Proper Care and Maintenance of Surgical Instruments:
Proper care and maintenance of surgical instruments are essential to ensure their longevity and optimal performance. At Artman Instruments, we understand the importance of instrument care, and we provide you with comprehensive guidelines to help you maintain your instruments in pristine condition.
Following these professional instrument care practices will not only extend the lifespan of your valuable surgical tools but also contribute to the safety and success of your procedures.
Avoid Using Tap Water:
Tap water should never be used for cleaning surgical instruments due to the presence of foreign ions that can cause damage. High concentrations of chlorides, for instance, can lead to pitting and stress-related fractures. Additionally, minerals in the cleaning water can result in discoloration.
To safeguard against these issues, it is strongly recommended to utilize salt-free, demineralized water exclusively for instrument cleaning.
Preparation for Cleaning:
The cleaning process should commence immediately after the use of instruments. However, if immediate cleaning is not possible, we advise placing the instruments in a basin of distilled water or a solution of neutral pH detergent until proper cleaning can be carried out.
Important Tip:
Avoid storing instruments in aqueous solutions for extended periods. If instruments are temporarily stored in a basin, ensure that the basin is drained and cleaned daily.
Manual Cleaning Procedures for Surgical Instruments:
To achieve optimal cleaning results, adhere to the following recommendations:
- Ensure that powdered cleaning solutions are given ample time to dissolve completely before use.
- We highly recommend utilizing a neutral pH cleaner specifically formulated for surgical instruments. Products with other pH levels may compromise the integrity of the instruments.
- Regularly change the cleaning solution on a daily basis to prevent concentration increase and potential corrosion. Dirty solutions are less effective in achieving thorough cleaning.
When manually cleaning instruments, utilize:
- Lint-free, soft textile cloth
- Paper cloth
- Soft plastic brushes (e.g., toothbrush)
- Water spray guns
After manual cleaning, perform two consecutive rinses:
- First, rinse with tap water.
- Then, rinse with distilled water.
This two-step rinsing process effectively removes surgical debris and eliminates any contaminants that may be present in tap water.
Drying
After rinsing, thoroughly dry the instruments. Whenever possible, employ forced air drying methods. If forced air drying is unavailable, gently remove excess water by shaking the instruments and placing them on clean, dry, lint-free towels.
Using Ultrasonic Cleaners for Efficient Instrument Care:
Ultrasonic cleaners provide an efficient and effective means of cleaning surgical instruments. To ensure optimal results and preserve the instruments' integrity, follow these guidelines:
- Promptly clean away any buildup of rust-like substances, particularly around the box lock of needle holders, hemostats, or on the screws of scissors. A soft toothbrush should be used for this purpose.
- Ensure sharp blades, such as scissors, knives, and osteotomes, do not come into contact with other instruments in the ultrasonic cleaner.
- Fully submerge all instruments during the cleaning process.
- Avoid mixing dissimilar metals (e.g., stainless steel, copper, chrome-plated) in the same cleaning cycle.
After ultrasonic cleaning, rinse the instruments thoroughly with distilled or deionized water to remove any residue from the cleaning solution.
Automatic Washer Sterilizers:
For the proper maintenance of your instruments using automatic washer sterilizers, strict adherence to the manufacturer's recommendations is paramount. Additionally, ensure the instruments are adequately lubricated after the last rinse cycle and before the sterilization cycle.
Best Practices for Instrument Inspection and Maintenance:
Regular inspection of instruments after cleaning is crucial to verify their proper function and condition. Pay close attention to the following:
- Scissor Blades: They should glide smoothly from open to closed positions without looseness when closed. Test scissors by cutting into thin gauze, ensuring that three-quarters of the blade’s length cuts all the way to the scissor tips.
- Forceps: Ensure that the tips are properly aligned.
- Hemostats and Needle Holders: These should not exhibit any light between the jaws. They should lock and unlock easily, and the joints should not be excessively loose. Additionally, check needle holders for any signs of wear at the tips.
- Suction Tubes: Should be clean inside.
- Retractors: Ensure that they open, close, and lock properly.
- Cutting Edges: All cutting edges should be sharp and undamaged.
Steam Sterilization:
Steam sterilization is a critical step in ensuring the sterility of surgical instruments. Follow these guidelines to optimize the steam sterilization process:
- Complete an "empty" cycle daily to remove foreign substances and prevent corrosion damage.
