Using contaminated surgical equipment can cause severe health complications for the patients. That is why medical practitioners need to be conscious of the instruments’ health before starting a procedure.
As a matter of fact, cleaning surgical instruments is as necessary as the availability of proper equipment for a certain procedure. In addition, cleaning and disinfecting medical equipment minimize the chances of disease spread from patient to patient.
Surgical instrument processing technicians, as well as surgeons themselves, should be well aware of how to clean surgical instruments properly. Apart from that, they should be experts at identifying whether an instrument is disinfected.
In this comprehensive guide on surgical instrument cleaning, we will learn in detail about different cleaning methods. Moreover, we will discuss the difference between cleaning, disinfecting, and sterilizing medical tools.
First, let’s learn some basic concepts related to cleaning instruments.
Surgical instruments are the helping hands of medical professionals. The importance of medical equipment defines the importance of surgical instruments cleaning.
Proper medical instrument cleaning :
• Prevents the likelihood of disease spread, such as HIV and hepatitis B and C.
• Ensures the smooth functioning of the tools during the procedure.
• Minimizes the chances of surgeons’ hand infections.
• Provides a clear view of the instruments while using them at different angles.
• Prolongs the life of the medical equipment.
• Makes the instruments resistant to corrosion and rust.
• Prevents debris accumulation on the tools that can be hard to remove later.
• Maintains the proper movement of hinges and lock boxes of the medical instruments.
There are different methods of cleaning surgical instruments. Each of them has a specific protocol. Besides, all cleaning methods have some limitations and restrictions.
However, the cleaning agents and chemicals can be the same for multiple methods. Yet, the lab technicians must adopt the most suitable method for properly cleaning the medical equipment.
Actually, the cleaning method depends on the structure and material of the surgical instruments. The best way is to choose the common techniques and methods for cleaning and disinfecting medical equipment.
Apart from that, the instrument processing assistants should read the instructions for use provided by the manufacturers. It would help them get how to clean the surgical instruments accordingly without any complications.
After use, dampen the instrument with a wet towel or soft cloth, so the blood and debris do not get hard.
Place the instrument in an approved enzymatic detergent with neutral pH or sterile water.
Prepare a solution with recommended and approved disinfectant agents. Then soak the instruments in the solution for 10 to 15 minutes.
After disinfecting, again rinse the instrument with sterile water. It would help clean the instrument completely.
In this step, use a steam sterilizer or autoclave machine to completely kill all the germs on the instruments.
It is better to see manufacturers' recommendations for adopting the best suitable sterilization methods.
Rinse the instruments last time to remove the remains of any chemicals from the previous processes.
At last, do not forget to dry the instruments; otherwise, they will be rusted and corroded when stored.
Using an air drying method, leave the instruments in an open but controlled area. OR
You can use a lint-free towel that will absorb moisture from the instruments’ surfaces.
Authorized cleaning agents ideal for cleaning surgical instruments include.
• Isopropyl (rubbing) alcohol
• Non-abrasive polish
• Clean (distilled) water with a pH of 7
• Mild detergents
• White Vinegar
• Sodium Bicarbonate/Baking soda
• Alkaline chlorinated cleaners
• Hospital-grade (bleach-free) disinfectants
• Non-chloride cleaners
• Windex
Avoid using the following cleaning agents, as they can damage the instruments.
• HCL/Muriatic Acid
• Ammonia
• Hard Water / PH above 7
• Bleach
• Cl-containing compounds
• Quaternary Salts
• Abrasive cleaners
There are 3 basic methods of cleaning surgical tools. These include :
• Manual cleaning
• Washer Disinfectors cleaning
• Ultrasonic Cleaning
Sink bay systems, ultrasonic cleaners, and washer disinfectors are the common surgical instrument cleaners.
Let’s have an overview of each type of cleaning method.
Cleaning surgical instruments manually is ideal when the tools have complex structures, and machine cleaning is not feasible.
Moreover, instruments with dirt and accumulated debris are processed through manual cleaning.
In this method of surgical instrument cleaning, using a three-bay sink is a wise choice.
• Keep the instruments in the first bay sink after thoroughly cleaning them in the cold water.
• In the second bay, manually brush the instruments using soft cleaning brushes. To submerge the instruments as per IFU, clean the sink beneath the waterline to avoid exposure to germs and the production of aerosols, especially when using brushes to clean the lumens. Consider using low-foaming cleaning detergents.
• Perform rinsing in the third sink bay with sterile water.
It is an optional method for cleaning surgical instruments.
Washers/disinfectors use spray arm technology with pressured water for cleaning instruments.
