How to properly sterilize your surgical instruments

Surgical instrument forceps

Instrument sterilization is not merely a task. Rather, it is a comprehensive process, incorporating best practices in workflow, logistics, equipment, techniques and procedures.

WARNING: this is not a sterilization manual. Rather, this is a summary of the very detailed process. If you are developing a sterilization capability for your facility, please contact us at CONTACT@LHMEDS.COM.

Step 1: Right after use 

This step begins during the medical or surgical procedure where the instrument is used. Immediately after use, clean the instrument and soak it in a decontaminating solution to avoid debris drying up and sticking to the instrument. Do not splash the solution on other items and surfaces in the room. Use a purpose-built container for soaking; this container should also protect the instruments during transport, as well as have a watertight lid to avoid spillage. 

Sklar decontaminating solution

Sklar sterilization container with a lid

Step 2: Transporting the instruments

Also critical is the process of moving instruments to the sterilization area. Firstly, guard against contaminating the surroundings. Cover all instruments and equipment. Move everything in covered carts, closed containers or closed plastic bags. Secondly, protect yourself and wear scrubs covered by a moisture-resistant barrier such as a gown, shoe covers, rubber or plastic gloves and a hair covering. Also, during manual cleaning, when splashing can occur, use safety goggles and a face mask or a face mask with a shield.

Medline personal protective equipment. We would also recommend goggles or face shield.

Step 3: Instrument cleaning

You can use an ultrasonic cleaner or an instrument washer. We would suggest an ultrasonic cleaner unless your instruments are chromed (do not use an ultrasonic cleaner on chromed instruments!). Separate instruments by alloy or composition to avoid potential damage. Additionally, disassemble instruments with movable parts to make cleaning easier. Instruments with lumens may require special equipment, attention and know-how; make sure you have a technician experienced in working with lumened instruments handling them.

Elma ultrasonic surgical instrument cleaner 

Step 4: Rinse and inspect the cleaned instruments

Rinse ultrasonically cleaned instruments with water so there is no clinging debris or traces of cleaning solution. All locks, serrations, and crevices should be critically inspected for cleanliness. Instruments with cutting edges such as scissors, rongeurs, chisels, curettes, etc., should be checked for sharpness. There should be no dull spots, chips, or dents. Hinged instruments such as clamps and forceps should be checked for stiffness and alignment of jaws and teeth.

Step 5: Packaging the instruments 

Pack and store instruments so that sterility remains to the point of use. To achieve this, remember that the packaging materials and techniques must allow the sterilant to contact the device during the sterilization process. Also, the packaging must protect the device from contamination during storage and handling until the time of use.

Medline sterilization pouches, different sizes

Step 6: Sterilization

Steam autoclaving is a proven-effective and cost-efficient method of sterilization.

Euronda steam autoclave

Step 7: Transfer instruments to a secure, clean storage area 

It is best to store sterile surgical instruments in a dedicated, secure and neatly organized area at your facility. Also, it should be easy, quick and convenient to retrieve instruments and take them to the point of use.

Throughout the process: monitoring of the sterilization process is essential. Work practices must be supervised. Written policies and procedures must be strictly followed by all personnel responsible and accountable for sterilizing and disinfecting items, and for handling sterile supplies. Sterilization indicators may be helpful. Use checklists to ensure all steps are followed. Have a continuous training, fine-tuning and monitoring program.

What Lighthouse Medical can do

  • Design the workflow and logistical processes
  • Supply, maintain and restock equipment and consumables, including everything mentioned in this article
  • Design and help implement checklist-based procedures
  • Provide training, monitoring and quality assurance

Give us a call today at 747-5483 or write to CONTACT@LHMEDS.COM

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