• Author / Uploaded
• Naveenbabu Soundararajan

Citation preview

Causes of Surgical Instrument Corrosion — Staining, Pitting, and Marking Surgical Residues Blood, pus, and other secretions contain chloride ions which lead to instrument corrosion most often appearing as dark spots. If blood is left on the instruments for any period of time (20 minutes or longer), the instrument will mark and stain, especially if these residues are allowed to dry. Therefore, always clean and dry every instrument thoroughly after use. Only sterilize a clean instrument. The most damaging procedure is to allow dried-on debris to become baked-on stains in the autoclave. The temperature of the autoclave (250°-270°) will cause chemical reactions that can make the stain permanent and cause instrument corrosion. Remember, an autoclave does not clean; it will only sterilize. Tap Water Even tap water can stain an instrument. Tap water contains a high concentration of minerals which can contain chlorine which can be seen as a fine deposit (water spots) on the instrument surface. Rinsing with distilled water eliminates such deposits. Water with high mineral counts left to sit on an instrument can cause severe stains. Therefore, it is important to towel dry your instruments immediately and thoroughly, and never allow air-drying. Cleansers The cleansers and cleaning agents you use could also be a cause of instrument corrosion. Strong substances, as well as those containing a chemical make-up of acid or alkaline-based solutions can lead to pitting and staining. Wash instruments with a neutral pH soap (between 7pH - 8pH) that is designed for surgical instruments for optimal results. Anything with a higher pH may damage the instrument. Do not use dish soap, iodine, bleach, cold-soak solution, chlorhexidine-based solutions , laundry soap or surgeons hand scrub. These products will cause spotting and instrument corrosion. Using an instrument cleaning brush is recommended , especially for jaw serrations, teeth and hinged areas.

Importance of Cleaning Surgical Instruments After Surgery to Help Prevent Staining & Corrosion The washing process should begin within 20 minutes after surgery, even if sterilization will take place much later. Washing surgical instruments within a few minutes of surgery prevents blood from drying and is your best defense against corrosion, pitting and staining.

Only use approved solutions for washing, disinfecting and lubricating. Non-approved solutions are any that do not specifically state on the label: "for surgical instruments". Approved solutions are specially designed for surgical instruments and the sterilization cycle. Their product labels will state this use. TIP: If more time is needed, keep post-op instruments moist so that blood, tissue and other debris does not dry on the instruments. The best way to keep your instruments moist is to place a wet towel over the instruments, or use our Spectra-Moist™. This wetting-agent keeps blood from drying for hours.

Cold Sterilization Cold sterilization is not a recommended method for disinfecting surgical instruments. Why not? When you use cold sterilization, or anytime you immerse instruments for long periods of time in any solution, it can prove damaging. In fact, you should never leave instruments in any solution for longer than 20 minutes. Do not immerse instruments with tungsten carbide inserts (needle holders with gold handles) in solutions containing Benzyl Ammonium Chloride (BAC). This chemical is known to loosen the tungsten carbide. What's a better alternative to using cold sterilization? Learn the proper procedure for cleaning surgical instruments through instrument disinfection. You can also read more about cleaning surgical instruments in the excerpt "Enemies of Surgical Instruments" from Spectrum Surgical Instruments Corp CEO Rick Schultz's new book, Inspecting Surgical Instruments, An Illustrated Guide.

Enemies of Surgical Instrument Staining Water and moisture of any kind (especially blood, pus, surgical debris and chlorhexidine solutions) are the primary causes of instrument staining and pitting of surgical instruments. Allowing any type of moisture to air-dry on your surgical instruments will cause severe damage. Other enemies include cold soaking or washing instruments with inappropriate solutions such as dish or laundry soap, bleach, iodine-type solutions, general disinfectants, surgeon's hand scrub and most importantly, any solution that contains chlorhexidine or is a chloride-based solution. Surgical instruments are made from 300 and 400 series stainless steel. Despite its name, stainless steel definitely stains and it can also rust and become pitted.

Surgical Instrument Sharpening & Restoration Services

Spectrum Surgical offers surgical instrument sharpening and restoration services for a variety of medical instruments from surgical scissors and osteotomes to kerrison rongeurs and clipper blades*. Please follow the instructions below for sending your surgical instruments in for sharpening services: 1. Simply package instruments securely 2. Include all contact information inside the package 3. Ship to the following address: Spectrum Surgical Instruments Corp. Attention: Repair Facility 4575 Hudson Drive Stow, OH 44224-1725 *In order to prevent damage when shipping surgical clipper blades, wrap each blade in newspaper, bubble wrap or paper towels. Send your clipper motor with blades whenever possible. Do not send in blades with broken or missing teeth.

