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Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
813-889-9614www.sharn.com
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
Table of Contents
18 BoneCutterInspection
3 CausesofCorrosion,Staining,PittingandMarking
4 CleaningandSterilization
24 CustomerService
2 EnemiesofSurgicalInstruments
15 HemostatInspection
6 InstrumentLubrication
7 InstrumentStaining
8 InstrumentStringers,RepairTags,TipProtectors 9 InstrumentMarking/IdentificationTape
1 Introduction,ProperCareofInstuments
17 LaminectomyandCervicalRongeurInspection
19–23 LapInstrumentInspection,Testing,andCleaning
12 NeedleholderInspection
14 RetractorInspection
10 StainlessSteelInstrumentBrushStudy
11 ScissorTestingandInspection
13 SuctionDeviceInspection
16 TissueandDressingForcepInspection
5–6 UltrasonicCleaning
Contact Sharn
813-889-9614Email:[email protected]
www.sharn.com
4517GeorgeRoadSuite200Tampa,FL33634
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Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
About This Guide
Asamedicalprofessional,youwanttoensuretheutmostqualityandintegrityofyoursurgicalinstrumentsatalltimes.Youalsowanttoprotectyourconsiderableinvestmentinthesehigh-grademedicaldevices.
Thecostofreplacingsurgicalinstrumentsisfargreaterthanthecostofmaintainingthem.Forthisreason,acomprehensivemaintenanceprogramisextremelyimportant.ThisguideprovidedbySharnwillhelp.
Proper Care and Scheduled PreventativeMaintenance
Propercareofsurgicalinstrumentsbeginswithpropercleaning.Thisguidediscussesproperwashing,cleaningandsterilizationofmanytypesofsurgicalinstruments.PropercarealsomeansmaintenanceofGerman-madeinstrumentsonaregularbasis,consistingofsharpeningandrestoration.AgeneralruleofthumbforbusyO.R.’sistoschedulemaintenancequarterly.Instrumentsthatmayrequirethismaintenanceinclude:scissors,needleholders,bonecutters,hemostats,osteotomes,rongeurs,chisels,bonecurettes,knivesandpunches.German-madesurgicalinstrumentsaredesignedtobere-sharpenedandrestored.Performingthismaintenancewillallowtheinstrumentstolastformanyyearsandperformflawlessly.
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Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
The Look and Feel of New Instruments
Mostprofessionalswillrecognizethatnewinstrumentsfeeldifferent.Newinstrumentstendtobeharderandhaveastifferfeeltothem.Asinstrumentsage,theysoftenwithuseandsterilization.Withpropercare,theseinstrumentscanlastalifetime.Itisimportanttorealizethatallsurgicalinstrumentswillexperiencesofteningovertime.Remember,newinstrumentsaredesignedtobestiffattheonsetofuse.Theideaistousethemfortheirdesignedpurposeandalwaysproperlyclean,lubricate,andperformpreventativemaintenance.
Enemies of Surgical Instruments
Inadditiontogivingtipsonthecareandcleaningofinstruments,thisguidewilldiscussseveralenemiesofsurgicalinstruments.Waterandmoistureofanykind(especiallyblood,pus,surgicaldebrisandchlorhexidinesolutions)aretheprimarycausesofstainingandpittingofsurgicalinstruments.Allowinganytypeofmoisturetoair-dryonyourinstrumentswillcauseseveredamage.Otherenemiesincludecoldsoakingorwashinginstrumentswithinappropriatesolutions.Examplesofthesesolutionsaredishorlaundrysoap,bleach,iodine-typesolutions,generaldisinfectants,surgeon’shandscrubandmostimportantly,anysolutionthatcontainschlorhexidineorisachloride-basedsolution.Surgicalinstrumentsaremadefrom300and400seriesstainlesssteel.Despiteit’sname,stainlesssteeldefinitelystainsanditcanalsorustandbecomepitted.
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Stainedandpittedinstruments
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
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TIP:Extendthedryingcycleofyourautoclave,especiallywhenasterilizingtrayisfullyloaded.Thiswillhelptoreducecondensationontheinstruments.
Causes of Corrosion–Staining, Pitting and Marking
Surgicalresiduessuchasblood,pusandothersecretionscontainchlorideionswhichleadtocorrosionmostoftenappearingasdarkspots.Ifbloodisleftontheinstrumentsforanyperiodoftime(20minutesorlonger),theinstrumentwillmarkandstain,especiallyiftheseresiduesareallowedtodry.Therefore,alwayscleananddryeveryinstrumentthoroughlyafteruse.Onlysterilizeacleaninstrument.Themostdamagingprocedureistoallowdried-onbloodtobecomebaked-onstainsintheautoclave.Thetemperatureoftheautoclave(250º–270ºFor121º–132ºC)willcausechemicalreactionsthatcanmakethestainpermanent.Remember,anautoclavedoesnotclean;itwillonlysterilize.
