Importance of Cleaning Surgical Instruments
The primary purpose of cleaning surgical instruments is to remove all inorganic and organic proteinaceous bioburden material from the internal and external surfaces cleaning surgical instruments inside and out with careful attention to cleaning cannulated surgical instruments.
The secondary purpose of cleaning surgical instruments is to maintain and improve the “passive Layer” of surgical stainless steel. The passive layer is provided by the manufacturer of the surgical instruments, within the surgical stainless steel, to resist (prevent) corrosion. Proper cleaning of the surgical instrument will maintain and improve this passive layer. (for more information go to: Prevent Corrosion ) If the manual cleaning, brushing and rinsing steps are not properly carried out, protein debris can harden and lead to formation of biofilm on the surgical instrument, i.e. the biopsy channel of an endoscope. The optimal surgical instrument cleaning protocol will break down proteinaceous bioburden and clean the surface. Inadequate cleaning can result in material remaining on the surgical instrument which will prevent disinfection and sterilization fluids or gases reaching all parts of the potentially contaminated device. Inadequate sterilization or disinfection sterilization and may in turn result in transmission of infectious organisms when the device is reused. The intricate design and delicate materials of flexible scopes complicate the cleaning process. This requires repetitive and consistent oversight.
Surgical Instrument Cleaning is the Prerequisite for Sterilization
The reprocessing decontamination Cleaning of Surgical Instruments, whether done manually or automatically in a surgical instrument washer decontaminator disinfector, can only be effective if "cleaning" is adequate. Effectively sterilizing surgical instruments (Generic Sterilization with a Pre-Vacuum Sterilizer (HI-VAC): 270-272° F (132-134° C), 16-minute exposure time, with 4 pulses and a 30-minute dry time. Generic Sterilization with a Gravity Displacement Sterilizer: 270-272° F (132-134° C), 30-minute exposure time, with a 30-minute dry time.) is not possible if "cleaning", the "prerequisite for sterilizing surgical instruments", is not adequate.
All disinfection processes, whether done manually or done automatically in a surgical instrument washer decontaminator disinfector, can only be effective if prior cleaning is adequate. Effective disinfection or sterilization of an inadequately cleaned surgical instrument or scope is not possible. Endoscopes should be cleaned with an enzymatic enzyme detergent compatible with the endoscope immediately after use and before manual or automated disinfection. Cleaning involves the entire endoscope, including valves, working channels, connectors and all detachable parts. High level enzymatic enzyme detergent formulations ("Enzymatic" Surgical Instrument Cleaners), in combination with a high level surfactant chemical complex, have been shown to be effective in removing stains, hard water deposits, and encrusted bioburden, while being safe to use for rigid or flexible scopes.
Enzyme Surgical Instrument Cleaning Concentrates
Enzymes: Enzymes are costly, clinically and financially effective.
Manufacturers of surgical instrument usually recommend that Enzyme Cleaning concentrates should be discarded after each use as these products are not microbicidal and will not retard microbial growth. Some manufactures of "combination" or all-in-one surgical instrument cleaning concentrates include a bacteriostatic agent which will prevent the growth of microorganisms. Some detergent complexes contain antimicrobial-microbicidal substances. Although these agents do not replace disinfection they are designed to reduce the risk of infection to reprocessing personnel by rendering instruments that are clean and safe to handle. The cleaning function efficacy of enzyme cleaning concentrates is determined by the ratio of enzymes to bioburden. The higher the proportion of enzymes the higher the efficacy. As a result, if the cleaning solution becomes laden with bioburden from previous cleaning, the efficacy of the enzyme cleaning concentrates is lower. When a cleaning concentrate states that is it "multi-tiered", the inference is that is contains: protease (enzyme) which break protein debris into smaller, more soluble subunits, amylase (enzyme) which catalyses the breakdown of starch, and lipase (enzyme) which breaks up fat-containing debris and carbohydrates. When a detergent cleaning concentrate states that is it "high-level", the inference is that is contains a high concentration of enzymes. When a cleaning concentrate states that is provides "enzyme activity" the inference is that is contains enzymes but this is usually is a misrepresentation of ingredients for a detergent cleaning concentrate that does not contain enzymes. Enzymes are effective and they are costly for manufacturers to include in the formulation. As is true for all detergent cleaning concentrates, the most effective test is against your most difficult cleaning challenge. The two most common tests for cleaning concentration efficacy that are commercially available are the "TOSI Test" and the "film test". Be aware that some manufacturers use advertising wordage and product names that imply enzymes are an active ingredient but do not actually include enzymes in their product formulation. Refer to product labels and ingredients for disclosure.
Optimal Temperature for
Enzyme Cleaning Concentrates
Enzyme cleaning concentrates function more effectively at temperatures above room temperature. The optimal range begins as > 22C - 72°F with performance reaching it's peak at 58.3C - 137F. This is often referred to as the optimal temperature for the performance or activity of enzymatic action. The activity of enzymes does not stop at higher temperatures but the level of performance does begin to decrease. Enzyme cleaning concentrates enzyme-detergents and all-in-one cleaning concentrates, which include enzymes, should be used in accordance with the manufacturer's recommendations and the recommendations of the medical devices being cleaned.
(Creutzfeld-Jakob disease) deactivating prions (protein and prion contamination)
Ultrasonic cleaning of reusable endoscope accessories and components may be needed to remove material from hard-to-clean areas. The same detergent used for ultrasonic cleaning can be the same as used for manual cleaning. Recommendations for detergents used for ultrasonic cleaning.
