Proper Surgical Instrument Cleaning
Surgical Instrument Disinfecting Prior to Sterilization
Surgical Instrument Cleaning Prior to Surgical Instrument Sterilizing
Studies demonstrated that surgical instrument washer disinfectors using a combination enzyme detergent cleaning concentrate rendered the efficacy of disinfection of 100%. All surgical instruments and utensils tested were sterile at the completion of the process.
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Articles have been published worldwide regarding the complexity of manually reprocessing flexible endoscopes and the related concerns. Automated reprocessing and combination all-in-one enzymatic-detergent-complex cleaning concentrates can provide valuable alternatives and have demonstrated superior outcomes. These new developments, in automated scope cleaning and cleaning concentrates, can improve scope performance, and protect flexible scopes from damage, while reducing the risks and costs associated with manual reprocessing. These developments have shown an increase in safety and have demonstrated a decreased risk of nosocomial infections. Endoscope manufacturers have focused on improving the functionality and clinical performance of scopes while manufacturers of washer decontaminators and washer disinfectors have focused on improving the automation of reprocessing (cleaning, disinfection, packaging, and sterilization). One main issue still remains and ongoing concern... human error. Contact us for surgical instrument cleaning, surgical instrument disinfecting, surgical instrument sterilizing, enzymatic cleaners surgical, and washer disinfector detergents.
The most common human errors occur during manual cleaning and when flexible endoscopes are connected to automated endoscope re-processors (AERs). These errors occur in endoscope departments worldwide and have not been correlated to specific scopes or re-processors. Validation of these reprocessing methods and operations may be written down in Standard Operation Procedures (SOP‘s) but in fact, the verification on how close these procedures are followed may be quite difficult. Product improvements by scope manufacturers require ongoing changes to reprocessing protocols and present new challenges to the reprocessing staff as well as the manufacturers of automated washer decontaminators and disinfectors. These ongoing changes require an ongoing review of the cleaning, disinfection and sterilization protocols. Reprocessing departments contend with daily shortages of flexible scopes that are ready to use and frequently experience FTE levels that are inadequate for manual cleaning. These factors may lead to endoscopes not being properly cleaned according to manufacturers or association recommendations. It has been found, that when a reprocessing staff is pressured for increasing the turnaround rate, cleaning may not be given the high priority necessary, due to the assumption that the sterilization to follow will provide a medical device that is safe for patient care. If an instrument is not thoroughly cleaned, it cannot be sterilized. Proper cleaning is the prerequisite for sterilization. The German based company near Augsburg, a leading manufacturer of AER‘s for over 15 years, addressed this unsolved problem and launched their System CC to the European market. The System CC received the 2005 Frost & Sullivan Award for Product Innovation. According to Frost & Sullivan: The first and only product of it’s kind, in the world, that helps totally eliminate the need for the manual pre-cleaning of flexible endoscopes and significantly reduces the risk for patients.
Generic Temperature Parameters for Cleaning Rigid and Flexible Scopes
Always refer to manufacturers specifications prior to establishing your reprocessing protocol.
Temperature Parameters for Cleaning Rigid scopes should not be heated over 199,4°F (93°C).
Temperature Parameters for Cleaning Flexible scopes should not be heated over 149°F (65°C).
Scopes with the HAMOU head are not suitable for reprocessing via washer decontaminators or washer disinfectors. For the protection of scope surfaces we recommend the use of Purified Water (DI or RO de-mineralized water), at least for the final rinse treatment. A cleaning agent in neutral pH-range (less that 9) can augmented with an enzymatic cleaner. Combination all-in-one Enzymatic Surgical Instrument Cleaner detergent complexes have been shown to be highly effective. Depending on the water quality, it may be necessary to use a cleaning concentrate that softens the source water for the treatments: cold water pre-wash, detergent wash, and purified water rinse/lubrication. When the treatment processes are finished, the scopes should be removed from the reprocessor avoid corrosion. As recommended by virtually all manufacturers of Scopes Surgical Instruments and Instrument Containers, Cleaning Concentrates (alkaline) that require a neutralizing agent (citric acid) should not be used as they can etch instrumentation. Aluminum is highly susceptible to etching. Dyed anodized aluminum parts are not easily identified as aluminum. High level enzymatic formulations (Enzymatic Surgical Instrument Cleaners), in combination with a high level surfactant chemical complex, have been shown to be more effective in removing stains, hard water deposits, and encrusted bioburden, while being safe to use for rigid or flexible scopes. When using a Washer Decontaminator Disinfectors Pressure Box for automated cleaning, connect the channels of optics with the insufflating channel to the rinsing connections of the washer rack. This will effectively clean the lumens and working channels while cleaning the surface of the scope.
General Procedures for Hand washing Endoscope cleaning consists of mechanical and chemical cleaning of internal and external surfaces. This includes brushing and/or flushing of all internal channels with sterile, filtered or drinking-quality water and enzyme-detergent. Preliminary cleaning should be started before the endoscope is detached from the light source/video processor. This will significantly reduce the overall time expended and the deterioration that results from reprocessing scopes. As soon as the endoscope has been removed from the patient, begin reprocessing, observing the following steps: clear gross debris by sucking detergent through the working channel (250 ml/min) ensure the working channel is not blocked irrigate the air and water channels with water checking for blockages expel any blood, mucus or other debris wipe down the insertion shaft check for bite marks or other surface irregularities detach the endoscope from the light source/video processor transfer the endoscope to a reprocessing room with atmospheric extraction facilities conduct a pressure leak test daily to check the integrity of all channels before reprocessing The next stage involves the dismantling of detachable parts of the endoscope whereby valves and water bottle inlets are removed and detachable tips taken off the insertion tube. Rubber biopsy valve caps are discarded if breached. Water bottles and suction/air-water valves should be autoclaved. Topics include: importance of cleaning surgical instruments to deactivate prions, cleaning prior to disinfecting surgical instruments, sterilizing surgical instruments in the presence of pathological prions, cleaning surgical instruments prior to sterilization to avoid Creutzfeldt-Jakob Disease, surgical instrument detergents that deliver the power of four enzymes. The all-in-ONE four enzyme surgical instrument cleaners clean fast. Buy surgical instrument detergents that deliver four enzyme cleaners. Buy lubricating enzyme surgical instrument detergents that cut costs. The research was initiated to deactivate prions deactivating prions within the objective to prevent CJD Creutzfeldt-Jakob Disease. Contact us for product information and pricing. Click Here to go to cleaning surgical instruments prior to sterilization. Contact us for surgical instrument detergents and enzyme surgical instrument detergents.