Thecleansersandcleaningagentsyouusecouldalsobeasourceofcorrosion.Strongsubstances,aswellasthosecontainingachemicalmake-upofacidoralkaline-basedsolutions,canleadtopittingandstaining.WashinstrumentswithaneutralpHsoap(between7pH-8pH)thatisdesignedforsurgicalinstrumentsforoptimalresults.AnythingwithahigherpHmaydamagetheinstrument.Donotusedishsoap,Iodine,bleach,cold-soaksolution,chlorhexidine-basedsolutions,laundrysoaporsurgeonshandscrub.Theseproductswillcausespottingandcorrosion.Usinganinstrumentcleaningbrushisrecommended,especiallyforjawserrations,teethandhingedareas.
A Word on Cannula Cleaning Brush Tips…
Spectra-Soap®Order#SS2
Fan-tip
Acrylic-tip
Scraper-tip(Helpsremovebaked-onbioburden)
NylonbristlecleaningbrushOrder#45-303N
StainlesssteelbristlebrushOrder#45-303SS
Double-endednylonbristlebrushOrder#M-16
Double-HeadedbrushOrder#45-202NS
Box-lockinstrumentbrushOrder#45-7000
InstrumentbrushOrder#45-8000
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
TIP:Ifmoretimeisneeded,keeppost-opinstrumentsmoistsothatblood,tissueandotherdebrisdoesnotdryontheinstruments.Thebestwaytokeepyourinstrumentsmoististoplaceawettowelovertheinstruments,oruseSpectra-Moist®availablefromSharn.Thiswetting-agentkeepsbloodfromdryingforhours.
Spectra-Moist®Order#SS6
Cleaning After Surgery
Thewashingprocessshouldbeginwithin20minutesaftersurgery,evenifsterilizationwilltakeplacemuchlater.Washinginstrumentswithinafewminutesofsurgerypreventsbloodfromdryingandisyourbestdefenseagainstcorrosion,pittingandstaining.
Onlyuseapprovedsolutionsforwashing,disinfecting,andlubricating.Non-approvedsolutionsareanythatdonotspecificallystate,“forsurgicalinstruments”onthelabel.
Approvedsolutionsarespecificallydesignedforsurgicalinstrumentsandthesterilizationcycle.Theirproductlabelswillstatethisuse.
Sterilization
Allsurgicalinstrumentsmustbesterilizedpriortosurgerytopreventinfection.Butevensterilizationcanleavecontaminantsbehindifnotproperlycleaned.Sterilizeinstrumentswiththeratchetsopen.Thisallowsforbettersteampenetration.Plus,itpreventstheboxlocks(hingearea)fromcracking.Ifusingapanortray,werecommendonewithperforations.Thiswillalsoenablebettersteampenetrationandaidsinmoreeffectivedryingaswell.Forefficiency,placeheavyinstrumentsatthebottomandlighter,moredelicateinstrumentsontop.Ifsterilizinginpaperorplasticpouches,donotstackpouchesontopofoneanotherduringsterilization.Whenpossible,pouchesshouldbesterilizedontheirside,leaningagainstapackorsterilizerchamberwall.
Sterilizewiththeratchetsopen
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Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
5
TIP:Aheatedtankdoesnotsignificantlyimprovecleaning.Generallyspeaking,thereisnomeasurableimprovementincleaningwhenheatisappliedtothesolution.
Ultrasonic Cleaning
Amethodofcleaningthatisanecessityisultrasoniccleaning.Thismethodisthemostefficientandeffectiveavailabletoday.Infact,ultrasoniccleaningis16timesmoreefficientthanmanualcleaningalone.Placeinstrumentsintheultrasonicunitfor10-15minutesanduseaneutralpHultrasonicsolution.Hereareafewtipsforultrasoniccleaning:
1)Beforeplacingintotheultrasonicunit,cleaninstrumentsofall visibledebrisbyhand-washingtheminaneutralpHsoap.2)Beforeplacinginstrumentsintotheultrasonicunit,turnonthe ultrasonicmachineandletitrunfor10minutestode-gasthe solution.Thisprocessremovesanygasorairbubblesinthe solution.3)Thecleanertheinstrumentsgointotheultrasoniccleaner,the cleanertheywillcomeout.4)Aswithalltypesofcleaning,openallinstrumentssoratchetsand boxlocksarefullyexposedtothecleaningprocess.5)Makesureinstrumentshaveplentyofroom.Don’toverloadyour ultrasoniccleaner.6)Donotmixdissimilarmetals(suchasaluminumandstainless)in thesamecycletopreventcross-plating.7)Uponcompletionofthecycle,removeinstrumentsimmediately andrinsethem.8)Dryinstrumentsthoroughlywithatowel,ensuringthatno moistureisleftontheinstruments.