Surgical Instrument — Lubrication One of the easiest, yet most effective ways to keep instruments in excellent condition is to lubricate them after every cleaning. Proper lubrication keeps the moving parts of instruments from rubbing and scraping, thus preventing dulling and strain to joints and hinges. Moving parts on instruments, such as joints, box locks, ratchets, and screw joints, should be lubricated regularly. Before autoclaving, lubricate all instruments that have moving parts. Only use water-based surgical lubricants because they are steam penetrable. TIP: It is not recommended to use a lubricant bath because the container of the lubricant solution may contain certain bacteria from previous instruments dipped into this bath. A lubricant spray is advised. Sprays are safer, cost less, and take up less counter space

Surgical Instruments — Marking & Etching Vibrating engraving devices are not recommended because:    

They scratch off the protective surface of the instrument The box lock area is weakened Engraving creates a "bed" for bacteria Interferes with restoration/refinishing

Recommended: Acid-base etching can be performed by Spectrum or you may purchase an etching machine kit (Order #256AS available from Spectrum) to perform your own marking.

Proper Surgical Instrument Care & Maintenance Proper care of surgical instruments begins with appropriate cleaning and sterilization. Proper care also means regluar maintenance of German-made instruments, consisting of sharpening and restoration. A general rule of thumb for busy practices is to schedule maintenance every six months. Contact us at Spectrum Surgical for more information about our surgical instrument care services and products. Instruments that may require this maintenance include:          

Scissors Needle Holders Bone Cutters Hemostats Osteotomes Rongeurs Chisels Bone Curettes Knives Punches

 

Proper Cleaning of Surgical Instruments to Avoid Rust & Stains



Understanding the difference between Rust vs. Stains on surgical instruments. Stains can be removed, whereas rust will leave permanent damage. To determine if a brown/orange discoloration is a stain or rust, use the eraser test. Rub a pencil eraser aggressively over the discoloration. If the discoloration is removed with the eraser and the metal underneath is smooth and clean, this is a stain. If a pit mark appears under the discoloration, this is corrosion or rust.

Surgical Instrument Sharpening Services Discovering in the operating room that your instruments or scissors do not cut would be frustrating for anyone. Precision sharpness is an absolute prerequisite for any surgical

procedure. The best strategy is a proactive approach with an established routine inspection and regular surgical instrument sharpening maintenance. Cutting devices should be sharpened every 6-8 months. Those instruments which require sharpening most often include:        

Surgical Scissors Bone Cutters Osteotomes Rongeurs Chisels Bone Curettes Knives Punches

How to Send Surgical Instruments for Sharpening?

Please follow the shipping instructions below: 1. Package instruments securely to prevent any shipping damages 2. Include all contact information inside the package 3. Ship to the following address: Spectrum Surgical Instruments Corp. Attention: Repair Facility 4575 Hudson Drive Stow, OH 44224-1725 Once we recieve your package, a Spectrum Surgical representative will contact you to confirm your surgical instrument sharpening requests.

Stain Removal on Surgical Instruments To remove localized staining, dip a moistened cleaning brush into Spectra-Scrub® and brush the stain away. Use tap water or distilled water to rinse then dry with a towel

Steam Autoclave Most hospitals and practices use the Steam Autoclave for sterilizing instruments. If this is your method, there are a few important points to remember. First, only use distilled water for filling your sterilizer reservoir. Tap water contains minerals which will cause staining of the instrument. Secondly, if your autoclave has a steam line filter, clean it regularly using the manufacturer's recommendations as a minimum guide. Clean the inside chamber walls once a week. This will help prevent build-up of scale and will allow the sterilizer to operate more efficiently. To clean the inside chamber, follow these steps:

  

  

Turn the unit off, unplug and allow chamber to cool. Remove trays and racks. Using towels, remove any water lying in the bottom of the autoclave. Spray the inside walls of the unit with Spectra-Clave® (available from Spectrum). Allow the solution to stand for 5 minutes. Using a stiff, nylon-bristle brush, brush the inside chamber very aggressively. After brushing, wipe the inside clean with clean towels. Finally, using a moist towel, wipe the gasket clean on the inside of the door.

TIP: Before autoclaving, lubricate all instruments that have moving parts. Use surgical lubricants rather than industrial oils, as they are superior for surgical instruments.

Sterilization of Surgical Instruments All surgical instruments must be sterilized prior to surgery to prevent infection. But even sterilization can leave contaminants behind if not properly cleaned. Sterilize instruments with the ratchets open. This allows for better steam penetration. Plus, it prevents the box locks (hinge area) from cracking. If using a pan or tray, we recommend one with perforations. This will also enable better steam penetration and aids in more effective drying as well. For efficiency, place heavy instruments at the bottom and lighter, more delicate instruments on top. If sterilizing in paper or plastic pouches, do not stack pouches on top of one another during sterilization. When possible, pouches should be sterilized on their side, leaning against a pack or sterilizer chamber wall.

