Want to ensure the longevity of your surgical instruments? The key is their proper handling, care and maintenance. So, how exactly can healthcare institutions ensure the longevity of surgical instruments? What are the dos and don’ts in the handling and maintenance of surgical instruments?

Keep reading to find out.


#1 Use Surgical Instruments ONLY for Their Intended Purposes

Surgical instruments are designed and developed for specific procedures and purposes. And they must be used only for those purposes and in those procedures. When they are used incorrectly or outside of the intended purposes, surgical instruments can be damaged beyond repair, negatively impacting their performance and causing delays in the OR.

For instance, sharp instruments such as scissors, dissectors, etc. may lose their sharpness and get misaligned when they are not used for their intended purposes. As a result, the surgical precision may decrease and the chances of tissue trauma increase.


#2 Properly Clean Immediately After Use

Thorough cleaning of surgical instruments immediately after their use is critical as it helps remove dirt, debris, blood, mucous, pus and foreign particles from them. Else, it will lead to higher risks of infection and dangerous complications for the next patient on whom the surgeon uses these surgical instruments. Further, the unwashed residue will cause staining to the surgical instruments and reduce its usable life. Based on the type of instrument, manual, mechanical, ultrasound or a combination of these cleaning methods may be used.

While cleaning, don’t forget the hard-to-reach areas and moving parts as dirt and debris tends to accumulate in these spots. Follow up cleaning with disinfection to remove microorganisms and sterilization to destroy microbial life, making instruments sterile and surgery ready.


#3 Don’t Let Dirt Dry on Instruments

When dirt, debris, chemical residue and biological materials are allowed to dry prior to cleaning, they cause staining, damage their surface and make it more challenging to decontaminate surgical instruments. Their lifecycle shrinks and they become unhygienic and unsafe to use on patients. So, never let any dirt, debris or residue dry on instruments.

Point-of-use pre-cleaning and cleaning of instruments within 10-20 minutes after the procedure is useful. For pre-cleaning treatments to prevent residue from drying on instruments, you can lay a towel saturated with tap water over the instruments after use. Alternately, you can spray a moisturizer, foam or gel designed for this purpose over the contaminated instruments.


#4 Dry the Surgical Instruments Thoroughly after Cleaning

If not, there will be water spots and worse, corrosion. Use a soft cloth for thorough drying of instruments. For instruments such as scissors and forceps, they must be dried in an open position.


#5 Don’t Place Surgical Instruments in Saline or Harsh Solutions

Saline and harsh solutions tend to break down the surface of the surgical instruments, increasing the risk of corrosion and shortening their lifespan. Similarly, do not plunge instruments in chlorine or other disinfectant solutions for pre-cleaning treatments or carrying the instruments to the SPD (Sterile Processing Department) as it increases the risk of corrosion. Further, the blood and biological residue may inactivate the disinfectant and cause microbial contamination.

Manufacturers typically recommend the use of cool or warm water for pre-cleaning treatments, cleaning, rinsing and sterilization of instruments. Distilled water and solutions with a pH less than 10 can be used.

Hot water should not be used since substances with enough protein could coagulate on the surface under heat. In some cases, the instruments can be placed in a cold-water bath with an enzymatic detergent to break down oils and dissolve proteins thus, enabling easier cleaning.

Use pH neutral detergents to ensure stainless steel instruments do not get stained during cleaning. Alkaline detergents have high pH levels that leave a deposit and brown or orange stains on the surface of the instruments. Detergents with low pH cause dark brown stains.


#6 Don’t Use Abrasives and Steel Brushes for Manual Cleaning

Manual cleaning is used for surgical instruments when mechanical methods are unavailable. Manual cleaning is also used when the instrument is easily damageable. It is also used in combination with other cleaning methods when instruments are complex and need disassembly.

In either case, use non-abrasive, soft brushes (nylon or stiff plastic) to clean instruments. Using steel wool or wire brushes, erodes the protective coating on surgical instruments and drastically reduces their lifespan.


#7 Use Ultrasonic Cleaning

Ultrasonic cleaning is one of the most preferred mechanical cleaning methods as it seamlessly and effectively dislodges debris and dirt in hard-to-reach places in a way that manual cleaning cannot.

Keep the following in mind while using ultrasonic cleaning.

  • Mix detergent only as per manufacturer specifications
  • Exposure time should not exceed 5-10 minutes
  • Place instruments in open position in the cleaner and ensure they are fully submerged
  • Rinse instruments in cool water to remove the detergent and dislodged debris from instruments
  • Do not place instruments of different metals together
  • Do not let bladed instruments come in contact with other instruments

#8 Lubricate Instruments That Have Metal-on-Metal Action Before Sterilization

You must lubricate Instruments such as forceps, scissors, needle holders, etc. where there is metal-on-metal action before sterilizing them. Use only lubricants designed for this and not oil, WD-40 or other industrial lubricants. Leave these instruments open for sterilization to ensure steam reaches everywhere.


#9 Proper Storage of Surgical Instruments is A Must

Improper storage leads to corrosion, irreversible damage and increased risk of contamination. Make sure to segregate surgical instruments for storage. Bladed instruments must not come in contact with other instruments. Always place heavier instruments at the bottom and delicate ones on top.

Right after sterilization, you must properly store surgical instruments in a dry area to ensure they remain sterile with lower chances of contamination.


#10 Regularly Inspect Surgical Instruments

Even well-maintained surgical instruments will wear out overtime owing to continued use. It is crucial to inspect surgical instruments regularly to make sure they are usable and quickly replace faulty and worn-out equipment quickly. inspection must be conducted on cleaned and decontaminated instruments. Inspection of the instrument surface and functional testing are two phases of these inspections.


Look for the following during surface inspection of instruments:

  • Discoloration
  • Deposits on the surface
  • Bent/ misaligned ratchets, jaws, shanks, etc.
  • Cracks, burrs, chips and pits on the surface
  • Loose pins
  • Visible visual defects

If you find any of these in the instruments, they need to be replaced.

All surgical instruments have different protocols for functional testing. Perform these tests on a regular basis to ensure that the instruments are functioning perfectly.

Lastly, train all your surgical staff to handle surgical instruments with care and to report errors as soon as they spot them.


The Way Forward

Even the best surgical instruments made using top-quality raw materials and world-class technology will need to be handled and maintained with care to ensure they remain durable and in best usable condition for years. If not, the lifespan of the surgical instruments will shrink, and your bills will keep piling up.