UsedistilledwaterortapwaterwithaneutralpHultrasonicsolutiontoproperlyfillthetankofyourultrasoniccleaner.Neveruseamanualsoapintheultrasoniccleanerandalwaysfollowproperdilution.AneutralpHultrasoniccleaningsolution,whenproperlymixed,effectivelyreducesthesurfacetensionofthesolutionandincreasestheultrasoniccavitationprocess.Thesolutionshouldbechangedatleastdailyorsoonerifthesolutionappearsdirtyormurky.OnlypluganultrasonicmachineintoaGFIoutlet.
Spectra-Sonic®Order#SS1
UltrasonicCleaningKit
Order#1235KIT
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
6
(PhotoA)
(PhotoB)
(PhotoC)
Testing Your Ultrasonic Cleaning Machine
Todetermineifyourmachineisworkingproperly,simplyputwaterandproperlymixedultrasonicsolutioninthetank.Turnonmachineandviewthesurfaceofthewater.Ifyousee“sonic”waves(photoA)yourmachineisworking.Ifthesurfaceofthewateristotallyflat,yourmachinemayhaveaproblemwiththetransducer(s).
Thesecondtestiscalledthefoiltest.Simplyplaceasmallpieceofaluminumfoil(photoB)inthebottomofafilledtankandrunfor5-8minutes.Removefoilanditshouldbepeltedwithsmallholesanddents(photoC).Thisverifiesthattheultrasonicmachineisworkingproperly.
Lubrication
Oneoftheeasiest,yetmosteffectivewaystokeepinstrumentsinexcellentconditionistolubricatethemaftereverycleaning.Properlubricationkeepsthemovingpartsofinstrumentsfromrubbingandscraping,thuspreventingdullingandstraintojointsandhinges.Movingpartsoninstruments,suchasjoints,boxlocks,ratchets,andscrewjoints,shouldbelubricatedregularly.Beforeautoclaving,lubricateallinstrumentsthathavemovingparts.Onlyusewater-basedsurgicallubricantsbecausetheyaresteampenetrable.
Spectra-Lube®Order#T2Q
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
Rust vs. Stains
Stainscanberemoved,whereasrustwillleavepermanentdamage.Todetermineifabrown/orangediscolorationisastainorrust,usetheerasertest.Rubapencileraseraggresivelyoverthediscolor-ation.Ifthediscolorationisremovedwiththeeraserandthemetalunderneathissmoothandclean,thisisastain.Ifapitmarkappearsunderthediscoloration,thiscorrosionisrust.
Trouble Shooting Stain GuideBrown/Orange Stains-Mostbrown/orangestainsarenotrust.ThisstaincoloristheresultofhighpHsurfacedepositscausedbyanyofthefollowing:chlorhexidineusage,impropersoapsanddetergents,cold-steril-izationsolution,baked-onblood,soakinginsalineorusinglaundrysoap.
Dark Brown/Black Stains-LowpH(lessthan6)acidstain.Maybecausedbyimproperdetergentsandsoapsand/ordriedblood.
Bluish-Black Stains-Reverseplatingmayoccurwhentwodifferenttypesofmetalsareultrasonicallyprocessedtogether.Forexample,stainlesssteelinstrumentsprocessedwithchromeinstrumentsmaycauseastaincolorreaction.Exposuretosaline,bloodorpotassiumchloridewillcausethisbluish-blackstaintooccur.
Multi-Color Stains-Excessiveheatcausedbyalocalized“hotspot”intheautoclave.
Light and Dark Spots-Waterspotsfromallowinginstrumentstoair-dry.Withslowevaporation,mineralsfromwaterareleftontheinstrument’ssurface.
Bluish-Gray Stains-Coldsterilizationsolutionbeingusedoutsidemanufacturerguidelines.
Black Stains-Possibleexposuretoammonia.
Stain Removal
Toremovelocalizedstaining,dipamoistenedcleaningbrushinSpectra-Scrub®andbrushthestainaway.Usetapwaterordistilledwatertorinse,thendrywithatowel.