The water temperature, chemical concentration, and flow rate within a washer/disinfector are all set specifically for the load.
In a washer/disinfector, the heat rinse stage ensures some disinfection. However, four cycles are crucial to consider for the effective cleaning of medical equipment in washers/disinfectors; these include :
Cleaning may not be accomplished if the cycle is too short, yet efficiency may be impaired if it is too lengthy.
Cleaning agents and validated pre-programmed cycles influence temperature during the washer disinfecting procedure. Normally, in washers/disinfectors, enzymatic cleaning chemistries function best between 100-140 F/32-60 C. However, it is suitable to use detergents when the temperature is between 122-180 F/50-82 C.
The cleaning chemistries depend on the manufacturer's guidelines. It is wise to consider the quality of the water and the chemical concentration when choosing the cleaning chemistry in a washer disinfector.
Impingement is the mechanical force applied by spray arms. Choosing a more aggressive cleaning chemical is more effective if the user has a low-impingement washer/disinfector.
However, in high-impingement washers, water at high pressure would help remove the dirt effectively. Cleaning a washer/disinfector is more consistent and productive since parameter control is simpler. Nevertheless, staff must get enough training on device loading to guarantee optimal utilization.
For cleaning hard-to-reach areas of surgical instruments, such as lockboxes, hinges, and lumens, experts prefer the ultrasonic method of cleaning surgical instruments.
In this method of cleaning and disinfecting medical equipment, high-frequency sonic waves generate microscopic bubbles on the surfaces of the instruments, which eventually explode. As a result, the bubbles' bursting aids in clearing the dirt on the inner parts of the instruments.
Follow the instructions for using an ultrasonic cleaner.
• Keep instruments submerged in either a germicidal or enzymatic pre-soak, such as Pre-zyme, until they are prepared for cleaning.
• Before ultrasonic cleaning, don't allow the equipment to dry out.
• Use an ultrasonic cleaning solution, special for cleaning surgical instruments.
• To thoroughly submerge the instruments in the ultrasonic cleaning solution, put them in a mesh tray or basket hung by its handles.
• Prefer using EPA-approved chemicals. It is a cost-effective method for cleaning reusable surgical tools when diluted to 1 oz per gallon of water.
• The user-friendly control panel selects the temperature and cleaning duration before switching off the machine.
• Be aware that solution temperatures must be below 42 °C (1070 °F); otherwise, particles could "bake" onto the equipment and become too big for sterilization to remove.
• After completing the ultrasonic cleaning cycle, move on to the procedures for disinfecting or sterilizing the equipment.
• To lubricate the hinges and lockbox of the instruments, use a recommended lubricant.
Although not all materials or equipment are suitable for this method, ultrasonic cleaning saves time and removes the accumulated material completely.
The complete decontamination of the surgical instruments includes cleaning, disinfecting, and sterilization.
Let’s briefly discuss the difference between cleaning, disinfecting, and sterilizing surgical tools.
Cleaning is performed after the use of instruments. In other words, it is the first step to decontaminate the instruments.
In cleaning, the visible material, debris, and dirt are removed from the equipment. Lab technicians use sterile water and neutral pH detergents for cleaning purposes. Cleaning is followed by disinfecting.
Disinfecting is the second phase of decontamination. It helps reduce the number of germs and microorganisms on surgical instruments. In this step, instruments processing technicians immerse the equipment in an EPA-approved solution for 10 to 15 mins. Then instruments are rinsed to remove the remains of the disinfecting solution. Disinfecting is followed by sterilization.
It's the third and last phase of decontaminating surgical instruments. Autoclave or steam sterilization is the most common and recommended method to sterilize medical equipment. Sterilization kills all germs and makes the instruments ready for reuse.
As discussed above, cleaning surgical instruments is as important as having fundamental equipment for medical procedures. Therefore, lab attendants and surgical instruments reprocessing technicians should keenly decontaminate the medical equipment. Moreover, each instrument should be cross-checked before reuse. This way, many health complications spread through medical equipment can be prevented.
Apart from that, medical facilities should prefer high-quality surgical instruments. Such instruments last longer and do not get rust or corrosion quickly. GerMedUSA has surgical-grade German stainless steel instruments that require low maintenance and last for years. Contact us now to add high-end medical tools to your surgical kit.
Manual cleaning is considered the most common and effective method of surgical instrument cleaning.
Autoclave or steam sterilization is the best choice for decontaminating surgical instruments. Yet, it's better to see the manufacturer’s IFU.
Our surgical instruments are made of premium-quality material, i.e., surgical-grade German stainless steel, which makes them high-tensile, corrosion-resistant, and long-lasting. Moreover, these are easily sterilizable.
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