Ultrasonic Surgical Instrument Cleaners are very effective when used with hot water per Ultrasonic Surgical Instrument Cleaner manufacturer recommended temperatures and specially formulated Ultrasonic Surgical Instrument Cleaner Detergents. It is recommended that all visible debris and blood be removed from the instrument prior to ultrasonic cleaning. Sort instruments by similar metals to prevent corrosion due to the contact of dissimilar metals. (electrolytic deposition - galvanic corrosion) It is not recommended to clean plated instruments in an ultrasonic cleaner since the ultrasonic vibration and the presence of other sharp instruments may crack or rupture the plating. Because Ultrasonic Surgical Instrument Cleaners do not provide the complete "proper sequence of treatments" : final rinse(s) that are purified, purged between treatments, temperatures elevated to disinfection levels, they are not considered to be as clinically effective as surgical instrument washers. Ultrasonic Cleaning can effectively remove: long term encrustation and surgical cements or glues that have dried onto instrumentation.
Always refer to the printed Ultrasonic Surgical Instrument Cleaner recommendations prior to using Ultrasonics.
Recommendations for Maximizing the Efficacy of Ultrasonic Surgical Instrument Cleaners include: surgical instruments must be fully immersed, hinged surgical instruments must remain open during treatment, use surgical instrument cleaning trays that do not obstruct the ultrasonic cleaning process or add mass, wire surgical instrument cleaning baskets are preferred, large surface bulky items such as kidney shaped bowls must be positioned not to create anechoic (shadow) zones that will block the efficacy of ultrasonic transducer waveform. Position such items vertically or put them on top of the other items, always sort surgical instruments by similar metals to prevent surgical instrument corrosion, do not overload the ultrasonic surgical instrument cleaning tank with excessive mass as this will reduce the efficacy of surgical instrument cleaning, the soil being removed from the surgical instruments being cleaned adds to the mass within the tank and decreases the efficacy of the ultrasonic surgical instrument cleaner. Review the level of soil and renew the ultrasonic surgical instrument cleaner bath as needed. ALWAYS follow ultrasonic surgical instrument cleaning with separate rinse treatments. Ultrasonic surgical instrument cleaning will fragment and loosen soil but will not necessarily remove the soil from the surface of the surgical instruments being cleaned.
Surgical instrument cleaning detergents should contain substances that support the cleaning action: surfactants which reduce surface tension thus facilitating removal of debris, activated H2O2 which effectively loosens debris at room temperature, protease surgical instrument cleaning enzymes which break protein debris into smaller, more soluble subunits, amylase surgical instrument cleaning enzymes which catalyses the breakdown of starch, lipase surgical instrument cleaning enzymes which breaks up fat-containing debris, and Carbohydrase surgical instrument cleaning Enzymes: to breakdown high level starches to a lower level
Aldehydes Contained in Cleaning Concentrates for
When using Cleaning Concentrates which contain Aldehydes, be aware that they denature and coagulate protein.
Amine Compounds or Glucoprotamine in combination with Glutaraldehyde and Cleaning Concentrates
Detergents based on amine compounds or glucoprotamine in combination with Glutaraldehyde for disinfection should not be used as chemical reactions may result in formation of colored residues. These residues can appear to be corrosion. The use of a high level cleaning surfactant "combination" enzyme detergent instrument cleaner can be used to remove the corrosion-stains, and prevent corrosion or stains.
John Temple
Product Development
easy FOAM-itSurgical Instrument Cleaning
easy FOAM-it Surgical Instrument cleaner will clean surgical instruments fast.
all-in-ONE Surgical Instrument cleaner will lower surgical instrument cleaning costs.
Surgical Instrument Cleaning effectively and fast.
Surgical instrument detergent enzyme lubricant cleaners cut costs. Surgical instrument detergent enzyme lubricant cleaners clean fast.
Surgical instrument detergent enzyme lubricant cleaners rinse clean.
Contact ergo-Logistics via email: Temple@ergo-Logistics.com Phone:1-509-747-5027
The all-in-ONE Surgical Instrument Cleaner will lower your cleaning costs and replace multiple Surgical Instrument Care products for cleaning Surgical Instruments and cleaning Endoscopes.
Surgical Instrument Cleaning and Conditioning
Cleaning surgical instruments effectively and fast.
Surgical Instrument Cleaning effectively and fast.
Surgical instrument detergent enzyme lubricant cleaners cut costs. Surgical instrument detergent enzyme lubricant cleaners clean fast.
Surgical instrument detergent enzyme lubricant cleaners rinse clean.
Customer Service: CustomerService@ergo-Logistics.com or Phone:1-509-220-2456
The 4 Enzyme Surgical Instrument Detergent Cleaners deliver powerful surgical instrument cleaning and are:
- Non Irritating,
- 100% Biodegradable, and
- Neutral pH,
Recognized as the worldwide leader in Surgical Instrument Cleaning the ONEStep™ easy FOAM-it Surgical Instrument Pre-wash Cleaner, delivers the most effective 4 Enzyme Detergent surgical instrument cleaning power and comes pre-loaded into Endoscope Cleaning Sponges.
Enzyme Detergent Surgical Instrument Cleaner, Lubricant with Conditioning.
The ONEStep enzyme detergent surgical instruments cleaner delivers the 4 Enzyme Detergents are necessary to remove all forms of proteinaceous surgical instrument bioburden. The ONEStep enzyme detergent surgical instruments cleaner delivers:
- surfactant Enzyme Detergent Cleaners,
- surgical instrument stain removers, and a
Enzyme Detergent Surgical Instrument Cleaner and Pre wash. Nothing cleans faster than the 4 Enzyme Surgical Instrument Detergent.
Nothing will lower your cleaning costs as much as the all-in-ONE
Enzyme Surgical Instrument Detergent, and we guarantee it.
This domain and the contains of this domain are copyrighted and protected by yourCEBA , TMED , ergo-Logistics, and the property of yourCEBA.