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Spectra-Scrub™StainRemoverOrder#SS7
Stainedinstrument
Erasertest
NylonbristlecleaningbrushOrder#45-303N
StainlesssteelbristlebrushOrder#45-303SS
Double-endednylonbristlebrushOrder#M-16
Double-HeadedbrushOrder#45-202NS
Box-lockinstrumentbrushOrder#45-7000
InstrumentbrushOrder#45-8000
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
Instrument Stringers
Instrumentstringersallowforsaferhandlingofinstruments,fasterset-upofsterilefield,andmoreefficientorganizationofthetrayassemblyprocess.Instrumentstringersareproducedinvariouswidthsandlengths.Themostcommonwidthis2.5inchesandthemostcommonlengthbeing10inches.Afterselectingsize,thereareseveralstringerclosurestylestochoosefrom.
Repair Tags
Theuseofrepairtagsfacilitatesprecisecommunicationbetweentheoperatingroomandthesterileprocessingdepartment.Placing3–5newrepairtagsineachsetpriortosterilizationallowsthetagstobeavailableonthesterilefield.Onceadullordamagedinstrumentisdiscoveredduringaprocedure,asterilerepairtagcanthenbeplacedontheinstrument.Thissystemclearlyidentifiesthedefectiveinstrumentandpreventsunnecessaryrepairs.
Tip Protectors
Theuseoftipprotectorsisagoodpracticethatprotectsvaluableinstrumentsandscopesfromdamage.Manytimesthedamagetoaninstrumentfromnotusingtipprotectorsisnotrepairable,makingitnecessarytoreplacetheinstrument.Tipprotectorsareavailableinvented(withholes)ornon-vented(withoutholes)styles.Ventedtipprotectorsaresafertouseduetothefactthattheyareeasiertoremovefromtheinstrument,whichreducespossiblefingerinjuries.Theotheradvantageoftheventedtipprotectoristheimprovedexposureofthedevicesurfacetothesterilant.Tipprotectorscanbeusedonthetipsofpointedscissorsandsharpinstruments,skinhooks,distaltipsofrigidscopesandtoguardthecuttingedgesofosteotomes.
10”QuickRackStringerOrder#10QR
Sharpen/RepairTagsOrder#HL-4(Blue)Order#HL-4R(Red)
Assortmentofventedtipprotectors
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Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
Instrument Etching / Marking
Vibratingengravingdevicesarenot recommendedbecause:1)Theyscratchofftheprotectivesurfaceoftheinstrument.2)Theboxlockareaisweakened.3)Engravingcreatesa“bed”forbacteria.4)Interfereswithrestoration/refinishing.
Acid-baseetchingisrecommended.YoumaypurchaseanetchingmachinekitfromSharntoperformyourowninstrumentmarking(Order#256ASC).
Instrument Marking Tape Application
Howtoproperlyapply:1)Cleanfingerswithalcoholtoremoveoils,greaseanddirt.2)Wipetapesitewithalcoholtoremoveanylubricant.3)Tapelengthshouldbeonlyenoughtowrap1to1½timesaround instrument.4)Aftertapeisapplied,autoclaveinstruments.Theheatwillassist withthebondingofthetape.5)Tapetheshanksofallinstruments.Avoidinstrumentrings. Wrappingtape1to1½timesaroundwillnotinterferewiththe closingofmostscissortips.
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CompleteetchingkitOrder#256ASC
Markingtapeoninstrumentshanks
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
LaboratoryTestResultsBEFOREbrushing
HemostatClose-Up ScissorsClose-Up
New Afterseveraluses
Demonstratessoftnessofwirebristles
The Facts about Sharn’s Stainless SteelInstrument Cleaning Brushes
Ithasbeenreportedforyearsthattheuseofstainlesssteelcleaningbrusheswilldamageaninstrument’ssurfaceorpassivationlayer.Todispelthismyth,wehiredanindependenttestinglabtotestinstrumentsbeforeandafterbrushingwithaSharnstainlesssteel,bristledinstrumentcleaningbrush(order#45-303SS).Thetestemployedbeforeandafterphotos,takenwithanelectronmicroscopeat200Xmagnification.Inaddition,weexaminedthemetallurgicalpropertiesofthestainlesssteelbeforeandafterbrushing.Duringthetest,theinstrument’ssurfacewasbrushed60times.Asyoucanseefromthephotosbelow,thestainlesssteelbristlesdidnotharmtheinstrument’ssurface,provingthatusingSharn’sstainlesssteel-bristledcleaningbrushesWILLNOTHARMyourstainlesssurgicalinstruments.
