B-222 Instrument Care Manual - Accurate Surgical Instrument Care Manual.pdf · B-222 Instrument Care Manual_Layout 1 8/19/13 12:00 PM Page 11. 5 4. Rinse instruments thoroughly after

InstrumentCare

Manual

For diamond perfect performance®ACCURATE SURGICAL & SCIENTIFIC INSTRUMENTS®

®

B-222 Instrument Care Manual_Layout 1 8/19/13 11:59 AM Page 2


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INTRODUCTIONIt is a common belief that stainless steel surgical

instruments can become stained or rusted due to theeffects of sterilization. However, this is simply nottrue. The alloy used to produce surgical quality steelincludes specific passive layers that form a protectivefilm, that prevents corrosion and staining.

With proper care and handling, your instrumentswill have a long life. However, improper care andhandling can reduce that useful life significantly. It isvery important to follow a consistent pattern of properinstrument cleaning and preparation. (See Easy Guide.)

Staining and corrosion can be caused by manyfactors. Chief among them is exposure to chlorideions and other aggressive solutions. Also, the use ofacidic (pH 0-6) and alkaline (pH 9-14) solutions cancause pitting.

The procedures outlined in the handbook will helpyou avoid the situations that cause various stainingand corrosion problems.


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HANDLING NEW INSTRUMENTSFollowing the procedures outlined previously,

clean and rinse new instruments before their firststerilization. Note that there is no difference in thehandling of matte (dull) or mirror (bright) finishinstruments. If our new instruments arrive in a plasticbag that shows condensation, remove and dry them inan open position before storage. Of course, noinstrument should be stored in a cabinet with anychemical that produces a corrosive vapor.

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INSTRUMENT CARE PROCEDURE1. Before cleaning, inspect instruments for

chips and cracks. Don’t autoclave chrome plated andstainless steel instruments together.

2. After each use, clean instrumentsthoroughly.

a. Use only neutral pH-balance solutions forthe pre-soak.

b. When cleaning by hand or withultrasonic cleaner, clean instruments in openposition.

c. To remove stubborn stains, use anon-metallic brush (toothbrush). Abrasivecleaning solutions or scouring pads shouldNOT BE USED.

d. DO NOT USE bleach for cleaning.e. Follow the mixture ratios precisely for ALL

solutions that will touch your instruments. Failure tomonitor the acidic (pH 0-6) or alkaline(pH 9-14) balance will lead to instrument failure.

Even though instruments are passivated,serious damage can result if there is exposure to anyof the following:

Hydrochloric Acid IodineFerric Chloride BleachDilute Sulphuric Acid

Whenever possible, the following substances shouldbe kept away from instruments:

Aluminum Chloride LysolBarium Chloride Mercury ChlorideBiochloride of Mercury PhenolCalcium Chloride Carbolic AcidPotassium PermanganatePotassium ThiocynateChlorinated Lime Sodium HypochloriteDalkin’s Solution Stannous ChlorideFerrous Chloride Tartaric Acid

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INDEX:

Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Preparation for Cleaning . . . . . . . . . . . . . . . . . . . . 3

Manual Cleaning Procedure . . . . . . . . . . . . . . . . . 4

Ultrasonic Cleaners. . . . . . . . . . . . . . . . . . . . . . 4&7

Easy Guide Manual Cleaning . . . . . . . . . . . . . . . . . 5

Easy Guide Ultrasonic Cleaning. . . . . . . . . . . . . . . 5

Cleaning and Sterilization Trouble Shooting . . . . . 5

Steam Sterilization . . . . . . . . . . . . . . . . . . . . . . . . 8

Lubricants and Detergents . . . . . . . . . . . . . . . . . . 8

Instrument Care Procedure . . . . . . . . . . . . . . . . . . 9

Handling New Instruments . . . . . . . . . . . . . . . . . 10


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WATERDrinking water should not be used for cleaning

surgical instruments, as it frequently containssignificant quantities of foreign ions that can causedamage.

