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1. Specification for Buying

  • Choice of material / Does it fit the requirements?
  • Certificate of quality from the manufacturer.
  • Choice of surface finish.

2. Storage of Instruments

  • Avoid any corrosive fumes / chemicals in storage area.
  • Avoid area of high moisture to store instruments
  • Brand new instruments should be cleaned / protective caps removed.
  • Appropriate racks / containers should be used to store instruments.

3. Usage

  • Clean the instruments after every use.
  • Avoid prolonged exposure to saline.
  • Sterilise used and unused instruments.

4. Preparation for Disinfection & Cleaning

  • Check the correctness of the delivery.
  • Returning of the Instruments from OT:- Dry instruments should be returned in dry condition.
  • Returning instruments in wet condition:- Instruments should be immersed in a non-corrosive combined with disinfecting cum cleaning solutions.
  • All hinges / latches of instruments should be released. Assembled instruments should be dismantled.

5. Reusing Instruments

  • Dismantle and immediately immerse used and soiled instruments, completely in a pre-disinfection bath.
  • Use containers which are hermetically sealed during the process of thermal disinfection and cleaning. It is done at 93'C for approx. 10 min. For heat-sensitive material, chemo thermal disinfection is done at 60'C for approx. 10 min.
  • Open the containers at 60'C or lower

6. Pre - Disinfection

  • Use cold water only. Water over 45'C leads to coagulation of proteins and causes cleaning problems.
  • Epidemic Hygiene Aspect - disinfection first followed by cleaning. General Hygiene Aspect - first cleaning followed by disinfection.
  • Follow exposure times / dilution parameters / concentration levels as recommended by the manufacturer for optimal cleaning / disinfection, pH value 4.5 to 9.5 is recommended for cleaning and disinfection solutions.
  • Ultrasonic cleaners may be used in case of stubborn stains / encrustations.

7. Washing

  • Periodically test water for its chloride / silicate and mineral content.
  • Use of enzyme based detergents is recommended and instructions for dilutions as recommended by the supplier should be followed. If powered products are being used - particles should be dissolved.
  • Final rinsing should be done in demineralised water.

8. Drying

  • Instruments should be dried immediately after rinsing / washing.
  • Use of air pistol is recommended where ever possible.
  • Use lint free paper / cloth to wipe.

9. Care of Instruments

  • Ensure all instruments are clean.
  • Check functionality of individual instruments.
  • Separate instruments which are not functioning correctly, showing signs of corrosion and wear & tear.

10. Maintenance for Instruments

  • Periodically lubricate hinged/latched instruments and instruments with joints using lubricating oil.
  • Inspect edges of cutting instruments and sharpen if required. Inspect instruments with carbide tips for wear and tear. Replace tips if required.
  • Always arrange instruments systematically in terms of size, old or new, large bulky instruments and micro delicate instruments.

11. Conditions for Sterilisation

  • Do not overload instruments trays with more than 10 Kgs.
  • Do not mix old instruments with new instruments.
  • Micro and delicate instruments should be placed in secure containers.

12. Sterilisation

  • If all necessary steps prior to sterilisation have been followed - proceed.
  • Use demineralised water if possible / Quality of water / steam is very important.
  • Excessive silicates in water cause blackening of instruments.
  • Excessive chlorides can set in corrosion in instruments (level of chlorides should be less than 120mg / I equiv to 200mg / I of nacl).
  • Optimal loading of trays prevents formation of condensates.