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Ten commandments of surgical instrument care


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Know your enemies
water and moisture of any kind are the primary caused of marks and stains on instruments (blood,pus,surgical debris, chlorhexidine solutions)
do not cold soak in anything except an approved solution
understand the causes of corrosion
the primary corrosivce sulprits are surgical residues, tap water, cleansers, and surgical towels and drapes
surgical residues
blood, tissue, contain chloride ions that cause coorosion. with autoclaves: remember an autoclave does not clean it only sterilizes
tap water
container a high concentration of minerals. rinse instruements with disillted water, thoroughly towel dry immediately after washing. Or with the autoclave-extend the drying cycle of sterilization. this reduces the risk of condensation on instruments.
Wet surgery packs usually result in stained instruments
nonapproved cleaning agents cause corrosion
those containing acid or alkaline agents lead to pitting and staining.
opimal ph = 9.2 to 11
do not use prvidone-iodine
dish or laundry detergent
surgeion's hand scrub.
these cause spotting and corrosion.
use a non-metal instrument-cleaning brush.
surgical towels and drapes
if you recyle laundry, use as little detergents as possible when laundering. use an extra rinse cycle. the residue detergents corrode the surgical instruments
test for rust
rust leaves permanent damage. rubbing a pensil eraser over a mark; if the mark is removed the mark is a stain, if their is a pit the mark represents corrosion or rust
discard rusted instruments immediately.
clean immediately after surgery
washing process should begin within 10 min. after surgery. washing the instruments within a few minutes of surgery is the best defense against corrosion, pitting, and staining.
all surgical instrument must be sterile.
sterilize instruments with their jaws open.
never stack paper or plastic pouches on top of each other in the autoclave. stand them up on a holder
ultrasonic cleaning
do not place dis-similar metals together
16 times more efficient than hand cleaning. place instrument in a neutral-pH solution in the ultrasonic unit for 10 minutes.
clean autoclaves regulary
use only distilled water in the reservoir.
clean the filter regulary.
clean the chamber once a week.
lubricate instrument regulary
lubricate after every cleaning.
"instruments milk"
never use cold sterilization
not recommended it shortens the life of surgical instruments. never leave immersed for more than 20 min. never immerse tungsten carbide inserts in solutions containing bezyl ammonium chloride.

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