High concentrations of chlorides, for example, canlead to pitting and stress-related fractures. Lessserious, but also undesirable, the presence of mineralsin the cleaning water can discolor the instrument.(These discolorations can be removed by using theappropriate cleaning products according to themanufacturer’s instructions.)

To prevent these problems, it is recommended thatonly completely salt-free, demineralized water can beused for instrument cleaning.

PREPARATION FOR CLEANINGIdeally, instruments should ben cleaned immediately

after use. If that is not possible, they should be placed ina basin of distilled water or a solution of neutral pHdetergent until such time as cleaning is possible. Theobjective is to prevent impurities from drying on theinstruments. However, it should be remembered thatinstruments should not be stored in aqueous solutionsfor prolonged periods, and if they are placed in a basinprior to cleaning, the basin should be drained andcleaned everyday.

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STEAM STERILIZATIONComplete an “empty” cycle every day prior to

sterilizing the instruments.To prevent corrosion damage to the instruments,

it is important that the steam be completely free of for-eign substances. Therefore, the steam supply systemmust be constructed of chrome nickel steel.

To avoid excessive condensation, stay with themanufacturer’s recommended load for the sterilizingunit. If heavy sets are unavoidable, instrumentsshould be spread out to reduce the condensationbuildup.

Once sterilized, instruments must be dried com-pletely before being stored away. Without proper dry-ing times, “water spotting” can result.

LUBRICANTS AND DETERGENTSBesides lubricating moving parts, lubricants in-

hibit rust, corrosion, and discoloration. For this rea-son, they are an excellent investment for long-termprotection of your surgical instruments. As part of aregular instrument care program, proper lubricationhelps reduce instrument wear. A 30 to 60 secondsoaking prior to autoclaving is adequate to insure pro-tection.

Advantage:Prevents frozen box locks by dissolvingorganic debris.Does not interfere with steam autoclavingProvides a protective coating to your instruments,reducing repair costs.Non-toxicInhibits rust and discoloration

Detergents designed for surgical instrumentsremove protein, organic debris and blood.The neutral pH balance will not damage stainless steelor tungsten carbide inserts. The solution is gentleenough for manual (hand) as well as ultrasoniccleaning.

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ULTRASONIC CLEANERS (CONTINUED)Breaks resulting from corrosion are called “stress

corrosion cracking.” This usually shows up aroundthe box lock joints of needle holders and hemostats oron the screws of scissors. It appears as a buildup ofwhat looks like rust. If this is seen, and a brokeninstrument is to be avoided, it should be cleaned awayimmediately with a soft toothbrush.

As in manual cleaning, thorough rinsing aftercleaning is very important. If the cleaning solution isnot thoroughly rinsed away, the instruments willbecome discolored when they are autoclaved or heatsterilized. Demineralized, salt-free water isrecommended for rinsing. In addition, if instrumentshave been soaked in a disinfectant or cleaning solutionBEFORE ultrasonic cleaning, it is necessary to rinsethem thoroughly BEFORE placing them into theultrasonic cleaner.

Instruments should be in the open position whenthey are placed in the ultrasonic cleaner and shouldnot be piled on top of each other. For maximumcleaning effectiveness, the cleaning solution should bechanged regularly in accordance with themanufacturer’s recommendations.

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B-222 Instrument Care Manual_Layout 1 8/19/13 12:00 PM Page 9

MANUAL CLEANING PROCEDURECarefully follow all the manufacturer’s instructions

regarding solution temperatures, soaking times andmixture concentration. If powdered cleaning solutionsare used, be sure that the mixture has had adequatetime to dissolve.

Make certain to change the cleaning solutioneveryday. Evaporation can increase the concentrationand cause corrosion; also, dirty solutions do not cleaneffectively.

For manual cleaning, use lint-free, soft textilecloth, paper cloth, soft plastic brushes (toothbrush) orwater spray guns.

After manual cleaning, instruments should berinsed twice, first in tap water and then in distilledwater (it is critical that distilled water be used for thesecond rinse.) This two-step rinsing will remove anyremnants of surgical debris as well as remove anycontaminents that may have been in the drinkingwater.