Test: MetallurgicalLaboratoryStudyLaboratory: AnalyticalServices,Inc.Dateconducted: 2003Method: ScanningElectronMicroscope EnergyDispersiveSpectroscopy
A few words on wire brushes…
Thestainlesssteelbrushisdesignedtoremovebaked-ondebrisandstainsthatthenylonbrushcannotremove.Thedesignofthesoftstainlesssteelbristlesallowsthebristlestobendandremovedebrisatraumatically.Previously,wirebrushesthatdamagedsurgicalinstrumentswerebonecementbrushes.Theseverystiffbristlesoccasionallycauseddamage,whichledtothenegativeopinionofwirebrushes.Therecommendationistouseanylonbristlebrushfirst.Ifthedebrisisnotremoved,thenuseastainlesssteelbristledbrush.Thisbrushisintendedforuseonbonefiles,needleholderjaws,burs,reamers,vascularinstrumentserrationsandstubbornstains.
Notice:Insulated,coated,plated,orchromeinstrumentswillbedamagedbyusingastainlesssteel-bristledbrush.
LaboratoryTestResultsAFTERbrushing
HemostatClose-Up ScissorsClose-Up
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Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
Scissor Testing, Inspection, and Quality Assurance
Visuallyinspectcuttingbladesforburrs,chipsorcorrosion.Thedistaltipsshouldmeetevenly.Inspectsharptipsforbendingordamage.Thecuttingactionofascissorshouldbesmoothasthescissorclosesandthescissorshouldnotgrind,“jump,feellooseortootight.Usetheguideatlefttotestscissorsharpness. •Forscissorslongerthan4½”useSharn’sStandardScissorTest Material(Order#621431ornon-latex,order#621531). •Forscissorsshorterthan4½”length,useSharn’sThinScissor TestMaterial(Order#621430ornon-latex,order#621530).
Post-Operative Care
Separatetheringsandbeginthedecontaminationprocesswithin20minutesaftersurgery.Theuseofspray-onmoisturizerssuchasSpectra-Moist®(Order#SS6)isalsoaveryeffectivewaytopreventthebloodfromdrying.Soaktheinstrumentsinanenzymaticsolution(Spectra-Matic™Order#SS9)orplaceamoisttowelsaturatedwithwaterovertheinstruments.
Test Your Scissors:
1Usingrighthandthumband middle(orring)finger,make surethatscissorsareheld likeasurgeon.
2Cutthroughmaterialusing ½ofbladetocutalltheway throughtothedistaltip.
3Afterseveralcuts,extract scissors.Ifscissorsdonot pinchorgrabmaterial, scissorsaresharp.
4Thefinaltestishowthe scissorsfeel.Scissors shouldopenandclose smoothlyandshouldnot “jump”,grind,orfeelloose.
CORRECT
INCORRECT
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RecommendedBrushes:45-202NS,M-16,45-7000
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
Needleholder Inspection and Quality Assurance
1.Visuallyinspectjawsforsignssuchaspartialsmoothnessor inconsistentwear.Ifwornscheduleforrepair.2.Holdneedleholdertoalightsourceandclosejawsalltheway.If youcanseelightbetweenthejaws,thisneedleholderisinneed ofrepair.3.Inspectjawsandboxlocksforcracks.4.Checkjawsforburrs.5.Theshanksoftheinstrumentshouldbestraight.6.Checkratchettoseeifjawsstayclosedonlastratchet.Test ratchetbyopeningandclosing.Withneedleholderratchets closedcompletelyalledgesshouldmeetevenly.
Post-Operative Care
Separatetheringsandbeginthedecontaminationprocesswithin20minutesaftersurgery.Theuseofspray-onmoisturizerssuchasSpectra-Moist®(Order#SS6)isalsoaveryeffectivewaytopreventthebloodfromdrying.Soaktheinstrumentsinanenzymaticsolution(Spectra-Matic™Order#SS9)orplaceamoisttowelsaturatedwithwaterovertheinstruments.
Wornneedleholderjawinserts
Replacementneedleholderjawinserts
Acceptablecondition
Inneedofreplacement
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RecommendedBrushes:45-202NS,45-303SS,45-303N,M-16,45-7000
NylonbristlecleaningbrushOrder#45-303N
StainlesssteelbristlebrushOrder#45-303SS
Double-endednylonbristlebrushOrder#M-16
Double-HeadedbrushOrder#45-202NS
Box-lockinstrumentbrushOrder#45-7000
InstrumentbrushOrder#45-8000
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
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Suction Device Inspection and Quality Assurance
1.Visuallyinspectallareasofsuctiontubesforsharpedges,dents andtrappedsurgicaldebris.2.Inspectshaftfordentsasaresultofbending.3.Inspectthetubingunionofthesuctioncontrolareaforcracks andpropersoldering.Verifythereisnobreakdownoftheunion.4.Inspectstyletteandseethatstylettecanbeinsertedsmoothly intoproximalend.Note:Styletteshouldnotbeinsertedduring sterilization.
Cleaning Instructions
Useacleaningbrushthatisthepropersizeforeachsuctiontube.Alwaysallowbrushtoenterandcompletelyexitsuctionchannel,andthendrawbrushbackthroughdevice.
