Cleaning and Maintenance of Surgical Instruments
Surgical instruments must be cleaned and sterilized before they can be used.
In terms of patient safety the cleanliness of surgical instruments is very important.
When you check a surgical instrument it is vital to access all the parts to ensure that it is clean.Hard to reach areas are often missed where dirt maybe trapped.
Instruments with moving parts need to be disassembled before cleaning and have the surface checked.
Separate general instruments from delicate instruments as the manual cleaning process differs considerably. Especially complex instruments made from tungsten are harder to clean and require more detailed instructions.
A good starting point of the cleaning process is to determine if any corrosion has occurred
Dirt and contaminants leads to corrosion of an instrument. Corrosion often means that the surface of the surgical instrument becomes uneven and therefore easily collects dirt.
Corrosion impacts on the lifetime of the surgical instrument and it is significantly reduced.
A long lifetime is important for economic reasons and also for the environment.
Manual cleaning of instruments
Clean the instrument as soon as possible after use.
Do not allow blood or other materials to dry on the instruments. If the cleaning is delayed, place the instruments in a container with detergent or an enzyme solution in order to prevent any materials to dry on the instrument.
It is also very important to clean all instruments regardless of whether they have been used or not as they may accidentally have been in contact with blood or saline.
Start off by rinsing with cold tap water to remove visible contamination, followed by soaking the instruments in special solution such as 3E-Zyme which is effective against all residues.
Scrub the instruments thoroughly with a nylon brush, and rinse with a syringe to ensure all cavities and narrow places are reached
There should be instructions from the manufacturer on what type of disinfectants and cleaning agents to use and it is important to follow the exact instructions as using the wrong cleaning solution for example a harsh, abrasive agents or to high alkaline can result in damaging the instrument.
The cleaning solution recommended varies depending of for example type of steel and if the product contains tungsten.
The instructions on dosage and time are also to be observed, this can vary greatly depending of the type of solution.
Factors to Consider when ordering surgical instruments
The type of surface finish. A highly polished surface will increase the resistance to both coating and rust.
If the instrument is hand-forged and partly handmade it would impact on how smooth the edges and corners on the instruments are and decrease any pockets that can collect dirt.
It is also worth remembering that the instruments should have a batch number or lot number for sterilisation purposes and traceability.
There are some companies selling surgical instruments that are only marked with their own internal products code and this is sometimes mistaken for a batch or a lot number and would not be sufficient.
The instruments should also have a guarantee from the manufacturer that they are accredited to ISO 9001: 2000 and the products should also be CE marked. The CE mark must be engraved on the product.
What type of warranty the manufacturer offer. Most manufacturers offer warranties that states that a defective instruments will be repaired free of charge within a certain time period.
The manufacturer should supply information on what cleaning solutions should be used
One important question is where the instruments are manufactured. Surgical instruments manufactured in India and Pakistan tends to be a lot cheaper than the German and Scandinavian ones but the quality is sometimes very poor.
The type of steel used is also important. Japanese steel is considered to be superior in quality to for instance steel from Pakistan.
It is often possible to receive a free sample from the manufacturer for valuation.
Factors to consider repairing surgical instruments
Carry out an annual check of the instruments.
A good practice is to use identification tags which will identify if the instrument needs to be repaired or sharpened.
Only use a professional company that is specialised in repairs of surgical instrument.