1. Cleaning and Disinfection
Washing should remove all the dirt and biological debris from the surface of the materials and should be performed within 30 minutes of the end of the surgical procedures. To prevent blood from drying on the materials we suggest covering them with a damp towel.
The instruments shouldn’t be overexposed to physiological saline solutions, since prolonged contact promotes oxidation.
At the beginning of the washing process the material should be rinsed under running water, while opening and closing the instruments. Manual washing should be done with hard plastic brushes, with the instruments immersed in demineralised or distilled water with enzymatic detergent at a neutral pH, under 45ºC, in order to avoid the coagulation of protein substances. We recommend always using new detergents and washing solutions since the overuse increases chemical concentration due to evaporation, favouring the corrosion of the materials and reducing the effectiveness of the disinfection.
Ultrasonic cleaning by cavitation is the most effective cleaning method.
Disinfection can be effectively achieved by immersing the instruments in enzymatic detergent, at neutral pH, for 90 minutes at 25°C. At the end the instruments should be rinsed with demineralised or distilled water and dried with paper towels. Do not use alcohol when cleaning materials.
2. Lubrication
Cleaning may render instrument’s joints stiff due to mineral deposits and other impurities in the water system and regular metal to metal friction causes corrosion. Blue recommends applying a spray lubricant to all surfaces and instrument joints after each cleaning cycle.
3. Inspection
Before carrying out the sterilisation inspect each instrument and confirm the correct function of the joints, cleanness and general condition of the material.
4. Sterilisation
Sterilisation is essential to ensure that surgical instruments do not act as pathogen vectors. The most common method is autoclaving.
In the autoclave the instruments must always be in the open position to allow the steam to reach all surfaces. Do not overload the autoclave trays, which would block the steam penetration. The temperature, cycle duration and pressure should be those recommended by the manufacturer.
Regardless of the steriliser class, complete drying of all instruments and implants should be assured to prevent their degradation. The use of dry heat is not recommended for the sterilisation process.
Unpackaged instruments should be used immediately. Packaged instruments should be stored in a dry, closed and warm place.
Cold sterilisation, with prolonged immersion in enzymatic detergents, can impair delicate instruments. Avoid using solutions with benzium ammonium chloride on instruments with tungsten.
Most problems with the instruments can be attributed to one or more of the following causes:
- Improper cleaning and drying immediately after use;
- Prolonged exposure to sterilisation solution or use of corrosive solution;
- Using normal running water instead of demineralised or distilled water in the cleaning and sterilisation processes;
- Using non-recommended detergents or lubricants;
- Some sort autoclave failure.
