Sterile Surgical Instruments
Surgical Instrument Washer
After being washed in a properly designed surgical instrument washer, that used an enzyme detergent surgical instrument cleaning lubricant solution: all instruments and utensils tested were sterile at the completion of the process.
APIC ABSTRACT Paper accepted for presentation at APIC:
Eighteenth Annual Conference and International Meeting
Oral Presentation, Ann Drake,
Validation of the microbial safety of surgical instruments and utensils following automated cleaning by a properly designed Washer Decontamination Washer Disinfector
A. Drake, RN and L. Ayers, MD.
The application of universal precautions to instruments/utensils handling became an issue in the selection of replacement decontamination equipment for Central Sterile supply at our hospital. The new technology of an automated thermal disinfection Surgical Instrument Washer Decontamination Washer Disinfector CESCO Mercersburg, PA offered increased protection to our reprocessing staff due to decreased handling but raised concerns about the efficacy of thermal disinfection as opposed to traditional washer sterilization. Because of the limited scientific documentation of this new technology, a study was undertaken to establish the microbial safety of finished products and to identify any feature or function failure which could adversely affect outcome. The Surgical instrument Washer Proper Sequence of Treatments used was: cold water pre-wash, enzyme ultrasonic sonic bath, detergent wash, purified water rinses, instrument lubricant rinse, and hot air drying at 240 F for 4 minutes. The Surgical instrument Washer Decontaminator was challenged with selected instruments and utensils that are considered to be very difficult to clean. Included were 30 each of stainless steel non-perforating towel clips and stainless steel and glass medicine cups. Each item was rinsed with a 10 5ml suspension of Staphylococcus aureus, Pseudomonsa eruginosa, Enterococcus fecalis and Candida albicans in nutrient media and then dried. The instruments were processed in the Surgical instrument Washer during times of high volume operation. All products were tested for sterility. Ten separate cultures were taken of the final rinse solution of instrument lubricant and de-ionized water prior to the drying cycle. A culture was taken of the instrument lubricant fluid. All instruments and utensils tested were sterile at the completion of the process. Our findings support the practice of validating all features of new technologies that may compromise the expected final outcome. The Surgical instrument Washer is a valid replacement for the conventional washer-sterilizer.
Ann Drake, RN, Director of Sterile Processing,
University of Ohio
John Temple Product Development
The Surgical Instrument Washer and the Proper Sequence of Washer Treatments: the purpose of a Surgical Instrument Washer is to deliver surgical instruments that are clean and safe to handle for reprocessing and are clean so that they can be sterilized. Surgical instruments that are not clean cannot be sterilized. Surgical Instrument Washers prepare surgical instruments for sterilization. Clean is the Prerequisite for Sterilization.
After being cleaned in a properly designed Surgical Instrument Washer, that included using a four enzyme detergent surgical instrument cleaning solution: the evaluation of the surgical instrument washer using the proper sequence of washer treatments confirmed that the efficacy of disinfection was 100%. All instruments and utensils tested were sterile at the completion of the washing process.
The Proper Sequence of Surgical Instrument Washer Treatments includes a series of mechanical and chemical treatments. The surgical instrument washer mechanical treatments include: cold water pre-wash, ultrasonic surgical instrument cleaner, surgical instrument detergent wash, purified water rinses, and hot air drying. The surgical instrument washer chemical treatments include: four enzyme cleaners, (Lipase, Amylase, Carbohydrase, and Protease), surface cleaning detergent, surface conditioners, stain remover, and water soluble lubricant.