C.Automatic Washer sterilizer:
follow manufacturers" recommendations but ensure instruments are lubricated after the last rinse cycle and before the sterilization cycle
CAUTION:
Needle holder and forceps may check if sterilized with ratchet in closed position.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 instruments serrated areas, bone or on stained areas of knurled handles.
Use only neutral pH (7) detergents such. If not rinsed off properly, low pH (acidic less than 6 pH) detergents break down the stainless protective surface resulting in pitting and/or back staining. High pH detergents (alkaline more than 8 pH) which can also interfere with the smooth operation of instruments. Most brown stains are not rust and are easily removed with stain remover.
Brush delicate instruments carefully, and if possible, separate them from general instruments.
Make sure instruments surfaces are visibly clean and free from stain and tissue. Stain Remover can help remove residue stains. This is also a good time to inspect each instrument for proper function and condition.
Check scissors" blades to ensure proper function. Blades should glide open and closed smoothly. Test cutting performance at % length of the blade with the following recommended materials. Scissors should cut all the tips. Recommended cutting test materials:
Fine/Delicate scissors: Surgical gloves
Medium scissors: Single layer of stocking/cast netting
Large/utility scissors: Double layer of stocking/cast netting.
Check forceps (pickups) for proper jaw alignment. Teeth must meet properly without catching.
Check hemostats and needle holders to ensure jaw tips close in first ratchet position and entire jaw should close in third ratchet position. Check instruments for loose hinges and verify that they lock and unlock easily.
Suction tube should be clean inside.
Test Biopsy Punches by punching a clean hole in 36 mil thick polybag material. If polybag material is not available, use tissue paper.
Retractors should function properly.
Cutting edge instruments and knives should be sharp and free of damage.
After scrubbing, rinse instruments thoroughly under running water. While rinsing, open and close scissors, hemostats, needle holder and other hinged instruments to make sure the hinge areas are rinsed out and no debris remain.
5. AFTER CLEANING
Separate dissimilar metals prior to sterilizing/autoclaving. If instruments are to be stored, let them air dry
and store them in a clean and dry environment.
6. AUTOCLAVING
A.
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 and lubricants.
B.
Sterilizer instruments either individually or in sets.
Individual Instruments:
Disposable paper or plastic pouches are ideal. Make sure to use a wide enough pouch for instruments with ratchet locks so instruments can be sterilized in an open (unlocked) position.
Instruments locked during autoclaving can experience cracked hinges (box lock) or other problems because of heat expansion. If wrapping instruments, make sure the towel does not contain detergent residue, which can stain instruments.
Instruments Sets:
Unlock all instruments and sterilize in an open position. Place heavy instruments on the bottom of sets (when two layers are required). Do not overload the chamber because an air pocket may form that hinders steam penetration.
CAUTION:
With most portable tabletop autoclaves, at the end of the autoclave cycle and before the drying cycle, unlock the door and open it no more than crack, about % (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