Ultrasonic Cleaning A method of cleaning that is a necessity is ultrasonic cleaning. This method is the most efficient and effective available today. In fact, ultrasonic cleaning is 16 times more efficient that manual cleaning alone. Place instruments in the ultrasonic unit for 10-15 minutes and use a neutral pH ultrasonic solution. Here are a few tips for ultrasonic cleaning:  



Before placing into the ultrasonic unit, clean instruments of all visible debris by hand-washing them in a neutral pH soap. Before placing instruments into the ultrasonic unit, turn on the ultrasonic machine and let it run for 10 minutes to de-gas the solution. This process removes any gas or air bubbles in the solution. The cleaner the instruments go into the ultrasonic cleaner, the cleaner they will come out.

    

As with all types of cleaning, open all instruments so ratchets and box locks are fully exposed to the cleaning process. Make sure instruments have plenty of room. Don't overload your ultrasonic cleaner. Don't mix dissimilar metals (such as aluminum and stainless) in the same cycle to prevent cross-plating. Upon completion of the cycle, remove instruments immediately and rinse them. Dry instruments thoroughly with a towel, ensuring that no moisture is left on the instruments.

Use distilled water or tap water with a neutral pH ultrasonic solution to properly fill the tank of your ultrasonic cleaner. Never use a manual soap in the ultrasonic cleaner and always follow proper dilution. A neutral pH ultrasonic cleaning solution, when properly mixed, effectively reduces the surface tension of the solution and increases the ultrasonic calibration process. The solution should be changed at least daily or sooner if the solution appears dirty or murky. Only plug an ultrasonic machine into a GFI outlet. TIP: A heated tank does not significantly improve cleaning. Generally speaking, there is no measurable improvement in cleaning when heat is applied to the solution.

Surgical Instrument Sterilization and Instrument Disinfection Wrapping of surgical instruments is essential in the sterilization process. If your practice uses re-usable towels and drapes, please be certain to use as little laundry detergent as possible. Towels and drapes can retain soap particles. During the autoclave cycle, steam passes through the fabric, picking up these soap particles and depositing them on the surface of the instruments. One suggestion for preventing this is to run an extra rinse cycle to remove excess soap particles. Also, if your instrument packs are coming out wet, we suggest a towel be placed inside the pack to absorb moisture and that you increase the dry time of the autoclave cycle.

Surgical Instrument Inspection Approvals: IAHCSMM, CBSPD, Nursing Program Lengths: 1 and 2 hour programs Objectives Include:   

Learn the clinical elements of rapid instrument inspection Learn which clinical solutions damage instruments How to test scissors for sharpness

For more surgical instrument information, please call a customer care representative at 800-444-5644 orcontact us via email.

Surgical Instrument Maintenance The Care and Handling of Your Microsurgical Instruments Approvals: IAHCSMM, CBSPD Program Length: 1 hour program Surgical Instrument Maintenance Objectives Include:   

Learn why sterilization does not dull scissors Learn key inspection points Why ultrasonic cleaning is so important

For more surgical instrument information, please call a customer care representative at 800-444-5644 orcontact us via email.

Laparoscopic Instruments and Scope Processing Approvals: IAHCSMM, CBSPD Program Length: 1 hour program Objectives include:   

Learn how and when to test lap instruments What scope manufacturers don't want you to know Identify key inspection points of Scopes and Laparoscopic instruments

For more surgical instrument information, please call a customer care representative at 800-444-5644 orcontact us via email.

The Surgical Instrument Repair Process Approvals: IAHCSMM, CBSPD Program Length: 1 hour and 2 hour Programs Objectives include:   

How to identify the reasons surgeons complain about needle holders How to save your budget with a proactive approach to instrument repairs How to increase patient safety through a comprehensive repair program

For more surgical instrument information, please call a customer care representative at 800-444-5644 orcontact us via email.

Power Equipment and Flexible Scope Processing Approvals: IAHCSMM, CBSPD Program Length: 1 hour program Objectives include:   

Learn the common power of equipment repairs Learn the key inspection points of a flexible scope Why leak testing is so important

Spectrum can also repair any of your surgical instruments, including the flexible scope. Learn more by visiting: flexible scope repair.

For more surgical instrument information, please call a customer care representative at 800-444-5644 orcontact us via email.

Flexible Scope Leak Testing Developed by Spectrum to teach proper techniques and the overall importance of Leak Testing. Keep this if you need a speaker for your upcoming chapter meetings, please contact Spectrum immediately and we will bring Instrument University™ to you. By attending Instrument University™, you will learn valuable hands on techniques to improve patient safety and surgeon satisfaction. Instrument University™ lectures are even approved for continuing educational credits!

For more surgical instrument information, please call a customer care representative at 800-444-5644 orcontact us via emai

