Tap 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. 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.
Ultrasonic cleaners are very effective when used with hot water per manufacturer’s recommended temperature and specially formulated detergents. It is recommended that all visible debris and blood be removed from the instrument prior to ultrasonic cleaning. Contact between dissimilar metals can cause corrosion when Ultrasonics is applied. Sort surgical instruments according to similar metal types to prevent corrosion. (electrolytic deposition - galvanic corrosion) It is not recommended to clean plated instruments in an ultrasonic cleaner since the ultrasonic vibration and the presence of other sharp surgery instruments may crack or rupture the plating. Surgical Instrument Cleaner Lubrication of Surgical Instruments To maintain moving parts and protect instruments from staining and rusting during sterilization and storage, they should be lubricated with a water-soluble, preserved lubricant after each cleaning. Most automated washer decontaminators provide the option for lubrication at the end of the final rinse treatment. Since effective ultrasonic cleaning removes all lubricant, re-lubrication is important. "all-in-one" cleaning concentrates will provide lubrication. The lubricant should contain a chemical preservative to prevent bacterial growth in the lubricant bath. The bath solution should be made with de-mineralized water. A lubricant containing a rust inhibitor helps prevent electrolytic corrosion of points and edges. Immediately after cleaning, instruments should be immersed or rinsed for 30 seconds and allowed to drain off, not wiped off. A lubricant film will remain through the sterilization to protect surgery instruments during storage. Prevent Staining and Spotting when Cleaning Surgical Instruments 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". the passive oxide layer of surgical instruments when cleaning 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. What is Surgical Stainless Steel? Why is this important when cleaning Surgical Instruments?Stainless steel is essentially a low carbon steel which contains chromium at 10% or more by weight. It is this addition of chromium that gives the steel its unique stainless, corrosion resisting properties. The chromium content of the steel allows the formation of a rough, adherent, invisible, corrosion-resisting chromium oxide film on the steel surface. If damaged mechanically or chemically, this film is self-healing, providing that oxygen, even in very small amounts, is present. How is the passive oxide layer of surgical instruments Manufactured and Maintained when Cleaning Surgical Instruments and cleaning eye surgical instruments?
Removing Surgical Instrument Stains
Yellow-brown to dark-brown stains or spots on surgical stainless steel instruments are frequently mistaken for rust. These residue deposits (stains or spots arranged in groups or along edges or in crevices) are usually the instrument being exposed to result of high chloride content. They will lead to pitting of the surgical instrument surface if not removed. (see Avoiding High Levels of Chloride below) Excessively hard water can contain high levels of salt sufficient to cause stains or spots that appear as rust. Boilers used to generate the steam for steam sterilizers, if not cleaned properly, will produce contaminated steam which can deposit minerals onto instruments during the sterilization process.
Use cleaning agents containing "Nonionic Surfactants" whenever possible.
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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.
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