- Adhere to the manufacturer's recommended load for the sterilizing unit to prevent excessive condensation. Spread heavy sets of instruments to minimize condensation buildup.
- Handle delicate scissors carefully to prevent tip breakage.
- Never lock an instrument during autoclaving, as the steam cannot reach the metal-to-metal surfaces. Locking the instrument may result in cracks in hinged areas due to heat expansion during the autoclave cycle.
- After sterilization, ensure the instruments are thoroughly dried before storage. Inadequate drying time may result in unsightly water spotting.
Cold Sterilization: Disinfection vs Sterilization:
Cold sterilization solutions can provide effective sterilization or disinfection, but caution is needed due to the potential harm they can cause to surgical instruments.
- Most cold sterilization solutions require a 10-hour immersion to sterilize instruments, which can be more detrimental to the instruments than the typical 20-minute autoclave cycle.
- If disinfection is the primary requirement, cold sterilization is recommended as it achieves the desired effect in just 10 minutes.
Note: Cold sterilization achieves "disinfection" (essentially clean), not "sterilization" (no living organisms survive).
Important Note: Instruments with Tungsten Carbide Inserts:
For instruments with tungsten carbide inserts (e.g., needle holders, scissors, tissue forceps), avoid solutions containing Benzyl Ammonium Chloride, as they will cause irreversible damage to the tungsten carbide inserts.
The Role of Lubricants and Detergents in Surgical Instrument Care:
Lubricants not only reduce wear and tear but also act as protective agents against rust, corrosion, and discoloration. Proper lubrication, as part of a regular instrument care program, minimizes instrument wear.
- A one-minute soaking with the appropriate lubricant before autoclaving provides adequate protection.
For surgical instruments, we recommend using neutral pH detergents that are gentle on stainless steel and tungsten carbide inserts. These detergents effectively clean instruments during both manual and ultrasonic cleaning processes without compromising their integrity.
Handling New Surgical Instruments Properly:
When handling new instruments, follow these procedures:
- Clean and rinse new instruments before their initial sterilization.
- Avoid storing instruments in areas exposed to chemicals that produce corrosive vapors.
Note:
Though our instruments are passivated to enhance durability, serious damage can still occur if they come into contact with certain substances such as hydrochloric acid, iodine, ferric chloride, bleach, and dilute sulfuric acid. Keep instruments away from:
- Aluminum chloride
- Lysol
- Dakin's Solution
- Barium chloride
- Mercury chloride
- Ferrous chloride
- Bichloride of mercury
- Phenol
- Stannous chloride
- Calcium chloride
- Carbolic acid
- Tartaric acid
- Potassium permanganate
- Potassium thiocyanate
- Chlorinated lime
- Sodium hypochlorite
Artman Instruments team is committed to providing the highest quality surgical instruments and ensuring that you have the knowledge and guidance to care for them properly. Following these professional instrument care practices will help you maintain the integrity and performance of your instruments, enabling you to deliver exceptional surgical outcomes.
FAQs Related to Instruments Care and Maintenance
1- What is the best type of water to use for cleaning surgical instruments?
Answer:
Tap water should never be used for cleaning surgical instruments due to the presence of foreign ions, such as chlorides, which can cause pitting and stress-related fractures. The best type of water to use is salt-free, demineralized water to prevent discoloration and damage to the instruments.
2- How often should surgical instruments be inspected for damage or wear?
Answer:
Surgical instruments should be inspected after every cleaning to verify their condition and proper function. During inspection, check for smooth blade movement in scissors, alignment of forceps, locking mechanisms of hemostats, sharpness of cutting edges, and the cleanliness of suction tubes.
3- Can I use cold sterilization for surgical instruments, and is it as effective as steam sterilization?
Answer:
Cold sterilization can be used for disinfection or sterilization, but it requires a 10-hour immersion for full sterilization, which can be more damaging to instruments than the typical 20-minute steam sterilization cycle. For disinfection, cold sterilization is effective in just 10 minutes, but it’s important to note that disinfection is not the same as sterilization.
4- Why is it important to avoid locking instruments during autoclaving?
Answer:
Instruments should not be locked during autoclaving because the steam cannot reach the metal-to-metal surfaces, potentially leading to incomplete sterilization. Additionally, locking instruments can cause cracks in hinged areas due to heat expansion during the autoclave cycle.