Ultrasonic Surgical Instrument Cleaners
Optimal Ultrasonic Surgical Instrument Cleaning
and Sterilizing of  Surgical Instruments
Surgical Instruments that were cleaned in a Washer with automated Ultrasonic Surgical Instrument Cleaner Washer Decontaminator, Washer Disinfector and using a combination 4 enzyme detergent cleaning concentrate: evaluation of Tunnel Washers with an  Ultrasonic Surgical Instrument Cleaner confirmed that the efficacy of disinfection was 100%. All surgical instruments and utensils tested were sterile at the completion of the process.
Properly Designed Washer Decontaminators Washer Disinfectors
Provide the Prerequisite for Sterilizing Surgical Instruments and Utensils
John Temple, John Prohonic, Product Development
Summary: Properly Designed Washer Decontaminators Washer Disinfectors are designed to clean all surfaces thoroughly, thereby providing the critical prerequisite for the safe handling, and to disinfecting surgical instruments, and the sterilize surgical instruments. Critical cleaners, usually referred to as Washer Decontaminators Washer Disinfectors, perform pre-wash, ultrasonic (optional), detergent washing, purified water elevated temperature rinsing, lubrication and high temperature drying in such a manner as to provide thoroughly clean, stain free and lubricated medical devices. Surgical Instruments cannot be sterilized (be sterile) unless all exposed surfaces are properly cleaned, prior to sterilization, to remove soil (debris, bioburden) and properly rinsed to prevent staining. Not all Washer Decontaminators Washer Disinfectors provide adequate pre-rinsing, pre-cleaning, purified water rinsing, and thereby render higher rejection rates of processed surgical instruments.
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John Temple Surgical Instrument Enzymatic Cleaners and Washer Disinfectors
Proper Washer Decontaminator Washer Disinfector Design Secures Performance
The proper sequence of treatment and the correct choice of time, temperature and the components used are necessary to render surgical instruments that are critically clean, safe to handle, and have the prerequisite for sterilization. Washer Decontaminators Washer Disinfectors employ a cold water pre-wash to remove gross debris. This removes proteins and lipids, preventing them from being baked onto devices during the high temperature treatments to follow. Then, the ultrasonic process creates millions of micro implosions to loosen and free debris from lock boxes, hinge pins, serrations and other difficult-to-access surface areas. The Washer Decontaminators Washer Disinfectors detergent wash then applies high flow low pressure water with a cleaning concentrate (at ~ 135 degrees F) in such a manner as to evenly reach all areas of the load and strip bioburden from the surgical instruments. The elevated temperature (at ~ 194 to 209 degrees F) purified water final rinse secures the biocidal process, removes mineral deposits from prior cycles and lubricates the instruments. The high temperature (at ~ 158 to 230 degrees F) dry cycle presents heated, forced air which dries each device. The critical cleaned medical devices are now clean, safe to handle, have the prerequisite for sterilization, and are properly prepared for further reprocessing. 
Washer Decontaminator Washer Disinfector - Complete Removal of Pathogens
The Washington University School of Medicine at Washington University Medical Center examined the performance of a properly designed Washer Decontaminator Washer Disinfector (CESCO washer Decontaminator Model 520) and found that it removed all organisms from the surgical instruments tested.
The Washer Decontaminator Washer Disinfector was tested for its ability to complete remove pathological organism from surgical instruments.
Pure cultures of the following organisms were grown on appropriate agar plates:
1. Staphylococcus aureus;
2. Pseudomonas aerations;
3. Escherichia coli;
4. Bacillus species
Kelly clamps, tweezers and scissors wee placed on these plates of organism, taking care to ensure that all serrated edges were packed with all the organisms.  Each contaminated instrument was then dipped into the tube of Thiogycolate medium before being placed in all the washer baskets.  The instruments were then processed through the complete Washer Decontaminator Washer Disinfector cycle.  At the end of the drying cycle, the instruments were allowed to cool and then dipped into another tube of Thioglycolate medium.     
Results
All tubes of the Thioglycoate medium tested before the wash grew the appropriate organism within six to 18 ours after testing.  All tubes tested at the end of the wash showed no growth after 14 days of incubation. This Washer Decontaminator Washer Disinfector removed all organisms from the instruments. 
Washer Decontaminator Washer Disinfector Efficacy of Disinfection 100%
Another evaluation of Washer Decontaminators Washer Disinfectors confirmed that the efficacy of disinfection was 100%.  In this study, L.P. Jette and N.G. Lambert used two test methods.12   One method (N) was to test the effect of heat only within the disinfection process and the other test method (G) was to test the efficacy of both heat and washing.  Each method gave reproducible results and confirmed the efficacy of the Washer Decontaminator Washer Disinfector.
Washer Decontaminator Washer Disinfector Critical Cleaners Will Work for You
Washer Decontaminator Washer Disinfector Critical cleaners demonstrated the ability to completely remove pathological organisms with effective repeatability.  There operation is automatic, reliable, labor saving and easy to use.  Central Processing departments rarely find the need to manually treat devices and report an  exceptionally low rate of rejected devices. 
Conclusion
The Washer Decontaminator Washer Disinfector sequence, cold water pre-wash, ultrasonic cleaning, detergent washing action, final rinse and drying treatment of a properly designed Washer Decontaminator Washer Disinfector Critical Cleaner will provide critical cleaning, the prerequisite for safe handling, optimal disinfecting, and sterilizing of medical devices.
NOTE:
Surgical Instrument Washers Tunnel Washers with Ultrasonic Surgical Instrument Cleaner used in this research study were manufactured by CESCO, Mercersburg PA. Although the Surgical Instrument Washer Tunnel Washers with Ultrasonic Surgical Instrument Cleaner are not currently available from CESCO. The studies demonstrate the propensity for Surgical Instrument Washers Tunnel Washers with an automated Ultrasonic Surgical Instrument Cleaner to deliver optimal cleaning results. The surgical instrument cleaner used in these studies are currently available in the form of the all-in-ONE combination enzymatic enzyme detergent surgical instrument cleaner. A critical component for optimal cleaning is using the best possible surgical instrument cleaner. Recent European studies have illustrated and concluded that combination enzymatic enzyme detergent surgical instrument cleaner are more effective than conventional surgical instrument cleaner. The research was initiated to deactivate prions deactivating prions within the objective to prevent CJD Creutzfeldt-Jakob Disease.
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