Instrument Care and Handling

D.Dot Industries

Proper care and handling of your instruments will extend their longevity and ensure optimal performance. Follow the recommended cleaning protocols below to maintain their quality.

Rinsing

Immediately after use, rinse instruments under warm or cool running water to remove all blood, body fluids, and tissue. Avoid using hot water, as it can cause protein-based substances to coagulate, making cleaning more difficult.

Cleaning Techniques

Three key factors contribute to effective cleaning:

  • Time – The efficiency of cleaning chemicals depends on adequate exposure time.
  • Temperature – Higher temperatures improve cleaning efficiency.
  • Agitation – Manual scrubbing or ultrasonic cleaning helps remove debris from instrument surfaces.

Ultrasonic Cleaning

Ultrasonic cleaning is the most effective method, utilizing cavitation to dislodge dirt and debris from even the smallest crevices. To maximize effectiveness, follow these steps:

  1. Prepare an enzymatic or neutral pH/mild alkaline detergent solution according to the manufacturer’s instructions.
  2. Use deionized water if available.
  3. Run the ultrasonic cleaner for several minutes before use to degas the solution and reach the correct temperature.
  4. Place instruments in an open position inside the cleaner. Ensure that sharp instruments do not touch each other. All instruments must be fully submerged.
  5. Do not mix different metals (e.g., stainless steel, copper, or chrome-plated instruments) in the same cleaning cycle.
  6. Process instruments in the ultrasonic cleaner for 5–10 minutes.
  7. Rinse thoroughly with water to remove any residual cleaning solution and debris.
  8. Dry instruments thoroughly with a clean towel. This minimizes the risk of corrosion and
    formation of water spots.
  9. Use spray lubricant in the hinges to improve function of instrument.

Automatic Washer Sterilizers

  • Follow the manufacturer’s recommendations.
  • Lubricate instruments after the final rinse cycle and before the sterilization cycle.

Manual Cleaning

  1. Use Appropriate Cleaning Tools
    • Use stiff plastic cleaning brushes.
    • Avoid steel wool or wire brushes, as they may damage the instrument surface.
  2. Select the Right Detergent
    • Use only neutral pH detergents.
    • Low pH detergents (acidic) can break down the stainless-steel protective surface, causing black stains.
    • High pH detergents (alkaline) may leave brown deposits, interfering with smooth instrument operation.
  3. Handle Delicate Instruments with Care
    • Clean delicate instruments separately from general instruments to prevent damage.
  4. Inspect Instrument Functionality
    • Ensure all surfaces are visibly clean and free of stains and tissue.
    • Test instrument functionality:
      • Scissors – Blades should glide smoothly without looseness when closed.
      • Forceps – Tips should be properly aligned.
      • Hemostats & Needle Holders – Jaws should not show light between them, should lock and unlock easily, and joints should not be too loose.
      • Needle Holders – Check for wear in the jaws.
      • Cutting Instruments & Knives – Ensure blades are sharp and undamaged.
  5. Rinse Thoroughly
    • Rinse under running water, ensuring hinge areas are cleaned by opening and closing scissors, hemostats, and needle holders.
  6. Dry Completely
    • Use a clean towel to dry instruments, minimizing the risk of corrosion and water spots.
    • Apply a spray lubricant to the hinges to maintain smooth operation.

Soaking

  • Large, non-delicate instruments can be soaked in a corrosion-inhibiting detergent if other cleaning methods are impractical.
  • Rinse and dry instruments thoroughly after soaking.

Sterilization

Autoclaving

  1. Lubricate Metal-to-Metal Instruments
    • Apply surgical instrument lubricant to scissors, hemostats, needle holders, and self-retaining retractors.
    • Avoid using WD-40, oil, or industrial lubricants.
  2. Prepare Instruments for Sterilization
    • Individual Instruments – Use disposable paper or plastic pouches. Ensure pouches are at least 4” wide for instruments with ratchet locks (e.g., needle holders and hemostats) so they can remain in an open position.
    • Instrument Sets – Unlock all instruments and place heavy instruments at the bottom when stacking layers.
  3. Never Lock Instruments During Autoclaving
    • Locking instruments prevents steam from sterilizing metal-to-metal surfaces.
    • Heat expansion can cause cracks in hinge areas.
  4. Do Not Overload the Autoclave Chamber
    • Overloading hinders steam penetration, reducing sterilization effectiveness.
  5. Prevent Excess Moisture
    • Place a towel at the bottom of the sterilization pan to absorb excess moisture.
  6. Proper Drying Procedure
    • At the end of the autoclave cycle (before drying):
      • Unlock the autoclave door and open it slightly (about ¾ inch).
      • Run the drying cycle as recommended by the manufacturer.
    • Avoid fully opening the autoclave door before drying. This prevents cold air from causing condensation, which leads to water stains and wet packs.

Cold Sterilization

  • Most cold sterilization solutions require 10 hours for complete sterilization.
  • Prolonged chemical exposure may damage instruments more than a 20-minute autoclave cycle.
  • For disinfection only (not sterilization), a 10-minute immersion is sufficient.
  • For tungsten carbide instruments (needle holders, scissors, tissue forceps):
    • Avoid solutions containing benzyl ammonium chloride, as they can damage tungsten carbide inserts.

Storage

  • Store instruments in a clean, dry environment until use to prevent contamination and corrosion.