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Instruments Care

Guidelines for cleaning, sterilising and maintaining your surgical instruments.

For all of the procedures below, we recommend using distilled or deionised water and a neutral pH (7) cleaning solution.

Rinsing

Immediately after surgery, rinse instruments under warm (not hot) water. A nylon toothbrush can help rinse box locks and joints. Make sure all blood, body fluids and tissue are removed.

Cleaning

If you do not clean your instruments immediately after rinsing, submerge them in a solution of water and neutral pH (7) detergent.

Never place instruments in saline solution — it causes corrosion and, eventually, irreversible damage.

A. Ultrasonic cleaning

We recommend cleaning micro and delicate instruments by hand.
Run the cleaner for the full recommended cycle time, usually 5–10 minutes.
Place instruments in the open position. Make sure sharp blades (scissors, knives, osteotomes, etc.) do not touch other instruments.
All instruments must be fully submerged.
Do not mix dissimilar metals (stainless steel, copper, chrome-plated, etc.) in the same cleaning cycle.
Change the solution frequently — at least as often as the manufacturer recommends.
After ultrasonic cleaning, rinse instruments with distilled or deionised water to remove the cleaning solution.

B. Automatic washer-sterilisers

Follow the manufacturer’s recommendations. Make sure instruments are lubricated after the last rinse cycle and before the sterilisation cycle.

C. Manual cleaning

Ultrasonic cleaning is the most effective way to clean surgical instruments, especially those with hinges, locks and other moving parts. If ultrasonic cleaning is not available, follow these steps:

Use stiff plastic (e.g. nylon) cleaning brushes. Do not use steel wool or wire brushes, except stainless-steel wire brushes specially recommended for instruments such as bone files, or for stained areas on knurled handles.
Use only neutral pH (7) detergents, such as a neutral instrument cleaner or an enzymatic cleaner. Low-pH detergents that are not rinsed off properly break down the protective stainless surface and cause black staining; high-pH detergents leave a brown surface deposit (which can look like rust) that interferes with smooth operation.
Brush delicate instruments carefully and, if possible, handle them separately from general instruments.
Make sure all surfaces are visibly clean and free from stains and tissue. This is a good time to inspect each instrument (see the checklist below).
After scrubbing, rinse thoroughly under running water (distilled water is best). While rinsing, open and close scissors, haemostats, needle holders and other hinged instruments so the hinge areas are rinsed as well as the outside.

Inspection checklist

Scissor blades glide smoothly from open to closed and are not loose when closed. Test by cutting thin gauze: three-quarters of the blade length should cut cleanly to the tips without catching.
Forceps have properly aligned tips.
Haemostats and needle holders show no light between the jaws, lock and unlock easily, and their joints are not too loose. Check needle holder tips for wear.
Suction tubes are clean inside.
Retractors open, close and lock properly.
All cutting edges are sharp and undamaged.

After Cleaning

If the instruments are to be stored, let them air-dry and store them in a clean, dry environment.

Autoclaving

If instruments are to be reused or autoclaved:

Lubricate all instruments with metal-to-metal action, such as scissors, haemostats, needle holders and retractors.
Use disposable paper or plastic pouches to sterilise individual instruments. Use a pouch wide enough (4″/10 cm or wider) for ratchet instruments such as needle holders and haemostats, so they can be sterilised open and unlocked.
When autoclaving instrument sets, unlock all instruments and sterilise them in the open position. Place heavy instruments at the bottom of the set when two layers are needed.
Do not overload the autoclave chamber — pockets can form that stop steam from penetrating.
Place a towel on the bottom of the tray to absorb excess moisture and reduce the chance of “wet packs”. Make sure the towels have no detergent residue and are neutral pH (7) when soaked in water: residue from cheap high-pH (9–13) laundry detergents can stain instruments.

Never lock an instrument during autoclaving. Steam cannot reach the metal-to-metal surfaces, so the instrument will not be sterile, and heat expansion can crack the hinge area.

Caution: at the end of the autoclave cycle, before the drying cycle, unlock the autoclave door and open it only about ¾″ (2 cm). Then run the drying cycle for the time recommended by the autoclave manufacturer. If the door is opened fully before drying, cold room air rushes in and causes condensation, leaving water stains on the instruments and “wet packs”.

If you notice unusual staining on your instruments after sterilisation, please contact us.

Cold Sterilisation

Most cold sterilisation solutions make instruments sterile only after about 10 hours of immersion. This long chemical exposure can be more harmful to surgical instruments than a normal 20-minute autoclave cycle. If instruments only need to be disinfected, cold sterilisation is suitable, as disinfection takes only about 10 minutes.

Sterile

An absolute term: no living organism survives.

Disinfected

Basically clean, but not sterile.

Always use the correct sterilisation or cleaning method so the instrument is in the condition required for use.

Important: for instruments with tungsten carbide inserts, such as needle holders, scissors and tissue forceps, avoid cold sterilisation solutions containing benzyl ammonium chloride, as they can damage the inserts.

Have a question? Our team is happy to help.