Instruments
–
Instructions
for
Use
Distributed in Canada by:
Rev.IN-INSTRUM.0
Canadian
Hospital
Specialties
Ltd.
Canadian
Hospital
Specialties
|
2810
Coventry
Road,
Oakville,
Ontario
L6H
6R1
1
‐
800
‐
461
‐
1423
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CLEANING
AND
MAINTENANCE
A)
Rinsing
Directly
after
surgery,
rinse
instruments
under
hot
running
water,
removing
all
body
fluids
and
debris.
B)
Disinfecting
(the
protection
for
medical
personnel
from
accidental
contamination
during
cleaning)
To
avoid
blood
and
other
proteins
from
sticking
to
instrument
surfaces,
an
enzymatic
cleaner
bath
(soaking)
should
be
used
on
all
instruments.
After
soaking
for
a
minimum
of
10
minutes,
rinse
all
instruments
in
running
tap
water.
Immerse
instruments
completely
in
hospital
approved
disinfectant
for
an
additional
10
minutes
then
rinse
again
under
running
water.
DO
NOT
USE
BLEACH.
Exposure
to
bleach
will
damage
instruments.
C) Cleaning
Instruments
should
be
submerged
in
a
solution
of
water
and
neutral
pH
(7)
detergent.
Ultrasonic
Cleaning
Place
instruments
in
an
open
position
into
the
ultrasonic
cleaner.
Make
sure
all
“sharp”
(i.e.
scissors,
knives,
blades,
etc.)
do
not
touch
other
instruments.
All
instruments
must
be
completely
submerged.
Instruments
should
be
processed
in
the
ultrasonic
cleaner
for
the
full
recommended
cycle
time,
which
is
typically
5
‐
10
minutes.
A
lid
should
cover
the
ultrasonic
cleaner
during
the
operation
to
avoid
splashing.
Never
place
different
metals
in
the
same
cleaning
cycle.
For
example,
stainless
steel
and
copper,
etc.
Change
solution
frequently
per
manufacturer
recommendations.
Rinse
all
instruments
after
an
ultrasonic
cleaning
with
water
to
remove
the
excess
cleaning
solution.
Automatic
Washing
Sterilization
Follow
all
manufacturers’
recommendations.
Ensure
all
instruments
are
lubricated
after
and
before
the
sterilization
cycle.
Manual
Cleaning
Ultrasonic
cleaning
is
the
preferred
method
of
cleaning
and
strongly
recommended
to
ensure
all
dirt,
debris
and
are
fully
removed
–
particularly
with
instruments
with
hinges,
locks,
and
other
moving
parts.
If
ultrasonic
cleaning
is
not
available,
follow
the
below
instructions.
a)
Use
stiff
nylon
cleaning
brushes.
Do
not
use
steel
wool
or
wire
brushes
unless
specifically
recommended
for
cleaning
brushes
for
instrument
‐
serrated
areas
or
on
bone
files,
burs
or
on
stained
areas
in
knurled
handles.
Recommended
Cleaning
Procedure
for
Cleaning
Maintenance
and
Sterilization
of
Surgical
Instruments
b) Use
only
neutral
pH
(7)
detergents,
low
pH
(acidic
less
than
6
pH)
detergents
will
cause
breakdown
of
stainless
steel
protective
surface
(pitting)
and
black
staining.
Higher
pH
detergents
(alkaline
–
more
than
8
pH)
will
cause
a
surface
deposit
of
a
brown
stain
(phosphates),
which
will
also
interfere
with
a
smooth
operation
of
the
instrument.
Most
brown
stains
are
not
rust,
but
merely
a
high
pH
surface
(phosphate)
deposit
and
can
easily
be
removed
with
a
stain
remover.
c) Brush
delicate
instruments
carefully.
These
should
be
handled
separately
from
all
other
general
instruments.
d) Make
sure
all
instrument
surfaces
are
visibly
clean
and
free
from
stains
and
tissue.
The
stain
remover
will
aid
in
the
elimination
of
residue
stains.
Each
instrument
should
be
inspected
for
functionality
and
general
condition,
this
would
include,
but
is
not
limited
to:
Forceps
have
properly
aligned
tips.
Hemostats
and
needle
holders
should
not
show
light
between
the
jaws,
when
closed
in
the
first
ratchet
position
(hemostats
may
show
a
small
open
space
halfway
in
from
the
closed
tips),
lock
and
unlock
easily
at
joints
and
make
sure
they
are
not
too
loose.
Check
needle
holders
for
wear
on
jaw
surfaces.
Check
suction
tubes
to
ensure
they
are
clean
inside.
Ensure
biopsy
punches
are
clean
by
punching
a
hole
into
tissue
paper.
Check
working
functions
of
all
retractors.
