THE INSTRUMENT CARE

Preparing the Tools for a Procedure







HOW TO TAKE CARE OF SURGICAL INSTRUMENTS?
Like all other equipment,medical and surgical instruments also
require a regular care and maintenance protocol so that they
retain their useful character and prolong their life.
Instruments that are dirty or rusty are not only a source of
infection, but ultimately break before their expected life span.

CARE OF STAINLESS STEEL:
Stainless steel is the material of choice for most surgical
instruments;it combines a high resistance to corrosion and rust
and has a smooth surface. However the surface of the finest
stainless steel instruments can become pitted and stained, if
great care is not used in washing, cleaning, polishing and
lubrication of these instruments. Rough handling or the use of
abrasives can permanently mark stainless steel.
- So to start with all instruments after use should be cleaned
with a hard brush under running cool water.Very hot water will
cause coagulation of blood and exudate and make subsequent
cleaning more difficult.
- If use of an Ultrasonic cleaning bath using instrument
detergents is available, this will be ideal and insure good
cleaning and continued high polish of the instruments. This
equipment is available only in some hospitals in India.
- After washing,instruments should be dried to avoid water
remaining in any joint and causing corrosion.
- Lubrication using a water-soluble lubricant applied on joints is
recommended and will greatly prolong the useful life of any
instrument if they are to be stored.
- Salt solutions are a major cause of pitting,and instruments
should never be soaked in them, nor should a saline solution be
allowed to dry on an instrument.
- Whenever cleaning or washing instruments, keep all ratchets
unlocked and box joints open and avoid using wire wool or rough
brushes on the surface of instruments.
- Surgical blades and needles, both of which may rust and corrode
more easily than stainless steel instruments and therefore the
rules above apply to them also.
- Serrated surfaces on artery forceps and needle holders can be
effectively cleaned with a small brass wire brush
- Instruments or plastic parts of instruments are washed
with warm soapy water with a soft cloth sterilization may be
by either soaking in antiseptic solutions or autoclaving at a
lower temperature (121 degree C under 151b/in2 for 15 min.)
than is used for steel instruments.Cleaning and polishing
should only be undertaken using recommended cleansers and
polishers. Most plastics are best stored in a dry state rather
than prolonged soaking in antiseptic solutions.

WHAT ARE CRITICAL ITEMS?

Critical items are those that must be sterile. These objects
enter sterile tissue or the vascular system. Examples of
critical items include:

* Surgical instruments
* Cardiac and urinary catheters
* Implants
* Needles

NONCRITICAL ITEMS
This group of items comes in contact with skin. Skin is
effective in protecting the inner tissues of the body against
bacteria and viral invasions. This category includes items :

* Blood pressure cuffs
* Bed linens
* Bedside tables
* Crutches
* Some food utensils
* Bed frames
* Floors
* Walls
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