Ten commandments of surgical instrument care
Terms
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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)
- enemies
- 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
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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 - cleansers
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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
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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.
- sterilize
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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
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use only distilled water in the reservoir.
clean the filter regulary.
clean the chamber once a week. - lubricate instrument regulary
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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.