The Complete Guide to Cleaning, Sterilizing, and Maintaining Surgical Instruments

At MPM Medical Supply, we understand the importance of quality and reliability in medical instruments. That's why we proudly offer a range of German stainless steel surgical instruments, known for their durability and precision. These high-caliber tools are an investment in your practice, and like any investment, they require proper care and maintenance. This guide outlines the recommended steps for cleaning, sterilizing, and maintaining surgical instruments, ensuring that you get the most out of our premium offerings.

Rinsing Immediately After Surgery

Immediately after surgery, it's essential to remove organic materials like blood, fluids, and tissue from the instruments. Rinse the instruments under warm running water (make sure the water is warm, not hot).

Note: Do not process different metals (like stainless, copper, chrome-plated, etc.) together.

Disinfecting the Instruments

Disinfecting protects medical personnel from contamination during the cleaning process. Immerse instruments completely in an EPA-approved disinfectant for approximately 10 minutes. Then, rinse the instruments again with water.

Caution: Never expose stainless steel instruments to bleach or other corrosive chemicals to disinfect. Exposure to bleach may result in instrument pitting and will void all manufacturer guarantees.

Thorough Cleaning

All blood, dried body fluids, and tissue should be completely removed from the instruments prior to sterilization. Several methods are available:

A. Soaking

• Use an enzymatic cleaner bath or a solution of water and neutral pH (7) detergent.
• Instruments should be fully submerged for at least 10 minutes.
• Rinse instruments under running tap water to remove solutions.

B. Ultrasonic Cleaning

• Most instrument manufacturers recommend ultrasonic cleaning as the most effective way to clean surgical instruments, particularly those with hinges, locks, and other moving parts.
• All instruments must be fully submerged.
• Make sure that "sharps" (scissors, knives, osteotomes, etc.) blades do not touch other instruments.
• Change solution frequently, at least as often as the manufacturer’s recommendation.
• Rinse instruments with water to remove the cleaning solution.
• Lubricate all hinged instruments which have any "metal to metal" action, at the screw or box lock. A non-silicone, water-soluble surgical lubricant is recommended. Do not use industrial oils or lubricants.

C. Automatic Washer Sterilizers

• Follow manufacturer’s recommendations but ensure instruments are lubricated after the last rinse cycle and before sterilization cycle.
• Caution: Needle Holders and Forceps may crack if sterilized with the ratchet in the 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 specially recommended stainless steel wire brushes for instrument serrated areas, bone files, burs, or on stained areas of knurled handles.
• Use only neutral pH (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. 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.
• Brush delicate instruments carefully, and if possible, separate them from general instruments.
• Make sure instrument surfaces are visibly clean and free from stains and tissue. Also, inspect each instrument for proper function and condition.

Inspection Checklist:

• Scissor blades should glide smoothly all the way and must not be loose when in the closed position.
• Forceps should have properly aligned tips and teeth must meet properly without cracking action.
• Hemostats and Needle Holders should not allow light between the jaws when closed in the first ratchet position.
• Suction tubes should be clean inside.
• Biopsy Punches should punch a clean hole into tissue paper.
• Retractors should function properly.
• Cutting Instruments and knives should have sharp, undamaged blades.

After scrubbing, rinse instruments thoroughly under running water. While rinsing, open and close scissors, hemostats, needle holders, and other hinged instruments to make sure the hinge areas are rinsed out, as well as the outside of the instruments.

Autoclaving (Sterilization)

The sterilizer manufacturer’s written instructions for cycle parameters should be followed. In general, the most common temperatures and time parameters are:

A. For Gravity Displacement Cycles

• 10 to 25-minute exposure time at 132° to 135° C (270° to 275° F)
• 15 to 30-minute exposure time at 121° to 123° C (250° to 254° F)

B. For Pre-Vacuum Cycles

• 3 to 4 minutes at 132° to 135° C (270°-275° F)

C. For Steam-Flush Pressure-Pulse Cycles

• 3 to 4 minutes at 132° to 135° C (270°-275° F)
• 20 minutes at 121°-123° F (250° to 254° F)

D. Lubrication

• Lubricate all hinged instruments which have any "metal to metal" action at the screw or box lock. A non-silicone, water-soluble surgical lubricant is recommended. Do not use industrial oils or lubricants.

E. Sterilization Methods

• Sterilize instruments either individually or in sets.

Caution: With most portable tabletop autoclaves, at the end of the autoclave cycle—before the drying cycle—unlock the door and open it no more than a crack, about 1/4" (6.4mm). Then run the dry cycle for the period recommended by the autoclave manufacturer. If the autoclave door is fully opened before the drying cycle, cold room air will rush into the chamber causing condensation on the instruments that may result in water stains or cause wet packs. Make sure autoclave filters and chambers are cleaned as recommended by the manufacturer.

Cold Sterilization

Most cold sterilization solutions render instruments sterile only after a 10-hour immersion. This prolonged chemical action can be more detrimental than the usual 20-minute autoclave cycle. If the instruments need to be "disinfected" only, a cold sterilization soak is acceptable, as disinfection will take place in approximately 10 minutes.

Terminology

• Sterile: An absolute term (no living organism survives)
• Disinfected: Basically clean, some organisms may survive

Caution: For instruments with tungsten carbide inserts, cold sterilization solutions are not recommended as they will deteriorate the instrument’s jaw.

After Cleaning

Storage

If instruments are to be stored, let them air-dry and store them in a clean and dry environment.

Conclusion

By following these methods, you can ensure that your surgical instruments are properly cleaned, sterilized, and maintained. If you’d like a PDF version of these instructions, you do download our surgical instrument care guide here.