Surgical Instrument Cleaning recommendations of the manufacturers of Surgical Instruments.
Neutral pH enzymatic and cleaning agents are recommended and preferred for cleaning Surgical Instruments.
D. Point of Use Preparation for Reprocessing
• Remove excess body fluids and tissue from instruments with a disposable, non-shedding wipe. Place instruments in a basin of distilled water or in a tray covered with damp towels. Do not allow saline, blood, body fluids, tissue, bone fragments or other organic debris to dry on instruments prior to cleaning.
Note: Soaking in proteolytic enzyme solutions facilitates cleaning, especially in instruments with complex features and hard-to-reach areas (e.g. cannulated and tubular designs, etc.). These enzymatic solutions break down protein matter and prevent blood and protein based materials from drying on instruments. Manufacturer’s instructions for preparation and use of these solutions should be explicitly followed.
Instruments should be cleaned within 30 minutes of use to minimize the potential for drying prior to cleaning.
Used instruments must be transported to the central supply in closed or covered containers to prevent unnecessary contamination risk.
F. Preparation of Cleaning Agents
Neutral pH enzyme cleaning agents with low foaming surfactants are preferred and recommended by Zimmer . Alkaline agents with pH of 12 or less may be used in countries where required by law or local ordinance. Alkaline agents should be followed with a neutralizer and thorough rinsing.
All cleaning agents should be prepared at the use-dilution and temperature recommended by the manufacturer. Softened tap water may be used to prepare cleaning agents. Use of recommended temperatures is important for optimal performance of cleaning agents.
Dry powdered cleaning agents should be completely dissolved prior to use to avoid staining or corrosion of
instruments. Fresh cleaning solutions should be prepared when existing solutions become grossly contaminated (bloody and/or turbid).
Cleaning Eye Surgical Instruments cleaner.
1
Completely submerge instruments in enzyme solution and allow to soak for 20 minutes. Use a soft-bristled, nylon brush to gently scrub the device until all visible soil has been removed. Particular attention must be given to crevices, lumens, mated surfaces, connectors and other hard-to-clean areas. Lumens should be cleaned with a long, narrow, soft-bristled brush (i.e. pipe cleaner brush).
2
Remove the device from the enzyme solution and rinse in tap water for a minimum of 3 minutes. Thoroughly and aggressively flush lumens, holes and other difficult-toreach areas.
3
Place prepared cleaning agents in a sonication unit. Completely submerge device in cleaning solution and sonicate for 10 minutes at 45-50kHz.
4
Rinse instrument in purified water for at least 3 minutes or until there is no sign of blood or soil on the device or in the rinse stream. Thoroughly and aggressively flush lumens, holes and other difficult-to-reach areas.
5
Repeat the sonication and rinse steps above.
6
Remove excess moisture from the instrument with a clean, absorbent and non-shedding wipe.
Note: If stainless steel instruments are stained or corroded, an acidic, anti-corrosion agent in an ultrasonic cleaner may be sufficient to remove surface deposits. Care must be taken to thoroughly rinse acid from devices. Acidic, anti-corrosion agents should only be used on an as needed basis.
The use of a high quality enzyme detergent will remove stains rapidly.
H. Combination Manual/Automated Cleaning and Disinfection Instructions
1. Completely submerge the instruments in enzyme solution and allow to soak for 10 minutes. Use a soft nylon-bristled brush to gently scrub the device until all visible soil has been removed. Particular attention must be given to crevices, lumens, mated surfaces, connectors and other hard-to-clean areas. Lumens should be cleaned with a long, narrow, soft nylon-bristled brush (i.e. pipe cleaner).
Note: Use of a sonicator at 45-50kHz will aid in thorough cleaning of devices.
Note: Use of a syringe or water jet will improve flushing of difficult to reach areas and closely mated surfaces.
Cleaning agents with low foaming surfactants should be used during manual cleaning procedures to ensure that instruments are visible in the cleaning solution. Manual scrubbing with brushes should always be performed with the instrument below the surface of the cleaning solution to prevent formation of aerosols and splashing which may spread contaminants. Cleaning agents must be easily and completely rinsed from device surfaces to prevent accumulation of detergent residue.
Do not place heavy instruments on top of delicate devices.
Do not allow contaminated devices to dry prior to reprocessing. All subsequent cleaning and sterilization steps are facilitated by not allowing blood, body fluid, bone and tissue debris, saline, or disinfectants to dry on used instruments.
Saline and cleaning/disinfection agents containing aldehyde, mercury, active chlorine, chloride, bromine, bromide, iodine or iodide are corrosive and should not be used. Instruments must not be placed or soaked in Ringers Solution.
Mineral oil or silicone lubricants should not be used because they: 1) coat microorganisms; 2) prevent direct contact of the surface with steam; and 3) are difficult to remove.
Soaking in disinfectants may be a necessary step to control certain viruses. However, these agents may discolor or corrode instruments (household bleach contains or forms chlorine and chloride in solution and has a corrosive effect similar to saline). Disinfectants containing glutaraldehyde, or other aldehydes, may denature protein based contaminants, causing them to harden and making them difficult to remove.
Where possible, soaking in disinfectants should be avoided.
Remove excess body fluids and tissue from instruments with a disposable, non-shedding wipe. Place instruments in a basin of distilled water or in a tray covered with damp towels. Do not allow saline, blood, body fluids, tissue, bone fragments or other organic debris to dry on instruments prior to cleaning.
Note: Soaking in proteolytic enzyme solutions facilitates cleaning, especially in instruments with complex features and hard-to-reach areas (e.g. cannulated and tubular designs,
Use of hard water should be avoided. Softened tap water may be used for initial rinsing. Purified water should be used for final rinsing to eliminate mineral deposits on instruments. One or more of the following processes may be used to purify water: ultra-filter (UF), reverse-osmosis (RO), deionized (DI), or equivalent.
Cleaning Eye Surgical Instruments cleaner and residue free.
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