After rinsing, instruments should be thoroughlydried. If it is possible, a pneumatic air gun should beused for drying. If that is not possible, gently shakethe excess water from the instruments and place themon clean, dry, lint-free towels to dry.

ULTRASONIC CLEANERSMany experts consider ultrasonic cleaning the

best method for cleaning surgical instruments. Inaddition to cleaning more efficiently than othermethods, ultrasonic cleaning is also safer. Since itrequires less instrument handling, there are fewerchances for accidental cutting. Reduced handling alsocuts down on breakage.

As in all cleaning methods, the solutions used inultrasonic cleaning must be prepared according themanufacturer’s instructions. Failure to do so willresult in either an acidic or alkaline pH balance, both ofwhich can cause corrosion and breakage.

(continued on page 7)

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1. Check instrument for cracks and chipped areas.2. Clean instruments immediately after use with a neutral pH-balanced solution. Be sure to follow manufacturer’s instructions for soak time and mixture ratio.

3. When cleaning, use a soft brush, NOT a steel brush or scouring pad.Clean in open position and pay special attention to removing debris from box locks.

1. Check instrument for cracks and chipped areas.2. Rinse off large debris in tap water, followed by soaking in a neutral pH-balanced cleaning solution (be sure to follow manufacturer’s recommended mixture ratio).

3. When loading ultrasonic cleaner, do not stack instruments on top of each other and be sure instruments are in the open position.

EASY GUIDE MANUAL CLEANING PROCE

EASY GUIDE ULTRASONIC CLEANING PR

CLEANING AND STERILIZATION TROUBLE-

PROBLEM CAUSE PREVENTIONSpotting Mineral 1.Check operating instruments

deposits left and operation of autoclave.by slow or 2.Use chloride-free solutionsimproper for sterilizing, disinfecting,drying rinsing and cleaning. Distilled

or mineral free water preferred(pH approx. 7.0)

Rust Film left by 1.Check purity of water supply.(corrosion) steam 2.If water softeners are used,

check for composition.3.Purge steam pipes, especiallynew installations.

Rust Deposit 1.Do not mix stainless steel(corrosion) with other metals especially

where there is evidence ofdefective plating.

2.Rinse with distilled water(important where tap water mayhave high metallic content).

3.Remove debris from lock.4.Dry all instruments thoroughly.Use full-time cycle (important when instruments are wrapped).

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4. Rinse instruments thoroughly after cleaning. Use distilled water, not drinking water.

5. Dry instruments with clean, dry, lint-free towels.6. Just before sterilizing, soak the instruments in milk for 30-60 seconds. Do not use dry heat sterilizers.

7. Autoclave.

4. Follow manufacturer’s instructions for cleaning cycle time. Remove instruments promptly when cycle is complete and rinse thoroughly in distilled water.

5. Dry instruments with clean, dry, lint-free towels.6. Just before sterilizing, soak the instruments in milk for 30-60 seconds. Do not use dry heat sterilizers.7. Autoclave.

OCEDURE

G PROCEDURE

BLE-SHOOTING GUIDE

PROBLEM CAUSE PREVENTIONPitting Chemical 1.Rinse instruments thoroughly

and immediately after use.Electronic 2.Avoid long exposure toattack of chlorides and acids.surfaces 3.Do not use detergents having

high pH levels.4.Do not mix metals in ultrasonic cleaners.

Black to Ammonia 1.Avoid exposure to ammoniapurple in solutions and cleaningstains compounds.

2.Rinse instruments thoroughly(distilled water preferred).

Brown Minerals 1.Check water supply in sterilizer.Stains 2.Check cleaning compounds and

detergents. Avoid excessive use.Gray-Blue Improper 1.Use fresh, cold sterilizing stains Temperature solutions and follow manufacturer’s

suggestions for use.


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B-222 Instrument Care Manual - Accurate Surgical Instrument Care Manual.pdf · B-222 Instrument Care Manual_Layout 1 8/19/13 12:00 PM Page 11. 5 4. Rinse instruments thoroughly after