Your first-line-of-defense against Preventing Surgical Instrument Corrosion is maintaining the passive layer of Surgical Instruments. Stainless steel surgery instruments are made of corrosion resistant high-grade specialty steels. Corrosion resistant does not mean corrosion proof. One of the special characteristics of these steels is that the manufacturer forms a passive oxide layer on the surface, which protects them against corrosion. This makes surgery instruments as corrosion resistant as possible. It is imperative that you maintain the passive oxide layer to prevent corrosion and maintain your surgery instruments in optimal condition. If this is not done the stainless steel will be more susceptible to corrosion, pitting and stains.This will reduce the life of the surgery instruments and/or render it useless. Initially, all stainless steel surgical instruments have the same corrosion resistance. When strength and hardness requirements are important factors for instrument function, corrosion resistance is generally lower. Increasing the corrosion resistance would soften the stainless steel. Manufacturers of surgery instruments and surgical instrument containers recommend the use of neutral pH cleaning concentrates. Surgical Instrument Cleaning is the Prerequisite for Sterilizing Surgical Instruments. Disinfecting Surgical Instruments and Sterilizing Surgical Instruments can only be effective if the cleaning, whether done it's manually or automatically by using a Surgical Instrument Washer, Washer Disinfector, is adequate. Surgical instrument cleaners and enzyme surgical instrument cleaning detergents with conditioning clean surgical instruments effectively and fast. Neutral pH surgical instrument cleaning concentrates are recommended by all manufacturers of surgical instruments. Virtually all manufacturers of surgical instruments, rigid scopes, flexible scopes, and instrument containers recommend the use of neutral pH Cleaning Concentrates. Generic Example of this recommendation: Do not use high acidic (pH <4) or high alkaline (pH >10) products for disinfection or cleaning, since these can corrode metal, cause discoloration or stress fractures. Do not use abrasive pads or abrasive Cleaning Concentrates , which will scratch the surface allowing dirt and water deposits to collect. Abrasive cleaning will remove the protective passive layer. Do not use Cleaning Concentrates with high concentrations of chlorine bleach to clean or disinfect stainless steel instruments, as pitting will occur. Never use bleach to clean any surgical instruments. The high pH of bleach causes surface deposits of brown stains and might even corrode the instrument. Even high quality stainless steel is not impervious to an acidic bleach solution. Sort instruments by similar metal for subsequent processing so that electrolytic deposition (galvanic corrosion) due to contact between dissimilar metals will not occur. Rinsing Instruments Tap or Source Water when using surgical instrument cleaners and endoscope cleaners with yap water can contain many minerals, which may discolor and stain surgical instruments. It is recommended that de-ionized water be used for the final rinsing to prevent spotting. The all-in-one or combination cleaning concentrates can be effective in treating unacceptably hard source water and removing hard water encrustation from surgical instruments and equipment. If untreated tap water is used for final rinsing, then the instruments must be dried immediately to avoid staining.
Cleaning Conditioning Disinfection Sterilization of Surgical Instruments when
Clean instruments, or apply treatment to prevent the drying and encrustation of debris, as quickly as possible after use. Do not allow blood and debris to dry on the instruments. If cleaning must be delayed, place groups of instruments in a covered container with appropriate enzyme-detergent or apply an enzyme-detergent foam spray to delay drying. The use of pre-soaking enzyme-detergent foam sprays have been shown to reduce the time expended for manual cleaning and render higher quality outcomes. After surgery, open all box locks and disassemble instruments with removable parts. This will limit blood drying on instruments that may cause them to corrode. The all-in-one cleaners and the enzyme-detergent foam sprays deliver a chemical complex to: maintain the hydration of bioburden, prevent corrosion, clean the surface, and condition the surface of instruments and scopes. This can significantly reduce manual cleaning and facilitate cleaning the surface of surgical instruments, scopes, and the lumens of cannulated instruments inside-and-one. If used properly, all-in-one enzyme detergent foam sprays and/or all-in-one combination cleaning concentrates can render excellent outcomes and facilitate cleaning instruments and scopes inside-and-out. They effectively cleaning the surface while cleaning lumens and working channels. This can eliminate or reduce the manual labor expended, rendering lower reprocessing costs while improving turnaround.
Cleaning is the prerequisite for sterilization.
Ultrasonic Cleaners do not provide the complete proper sequence of treatments, purified final rinses that are purified, purged between treatments and have temperatures elevated to disinfection levels. Ultrasonic Cleaning can effectively remove: long term encrustation and surgical cements or glues that have dried onto instrumentation. Overloading, and low water temperature, will decrease the effectiveness of ultrasonic equipment. Ultrasonic cleaners are most effective when used with hot water per manufacturer’s recommended temperature and with high level multi-tiered enzyme detergents. It is recommended that all visible debris and blood be removed from the instrument prior to ultrasonic cleaning. Sort instruments by similar metal for subsequent processing so that electrolytic deposition (galvanic corrosion) due to contact between dissimilar metals will not occur. It is not recommended to clean plated surgery instruments in an ultrasonic cleaner since the ultrasonic vibration and the presence of other sharp instruments may crack or rupture the plating. Always refer to the printed manufacturer recommendations prior to using ultrasonics.
Staining and spotting may result if residual chemicals are not completely rinsed from surgery instruments that are subjected to steam sterilization. Following the manufacturer’s recommendations for the proper sequence of treatments (cold water pre-wash, enzyme-detergent wash, purified water rinse/lubrication, and drying) is critical to prevent stains and spots. A Cleaning Concentrates that will avoid spotting are free-rinsing or rinse clean. Studies regarding the passive layer of Surgical Instruments Guidelines on metals and alloys in contact with food; Council of Europe; published 11.10.2000. Systemic nickel: the contribution made by stainless steel cooking utensils; Contact Dermatitis, Volume 32:2, 1994 of the stainless steel passive layer to prevent corrosion have revealed a reduction in corrosion prevention with the use of cleaning concentrates that are not neutral pH. The use of cleaning concentrates that deliver an acid rinse will release nickel from the stainless steel and decrease the efficacy of the passive layer. This is most critical on initial reprocessing events of stainless steel surgical instruments. Measurable levels of nickel have been detected. It was also shown that, as the number of subsequent uses increased, the level of nickel release diminished and reached a steady state (measured in the order of μg/l). These observations reflect the changes that occur in the passive oxide layer on first immersion of stainless steels in aqueous media. Neutral pH 7 surgical instrument cleaning solutions are recommended by all surgical instrument and container manufacturers. The all-in-one enzyme surgical instrument cleaners delvers water softeners that treat the source water to counter the corrosive effects of source hard water that contains high mineral levels, and a free rinsing ingredient breaks the surface tension of the final rinse for spotless and residue free surgical instruments. The all-in-ONE enzyme detergent lubricant cleaner is designed to deliver all of the ingredients necessary for effectively cleaning and maintaining surgical instrument stainless steel.