-quality lubricants also protect against rust and corrosion.

Soaking instruments in a lubricant for one minute before autoclaving provides added protection during sterilization.

Inspecting Instruments After Cleaning

Before moving on to the sterilization of surgical instruments, it is important to inspect all instruments for damage or debris. Key points to check include:

• Scissor Blades: Test the smoothness of movement and cutting ability.
• Forceps: Ensure tips are properly aligned.
• Hemostats and Needle Holders : Check that jaws align perfectly without light showing through.
• Suction Tubes: Ensure they are clean and free of blockages.
• Retractors: Confirm proper function and locking mechanisms.

Any damaged or worn instruments should be repaired or replaced before further use.

Artman Instruments Instructions for Optimal Care

Proper cleaning and maintenance of surgical instruments are crucial to ensuring sterility and longevity. At Artman Instruments, we provide FDA-approved and GMP-certified instruments that meet the highest industry standards.

Follow our care instructions and apply our recommendations for the sterilization of surgical instruments to keep your dental practice safe and up to standard.

For more information on instrument care and our products, visit Artman Instruments today.