Surgical Instruments - Care and handling

The proper handling, cleaning and maintenance of surgical instruments is essential to prolong their useful life. Learn how to take proper care of them.




How do we take proper care of the surgical instruments?

The proper handling, cleaning and maintenance of surgical instruments is essential to prolong their useful life, thus ensuring that they will perform properly in their daily use. It is important to follow protocols or norms regarding cleaning, maintenance and disinfection processes. This will help us to prevent and avoid possible complications with the end-users who are the patients.


One of the most effective measures in the fight against nosocomial infections is undoubtedly the cleaning, disinfection and sterilization of surgical instruments, all of which are the responsibility of the nursing staff. These methods used to ensure safety against pathogenic organisms in a hospital are absolutely fundamental; The first is known as the most effective process when it comes to eliminating microorganisms in instruments or material used in daily clinical practice, the second is considered as a method that goes by 'levels' of disinfection and therefore its lethality is not so guaranteed, finally sterilization, These processes are aimed at minimizing the transmission of infections in the environment of healthcare centers, and are therefore included in safety strategies for the protection of both users and professionals. The proper implementation of these processes will raise the level of quality of care provided by the Health Service.


In order to clean, disinfect and sterilize any instrument, leaving it completely free of microorganisms, it is necessary to adapt it for this purpose, so it will be cleaned, dried, inspected, lubricated (if necessary) and prepared in an appropriate wrapping, and then sterilized and stored until its new use.


A wide variety of instruments are used in hospital centers, and for this reason, protocols or guidelines should be established for each type.


The first thing to do is to carry out an adequate cleaning, by means of a physicochemical procedure aimed at removing any foreign material from the object to be cleaned. Cleaning can be done manually or automatically. For this, it is necessary to know how to choose a suitable Enzymatic Detergent (Endozyme). Of the multiple enzymatic detergents that exist in the market, the choice of the same will be made based on its descaling power, which facilitates its penetration to the most inaccessible points, eliminating blood, secretions, oil, etc., as well as being effective in the most inaccessible water. It should be effective in hard water, not form calcareous plaques, easy to rinse, non-corrosive and easily biodegradable, pH neutral, fast acting, low foaming, and bacteriostatic. We should never use common soap, because of the insoluble alkaline film that can form on the instruments, which would protect the bacteria that have been retained there at the time of sterilization. We should never use abrasive cleaning material, such as metallic brushes or sponges that can cause fissures or create a risk of corrosion. Nylon brushes are the best option.


Lubricants are used to prevent corrosion of the instruments and add another protection against rust and stains. After lubrication, the instruments should be left to drain without rinsing.


Subsequently, a disinfection process should follow. It has been described as a chemical method by which pathogenic and non-pathogenic microorganisms are eliminated, it can be of high, intermediate or low level according to the spectrum of activity of the agent:


a) high level, (where it eliminates all microorganisms, so in special conditions can sterilize, among them are: orthophthaldehyde, glutaraldehyde, peracetic acid (Nexacetic Plus), chlorine dioxide, hydrogen peroxide, formaldehyde).


b) intermediate level, the lethality capacity is only for vegetative bacteria and some bacterial spores, the best known in this group are: phenols and sodium hypochlorite.


c) low level, is performed by chemical agents that eliminate vegetative bacteria, fungi and some viruses in a short period of time (less than 10 minutes), such as, for example, the group of quaternary ammoniums.


Finally, there is the sterilization process. Each hospital should determine and protocolize the most appropriate sterilization methods according to its needs. These processes will define the sterilization for each type of input, instrument or equipment according to the material and the use it will have in patient care. The most commonly used sterilization methods at present are: moist heat (autoclave), dry heat, ethylene oxide, formaldehyde vapor, hydrogen peroxide plasma and liquid peracetic acid in specially designed equipment and for times that ensure the effectiveness of the agents and the safety of the personnel.



 


Jensen Instrument Technologies is a long-established company distributing precision surgical instrumentation across Australia and New Zealand. Our company specialises in the supply of maintenance of precision mechanical, optical and power surgical instruments for surgical theatres. Learn more about us here.

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