TIP:Brushofpropersizeshouldcompletelyexitsuctiontubewhencleaning.
Recommendedcleaningbrushes:
Baron Suction Tube Brushes Order# Diameter Length45-904 3french(1.0mm) 9.75”45-905 5french(1.6mm) 9.75”
Frazier Suction Tube Brushes
Order# Diameter Length45-906 6french(2.0mm) 9.75”45-907 7french(2.3mm) 9.75” 45-908 8french(2.6mm) 9.75” 45-909 9french(3.0mm) 9.75” 45-910 10french(3.3mm) 9.75”45-911 11french(3.6mm) 9.75” 45-912 12french(4.0mm) 9.75”
CleaningBrushScale
AvailablefromSharnOrder#45-0001
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
Retractor Inspection and Quality Assurance
1.Visuallyinspectretractorforchippingorflakingofsurface.2.Inspectvisuallyandbyfeelfordents,burrs,bentbladesor prongs.3.Ifretractorhasreleaselever,flicktheleverandseethatitsprings backintoplace.Levershouldopenandclosesmoothly.4.Ifretractorhasaspringandscrewarea,inspectcloselyfor cracks.5.Ifretractorischrome-platedandfinishisflaking,remove instrumentfromserviceandreplace.
Post-Operative Care
Separatetheringsandbeginthedecontaminationprocesswithin20minutesaftersurgery.Theuseofspray-onmoisturizerssuchasSpectra-Moist®(Order#SS6)isalsoaveryeffectivewaytopreventthebloodfromdrying.Soaktheinstrumentsinanenzymaticsolution(Spectra-Matic™Order#SS9)orplaceamoisttowelsaturatedwithwaterovertheinstruments.
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RecommendedBrushes:45-303N,45-303SS,M-16,45-7000,45-8000
Inspectchrome-platedinstrumentsforflaking
InstrumentbrushOrder#45-8000
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
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Hemostat Inspection and Quality Assurance
1.Visuallyinspectserrationsofjawsandallsurfaces.2.Tipsofserratedjawsshouldmeetflush,withnooverlay.3.Teethofhemostatictissueforcepsshouldbepresent,alignedand fittogetherperfectly.4.Openandclosehemostat,checkingforstiffness.5.Carefullyinspectboxlockareaforcracksanddebris.6.Testratchetpriortoeachassemblyoftray.Totestifratchetis sprung/inneedofadjustment,closeratchetandgentlytaprings evenlyonahardsurface.
Post-Operative Care
Separatetheringsandbeginthedecontaminationprocesswithin20minutesaftersurgery.Theuseofspray-onmoisturizerssuchasSpectra-Moist®(Order#SS6)isalsoaveryeffectivewaytopreventthebloodfromdrying.Soaktheinstrumentsinanenzymaticsolution(Spectra-Matic™Order#SS9)orplaceamoisttowelsaturatedwithwaterovertheinstruments.Besuretothoroughlyrinseandcleantheboxlockareaandserrationsofthejaws.Thesearethemostdifficultareastoclean.
TIP: Ratchetsshouldalwaysbeopenwhencleaningandsterilizingforthefollowingreasons:
1.Allowsforadequatesteam/ sterilantpenetrationintobox lockarea.
2.Preventscracksby reducingstressonbox lockareaduetorapid expansionofthesteel duringthesterilization process.
RecommendedBrushes:45-303N,45-303SS,45-202NS,M-16,45-7000
NylonbristlecleaningbrushOrder#45-303N
StainlesssteelbristlebrushOrder#45-303SS
Double-endednylonbristlebrushOrder#M-16
Double-HeadedbrushOrder#45-202NS
Box-lockinstrumentbrushOrder#45-7000
InstrumentbrushOrder#45-8000
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
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Tissue and Dressing Forcep Inspection andQuality Assurance
1.Visuallyinspectforcepsfromtiptotip.2.Makesureallteetharepresent.3.Tipsshouldmeetevenly,withnooverlay.4.Teethofforcepsshouldbealignedandfittogetherperfectlywith outstickingwhentesting.5.Carefullyinspectforcracksanddebris.6.TissueandDressingForcepsshouldnot“click”andshouldnot “stick”whentesting.
Post-Operative Care
Separatetheringsandbeginthedecontaminationprocesswithin20minutesaftersurgery.Theuseofspray-onmoisturizerssuchasSpectra-Moist®(Order#SS6)isalsoaveryeffectivewaytopreventthebloodfromdrying.Soaktheinstrumentsinanenzymaticsolution(Spectra-Matic™Order#SS9)orplaceamoisttowelsaturatedwithwaterovertheinstruments.