Make
sure
that
all
cutting
instruments
and
knives
have
sharp
undamaged
blades.
e)
After
scrubbing,
rinse
all
instruments
thoroughly
under
running
water.
While
rinsing,
open
and
close
scissors,
hemostats,
needle
holders
and
other
hinged
instruments
to
make
sure
the
hinged
areas
are
rinsed
out,
as
well
as
the
outside
of
the
instruments.
D)
After
Cleaning
If
instruments
are
to
be
stored,
let
them
air
dry
then
store
them
in
a
clean
and
dry
area.
E)
Autoclaving
Lubricate
all
instruments
that
have
any
“metal
to
metal”
action
(i.e.
scissors,
hemostats,
etc.).
Non
‐
silicone,
water
‐
soluble
surgical
lubricants,
such
as
spray
lube
is
recommended.
Do
not
sure
industrial
lubricants.
Put
instruments
up
for
sterilization
either
individually
or
in
sets.
For
Individual
Instruments
Disposable
paper
or
plastic
pouches
are
ideal.
Make
sure
you
use
a
wide
enough
pouch
(4
inches
or
wider)
for
instruments
with
ratchet
locks
(i.e.
hemostats
and
needle
holders,
etc.)
so
the
instrument
can
be
sterilized
in
an
open
(unlocked)
position.
Locking
instruments
during
autoclaving
will
result
in
cracked
hinges
and
other
defects
because
of
heat
expansion.
If
you
wrap
instruments,
make
sure
your
towels
do
not
contain
detergent
residue,
which
can
stain
your
instruments.
Make
sure
that
the
towels
used
in
sterilization
of
instruments
have
no
detergent
residue
and
are
neutral
pH
(7)
if
immersed
in
water.
This
can
be
a
problem,
as
laundries
will
frequently
use
inexpensive
but
high
pH
(9
‐
13)
detergents
and
do
not
properly
rinse
out
or
neutralize
those
detergents
in
the
final
wash
or
rinse
cycle.
Also,
sometimes
bleaches
are
added
and
are
not
neutralized.
Hospitals
use
a
“sour”
rinse
cycle
to
neutralize
all
detergent
residue.
For
Instrument
Sets
Unlock
all
instruments
and
sterilize
them
in
an
open
position.
Place
the
heavier
instruments
on
the
bottom
of
the
set,
when
two
layers
are
required.
Never
lock
an
instrument
during
autoclaving.
Steam
cannot
penetrate
contacting
surfaces
and
this
will
compromise
the
sterility
of
the
instruments.
The
instrument
will
develop
cracks
in
hinges
(lock
box)
areas
because
of
the
heat
expansion
during
sterilization.
Do
not
overload
autoclave
chambers
as
pockets
may
form
and
will
not
permit
steam
to
penetrate.
Place
a
towel
on
the
bottom
of
the
pan
to
absorb
the
excess
moisture
during
autoclaving.
CAUTION
:
With
most
portable,
tabletop
autoclaves,
at
the
end
of
the
autoclave
cycle
–
before
drying
cycle
–
unlock
the
door
and
open
it
no
more
than
a
crack
(approximately
1/4”).
Then
run
dry
cycle
for
the
period
recommended
by
the
autoclave
manufacturer.
If
the
autoclave
door
is
opened
fully
before
the
drying
cycle,
cold
room
air
will
rush
into
the
chamber,
causing
condensation
on
the
instruments.
This
will
result
in
water
stains
on
the
instruments
and
also
cause
wet
packs.
Make
sure
the
autoclave
filters
and
chambers
are
cleaned
periodically.
A
stain
remover
will
remove
stains
and
clean
the
autoclave
chamber.
F) Cold
Sterilization
Most
cold
sterilization
solutions
render
instruments
sterile
only
after
10
‐
hour
immersions.
This
prolonged
chemical
action
can
be
more
detrimental
to
surgical
instruments
than
the
usual
20
‐
minute
autoclave
cycle.
If
the
instrument
needs
to
be,
“disinfected”
only,
a
cold
sterilization
soak
is
okay,
as
disinfecting
will
take
place
in
10
‐
minutes
or
more.
Check
the
manufacturer’s
specifications.
Also,
see
the
warning
sign
on
using
bleach
(section
B).
Keep
in
mind
the
difference
between:
STERILE
–
No
living
microorganisms
DISINFECTED
–
Kills
most
but
not
all
microorganisms
CAUTION
:
For
instruments
with
Tungsten
Carbide
inserts
(hemostats,
scissors,
needle
holders
–
also
identified
by
a
gold
handle),
we
do
not
recommend
cold
sterilization
or
solutions
containing
Benzyl
Ammonium
Chloride,
which
will
deteriorate
the
Tungsten
Carbide,
inserts.
*French instructions to follow/* Mode d’emploi en français à suivre