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Cleaning of Surgical Instruments
Surgical instruments should be cleaned as soon as possible after use. Blood and debris should never be allowed to dry on an instrument. This only makes them harder to clean,and promotes corrosion. Also all the instruments involved in the case should be cleaned whether they were actually used or not. Immediately after the procedure, or piercing, whatever the case may be, rinse the instruments in demineralized, distilled water to remove excess blood and debris. NEVER use an abrasive cleaning pad on surgical instruments.
This will scar the instruments and leave a scratch or groove where dirt and water deposits can collect and lead to corrosion and pitting. This will also remove the passivation layer, which is the thin film that covers the instrument and protects its finish. Detergents: It is best to use a neutral ph detergent when cleaning your surgical instruments A ph of 7.0 to 8.5 will have the least adverse effect on the instrument.
A detergent that is a low-sudsing free-rinsing and a good wetting agent is best for a washer sterilizer or ultra-sonic cleaner. If a high sudsing detergent is used and all the detergent is not removed then the instruments are more likely to spot and stain. We had a continuing problem with spotting at one of our clinics and finally determined a new person had been scrubbing the instrument to make them shine. She had rubbed of all of the passivation film and scratched the instruments so much that the cleaning agent was causing them to spot. Washer sterilizers are a good method of cleaning and sterilizing your instruments, but I know most small shops do have the room or the facilities to use these. The next best thing is an ultrasonic cleaner. This a thorough and rapid way of cleaning your instruments. Surgical instruments can be cleaned and ready to autoclave, or sterilized in a matter of five minutes. Ultrasonic cleaning is much more effective than hand cleaning, mostly becasue the water is forced by the high frequency into all the crevices of the instruments, escpecially, things like hemostats. An ultrasonic cleaner can remove up to 90% of the soil and debris, but does not eliminate the need for sterilization.
After cleaning your instruments they should be lubricated with an approved surgical lubricant. This should be done to further protect your instruments during sterilization and storage. The lubricant should be water soluble and anti-microbial, and should be used after every cleaning. Follow the manufacturer's directions to prepare your lucrication bath. Immediately after cleaning your instruments, dip them into the bath for at least 30 seconds. Remove them and let the excess drain off, do NOT rinse them. The lubrication film should remain on the instruments through the sterilization process and storage to protect them. I will be adding more articles on sterilization so stay tuned.
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