Surgical instrument sterilization

Instrument sterilization is not merely a task. It is a comprehensive solution, incorporating best practices in workflow, logistics, equipment, techniques and procedures.

WARNING: this is not a sterilization manual. Rather, this is a summary of the very detailed process. If you are developing a sterilization capability for your facility, please contact us at CONTACT@LHMEDS.COM.

Step 1 of instrument sterilization begins during the medical or surgical procedure where the instrument is used. Immediately after use, clean the instrument and soak it in a decontaminating solution to avoid debris drying up and sticking to the instrument. Avoid splashing the solution on other items and surfaces in the room. Use a purpose-built container for soaking; this container should also protect the instruments during transportation, as well as have a watertight lid to avoid spillage. 

Sklar decontaminating solution

Sklar sterilization container with a lid

Step 2 is transporting instruments to the sterilization area. Guard against contaminating the surroundings. Equipment should be covered and supplies should be moved in covered carts, closed totes or containers, or closed plastic bags. Wear scrubs covered by a moisture-resistant barrier, shoe covers, rubber or plastic gloves, and a hair covering. During manual cleaning processes, when splashing can occur, use safety goggles and a face mask or a face mask with a shield.

Medline personal protective equipment. We would also recommend goggles or face shield.

Step 3 is instrument cleaning. You can use an ultrasonic cleaner or an instrument washer. We would suggest an ultrasonic cleaner unless your instruments are chromed (do not use an ultrasonic cleaner on chromed instruments!). Separate instruments by alloy or composition to avoid potential damage. Disassemble instruments with movable parts to facilitate cleaning. Lumened instruments may require special equipment, attention and know-how; make sure you have a technician experienced in working with lumened instruments handling them.

Elma ultrasonic surgical instrument cleaner 

Step 4 is to rinse and inspect the cleaned instruments. Rinse ultrasonically cleaned instruments with water to ensure there is no clinging debris or traces of cleaning solution. All locks, serrations, and crevices should be critically inspected for cleanliness. Instruments with cutting edges such as scissors, rongeurs, chisels, curettes, etc., should be checked for sharpness. There should be no dull spots, chips, or dents. Hinged instruments such as clamps and forceps should be checked for stiffness and alignment of jaws and teeth.

Step 5 is to package the instruments so that their sterility can be maintained to the point of use. The materials and techniques used for packaging must allow the sterilant to contact the device during the sterilization process as well as to protect the device from contamination during storage and handling before it is used.

Medline sterilization pouches, different sizes

Step 6 is sterilization. Steam autoclaving is suggested as a proven-effective and cost-efficient method of sterilization.

Tuttnauer steam autoclave

Step 7: Instruments are transferred to a secure, clean storage area from where they can be retrieved and taken to the point of use.

Throughout the process: monitoring of the sterilization process is essential. Work practices must be supervised. Written policies and procedures must be strictly followed by all personnel responsible and accountable for sterilizing and disinfecting items, and for handling sterile supplies. Sterilization indicators may be helpful. Use checklists to ensure all steps are followed. Have a continuous training, fine-tuning and monitoring program.

What Lighthouse Medical can do:

  • Design the workflow and logistical processes
  • Supply, maintain and restock equipment and consumables, including everything mentioned in this article
  • Design and help implement checklist-based procedures
  • Provide training, monitoring and quality assurance

Give us a call today at 777-5483 or write to CONTACT@LHMEDS.COM

Manufacturers mentioned: