Product Manual

1. HOLDING/PRESOAK
Never hold instruments in a dry container.
Doing so allows blood and debris to dry onto instrument surfaces
and makes cleaning more difcult. If rinsing and decontamination
processes are not immediately available, pre-treat instruments or
hold them in a neutral pH holding/presoak enzymatic solution such
as Pro Advantage Enzymatic Detergent Concentrate (6198-NDC)
after patient use but before actual cleaning. As soon as possible,
rinse and clean as follows:
2. RINSING
(Always wear safety protection gear.)
Immediately after surgery, remove organic materials by rinsing
instruments under warm (not hot) running water. Rinse should
remove most blood, uids and tissue. Do not process dissimilar
metals (stainless, copper, chrome plated, etc.) together.
Note: Disinfection can be included to protect medical personnel
from contamination during cleaning; however, protection also can
be accomplished by following standard precautions by wearing
appropriate PPE as promulgated by OSHA & AORN.
3. CLEANING
All blood, dried body uids and tissue should be completely
removed from instruments prior to sterilization. Several
methods for removing these materials are available.
A. Soak: An enzymatic cleaner bath (soak) such as Pro
Advantage Enzymatic Detergent Concentrate (6198-NDC)
or a solution of water and neutral pH (7) detergent is
effective in removing organic material from instruments.
Use distilled (demineralized) water, if possible. Instruments
should be fully submerged for at least 10 minutes. Do not
let “sharps” (scissors, knives, osteotomes, etc.) touch
each other. Ensure that dissimilar metal instruments are
separated. Rinse instruments under running water to
remove solutions and change solutions frequently.
B. Ultrasonic Cleaning: Most instrument manufacturers
recommend ultrasonic cleaning as the most effective way
to clean surgical instruments, particularly instruments with
hinges, box locks and other moving parts.
• All instruments must be fully submerged in an open
position using distilled (demineralized) water, if possible.
To prevent possible surface scratching make sure that
“sharps” do not touch other instruments. Also, separate
instruments of dissimilar metals.
• Process instruments for the full recommended ultrasonic
cleaning cycle. Change solution frequently
or as often as the manufacturer recommends.
• Rinse instruments with water to remove the
cleaning solution.
C. Automatic Washer Sterilizers: Following manufacturers’
recommendations, ensure that instruments are lubricated
before the sterilization cycle and after the last rinse cycle.
CAUTION: Needle holders and forceps may crack if sterilized with
ratchet in closed position.
D. Manual Cleaning: If ultrasonic cleaning is not available,
observe the following steps:
• Use stiff nylon cleaning brushes. Do not use steel wool or
wire brushes except stainless steel wire brushes specially
recommended for instrument serrated areas, bone les, burs
or on stained areas of knurled handles.
• Use only neutral pH (7) detergents. If not rinsed off properly,
low pH (acidic - less than 6 pH) detergents break down the
stainless protective surface resulting in pitting and/or black
staining on instruments. High pH detergents (alkaline - more
than 8 pH) can cause brown stains (phosphate surface
deposit) which can also interfere with the smooth operation
of instruments. Most brown stains are not rust and are easily
removed with a surgical instrument stain remover.
• Brush delicate instruments carefully, and if possible, separate
them from general instruments.
• Make sure instrument surfaces are visibly clean and are free
from stains and tissue. This is also a good time to inspect
each instrument for proper function and condition.
• Check scissors’ blades to ensure proper function. Blades
should open and close smoothly. Test cutting performance
at 3/4 length of the blade with the materials recommended
below. Scissors should cut all the way to the tips.
Recommended cutting test materials:
– Fine/Delicate scissors: Surgical glove
– Medium scissors: Single layer of stocking/cast netting
– Large/Utility scissors: Double layer of stocking/cast netting
• Check forceps (pickups) for proper jaw alignment. Teeth
must meet properly without catching.
• Check hemostats and needle holders to ensure jaw tips close
in rst ratchet position and that the entire jaw closes in third
ratchet position. Check instruments for loose hinges and
verify that they lock and unlock easily. Also check instruments
for wear on jaw surfaces.
• Suction tubes should be clean inside.
• Test Biopsy Punches by punching a clean hole in 3-6 mil thick
poly-bag material. If poly-bag material is not available, use
tissue paper.
RECOMMENDED STEPS IN CLEANING,
STERILIZATION & MAINTENANCE OF
PRO ADVANTAGE
®
SURGICAL INSTRUMENTS