RecommendedBrushes:45-303N,45-303SS,45-202NS,M-16,45-7000,45-8000
NylonbristlecleaningbrushOrder#45-303N
StainlesssteelbristlebrushOrder#45-303SS
Double-endednylonbristlebrushOrder#M-16
Double-HeadedbrushOrder#45-202NS
Box-lockinstrumentbrushOrder#45-7000
InstrumentbrushOrder#45-8000
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
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Laminectomy and Cervical Rongeurs
1.Closelyinspectrongeuratdistaltip,wheredamagemostoften occurs,significantlyreducingtheinstrument’sabilitytocut.2.Inspectchannelandinterlockingpartsforbioburden.3.Ifrongeursticks,lubricateorsendoutforrepairevaluation.4.Carefullyinspectspringsandscrewsforcracksanddebris.
Post-Operative Care
Beginthedecontaminationprocesswithin20minutesaftersurgery.Theuseofspray-onmoisturizerssuchasSpectra-Moist®(Order#SS6)isalsoaveryeffectivewaytopreventthebloodfromdrying.Soaktheinstrumentsinanenzymaticsolution(Spectra-Matic™Order#SS9)orplaceamoisttowelsaturatedwithwaterovertheinstruments.Besuretothoroughlyrinse,cleanandinspectthechannel/interlockingareasandcuttingportion.Thesearethemostdifficultareastoclean.
TIP:Sharpnessofarongeurcanbetestedbyusingastandard3”x5”indexcard.Therongeurshouldtakeacleanbiteoutofthecard.
RecommendedBrushes:M-16,45-303N,45-303SS,45-7000Nylonbristlecleaningbrush
Order#45-303N
StainlesssteelbristlebrushOrder#45-303SS
Double-endednylonbristlebrushOrder#M-16
Double-HeadedbrushOrder#45-202NS
Box-lockinstrumentbrushOrder#45-7000
InstrumentbrushOrder#45-8000
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
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Bone Cutters
1.Closelyinspectbonecutter’sjawsatdistaltip,wheredamage mostoftenoccurs,significantlyreducingtheinstrument’sabilityto cut.2.Ifdamagetocuttingsurfaceisdiscovered,schedulethe instrumenttoberepairedimmediatelyanddiscontinueuse.2.Ifbonecuttersticks,lubricateorsendoutforrepair.4.Carefullyinspectallspringsandscrewsforcracksanddebris.
Post-Operative Care
Beginthedecontaminationprocesswithin20minutesaftersurgery.Theuseofspray-onmoisturizerssuchasSpectra-Moist®(Order#SS6)isalsoaveryeffectivewaytopreventthebloodfromdrying.Soaktheinstrumentsinanenzymaticsolution(Spectra-Matic™Order#SS9)orplaceamoisttowelsaturatedwithwaterovertheinstruments.
TIP:Sharpnessofabonecuttercanbetestedbyusingastandard3”x5”indexcard.Thebonecuttershouldcutcleanlythroughasinglethick-nessofthecard.
TIP:TestPinCuttersinthecenterportionofthejaw.Thisistheareaofthejawthatisdesignedtocut.
RecommendedBrushes:45-303N,45-303SS,45-202NS,M-16,45-8000
NylonbristlecleaningbrushOrder#45-303N
StainlesssteelbristlebrushOrder#45-303SS
Double-endednylonbristlebrushOrder#M-16
Double-HeadedbrushOrder#45-202NS
Box-lockinstrumentbrushOrder#45-7000
InstrumentbrushOrder#45-8000
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
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Laparoscopic Instrument Inspection, Testing, and Cleaning
TIP:Totestlaparoscopicinsulation,visuallyinspecttheentireshaftforanynicksorcuts.Next,pullbackontheinsulation.Iftheinsulationslidesback,theinstrumentisinneedofreinsulation.
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
Laparoscopic Instrument Inspection, Testing, and Cleaning
TIP:Laparoscopictipprotectorshelpprotectvaluablelaparoscopicinstruments.
TipprotectorsareavailableinseveralsizesfromSharn.
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Order#LTP-5-800 5mmdiameter .75”length (20/pkg)
Order#LTP-5-168 5mmdiameter 1.68”length (20/pkg)
Order#LTP-10-800 10mmdiameter .75”length (20/pkg)
Order#LTP-10-225 10mmdiameter 2.25”length (20/pkg)
Order#LTP-VN-750 VerresNeedleProtector .75”length (50/pkg)
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
Laparoscopic Instrument Inspection, Testing, and Cleaning
Todetermineiftheinnerlinkageisworn,stretched,orfatigued,wigglethedriveringbackandforth.Ifthejawdoesnotmove,thelinkageisdamagedandisinneedofrepair.Astheringmoves,thejawshouldmoveaswell.
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Shallow Cannula Cleaning BrushesColor-codedhookhandles
Order# Diameter Handle Length45-0505 5mm Green 5” 45-0507 7mm Yellow 5” 45-0510 10mm Pink 5”
NEW BRUSH DESIGNS
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
Laparoscopic Instrument Inspection, Testing, and Cleaning
TIP:Whencleaninganylaparoscopicinstrumentshaft,thecleaningbrushmustenterandcompletelyexittoproperlyclean.
Toproperlyflushandirrigatelaparoscopicinstruments,connectsyringetoirrigationportandwithdistaltipunderwater,drawupwaterfromcleaningsink.Forcecleaningfluidsinandoutofshaft.
TIP: Whensoakinglaparoscopicinstruments,soakingtheinstrumentsverticallyallowsfluidtoenteratthedistaltipandriseup.Fluidwillseekit’sownlevel,andthis,inconjunctionwithanenzymaticcleaner,willassistwiththecleaningprocess.
SoakingCylinderOrder#3662-4000
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Recommendedcleaningbrushes:
Laparoscopic Instrument Brushes Order# Diameter Length45-542 2mm 12” 45-543 3mm 12” 45-544 4mm 12”45-545 5mm 12” 45-546 6mm 12” 45-539 5mm 16”45-540 7mm 16” 45-541 10mm 16” 45-550 2.5mm 24”45-551 5mm 24” 45-552 7mm 24” 45-553 10mm 24”
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
Laparoscopic Instrument Inspection, Testing, and Cleaning
Totestsharpnessofalaparoscopichookscissor,bladesshouldcutcleanlythroughastandard,1/4”widerubberband.Bladesshouldopenandclosesmoothlyandbefreeofnicksandburrs.
Totestsharpnessofastandardlaparoscopicscissor,bladesshouldcutcleanlythroughonethicknessoffacialtissue.Bladesshouldopenandclosesmoothlyandbefreeofnicksandburrs.
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Cleanables™ Instrument BrushesSingle-Ended
Order# Diameter Length45-1503 3mm 25” 45-1505 5mm 25” 45-1508 8mm 25”45-1510 10mm 25”
Double-Trouble Cleanables™ Instrument Brushes -Double-Ended
Order# Diameter Length45-2503 3mm 25” 45-2505 5mm 25” 45-2508 8mm 25”45-2510 10mm 25”
Reposables™ Instrument Brushes Disposablebrushtipswithreusable24”shaft
Order# Diameter Length45-2505 5mmDisposableBrushtip45-2508 8mmDisposableBrushtip45-2510 10mmDisposableBrushtip45-2400 24”ReusableHandle
Reposables™ Instrument Brush KitDisposablebrushtipswithreusableshaft
45-2499 24”Reusablehandlewith disposablebrushtips
NEW BRUSH DESIGNS
Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS
Customer Service
CustomerServiceisournumberonepriority.SHARNAnesthesia,Inc.hasawidenetworkofdealersacross36countries.Ifyouareanexistingcustomerofoneofourexcellentdealers,wethankyouforyourbusinessandhopetocontinuetoserveyouwithtopqualityproductsatcompetitiveprices.
Ifyouarenotyetacustomer,wewillbehappytoputyouintouchwiththedealerclosesttoyou.Ifyouareadealerandinterestedinsurgicalinstrumentcareproducts,wearehappytohearfromyou.Eitherwayyoucancontactusthroughcalling01-813-889-9614orviaemailatmailbox@sharn.com.PleaseaddressyourcommunicationstotheDirectorofInternationalSales.
Again,serviceisthewatchwordatSHARNAnesthesiaInc.Ourwholestaffandournetworkofdealersworkhardtoprovidethebestserviceforallourcustomers.
Thisguideiscompletelyprotectedbycopyright.Nopart,page,orimageofthispublicationmaybereproduced,scanned,stored,distributed,ortransmitted inany formorbyanymeanswith-out prior written permission from the author.The author has done everything possible toensurethattheinformationcontainedwithinthisbookisaccurateandup-to-dateinaccordancewithacceptedindustrystandardsatthetimeofprint. The author is not responsible for errorsoromissionsor forconsequences fromuseofthe guide, and makes no warranty expressedor implied regarding the content of this guide.Any practice or recommendation describedinthebookshouldbeappliedbythereader inaccordance with their facility’s professionalstandards and policies. Always consult yourfacility’spoliciesandalways refer toand followthe manufacturer’s cleaning and sterilizationguidelines.©2009SpectrumSurgicalInstrumentsCorp.
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