1 Rinsing

Immediately after surgery, rinse instruments under warm (not hot) water. It may be helpful to use a nylon toothbrush to rinse the lock boxes and joints of the instrument. Be sure to remove all blood, body fluids, and tissue.

2 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, as it may cause corrosion and irreversible damage.

A. Ultrasonic Cleaning

We recommend you manually clean micro and delicate instruments. Process instruments in a cleaner for the full recommended cycle time — usually 5–10 minutes. Place instruments in the open position. Ensure sharp blades (scissors, knives, osteotomes, etc.) do not touch other instruments. All instruments must be fully submerged. Do not place dissimilar metals (stainless, copper, chrome plated, etc.) in the same cleaning cycle. Change solution frequently, at least as often as recommended by the manufacturer. Rinse with distilled or deionized water after ultrasonic cleaning.

B. Automatic Washer Sterilizers

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

C. Manual Cleaning

Most manufacturers recommend ultrasonic cleaning as the best method for instruments with hinges, locks, and moving parts. If ultrasonic cleaning is not available, observe the following steps:

• I. Use stiff plastic cleaning brushes (nylon, etc.). Do not use steel wool or wire brushes except specially recommended stainless steel wire brushes for instruments such as bone files.
• II. Use only neutral pH (7) detergents such as Roboz Instrument Cleaner (IC-1000) or Roboz Enzymatic Cleaner (EC-1000). Low pH detergents can cause black staining; high pH detergents can cause brown surface deposits that look like rust.
• III. Brush delicate instruments carefully and handle them separately from general instruments where possible.
• IV. Ensure all instrument surfaces are visibly clean and free from stains and tissue. Inspect each instrument for proper function:
  • Scissor blades should glide smoothly and cut cleanly through thin gauze
  • Forceps should have properly aligned tips
  • Hemostats and needle holders should not show light between the jaws and should lock/unlock easily
  • Suction tubes should be clean inside
  • Retractors should open, close and lock properly
  • All cutting edges should be sharp and undamaged
• V. After manually scrubbing, rinse thoroughly under running water (distilled water is best). Open and close hinged instruments while rinsing to clean hinge areas.

3 After Cleaning

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

4 Autoclaving

If instruments are to be reused or autoclaved:

• A. Lubricate all instruments with metal-to-metal action such as scissors, hemostats, needle holders, and retractors.
• B. Use disposable paper or plastic pouches (4" or wider for ratchet-lock instruments) and sterilize in the open, unlocked position. Place heavy instruments at the bottom when two layers are required.

Never lock an instrument during autoclaving — steam cannot reach metal-to-metal surfaces and heat expansion may cause cracks. Do not overload the autoclave chamber. Place a towel on the bottom of the pan to absorb excess moisture and reduce wet packs. Ensure sterilization towels have no detergent residue and are neutral pH (7).

5 Cold Sterilization

Most cold sterilization solutions render instruments sterile only after a 10-hour immersion, which can be more detrimental than a 20-minute autoclave cycle. If disinfection only is needed, cold sterilization is recommended as disinfection takes place in about 10 minutes.

Remember: Sterile means no living organism survives; Disinfected means basically clean. Always use the proper sterilization and cleaning technique.

1 Rinsing

Immediately after surgery, rinse instruments under warm (not hot) water. It may be helpful to use a nylon toothbrush to rinse the lock boxes and joints of the instrument. Be sure to remove all blood, body fluids, and tissue.

2 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, as it may cause corrosion and irreversible damage.

A. Ultrasonic Cleaning

We recommend you manually clean micro and delicate instruments. Process instruments in a cleaner for the full recommended cycle time — usually 5–10 minutes. Place instruments in the open position. Ensure sharp blades (scissors, knives, osteotomes, etc.) do not touch other instruments. All instruments must be fully submerged. Do not place dissimilar metals (stainless, copper, chrome plated, etc.) in the same cleaning cycle. Change solution frequently, at least as often as recommended by the manufacturer. Rinse with distilled or deionized water after ultrasonic cleaning.

B. Automatic Washer Sterilizers

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

C. Manual Cleaning

Most manufacturers recommend ultrasonic cleaning as the best method for instruments with hinges, locks, and moving parts. If ultrasonic cleaning is not available, observe the following steps:

• I. Use stiff plastic cleaning brushes (nylon, etc.). Do not use steel wool or wire brushes except specially recommended stainless steel wire brushes for instruments such as bone files.
• II. Use only neutral pH (7) detergents such as Roboz Instrument Cleaner (IC-1000) or Roboz Enzymatic Cleaner (EC-1000). Low pH detergents can cause black staining; high pH detergents can cause brown surface deposits that look like rust.
• III. Brush delicate instruments carefully and handle them separately from general instruments where possible.
• IV. Ensure all instrument surfaces are visibly clean and free from stains and tissue. Inspect each instrument for proper function:
  • Scissor blades should glide smoothly and cut cleanly through thin gauze
  • Forceps should have properly aligned tips
  • Hemostats and needle holders should not show light between the jaws and should lock/unlock easily
  • Suction tubes should be clean inside
  • Retractors should open, close and lock properly
  • All cutting edges should be sharp and undamaged
• V. After manually scrubbing, rinse thoroughly under running water (distilled water is best). Open and close hinged instruments while rinsing to clean hinge areas.

3 After Cleaning

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

4 Autoclaving

If instruments are to be reused or autoclaved:

• A. Lubricate all instruments with metal-to-metal action such as scissors, hemostats, needle holders, and retractors.
• B. Use disposable paper or plastic pouches (4" or wider for ratchet-lock instruments) and sterilize in the open, unlocked position. Place heavy instruments at the bottom when two layers are required.

Never lock an instrument during autoclaving — steam cannot reach metal-to-metal surfaces and heat expansion may cause cracks. Do not overload the autoclave chamber. Place a towel on the bottom of the pan to absorb excess moisture and reduce wet packs. Ensure sterilization towels have no detergent residue and are neutral pH (7).

5 Cold Sterilization

Most cold sterilization solutions render instruments sterile only after a 10-hour immersion, which can be more detrimental than a 20-minute autoclave cycle. If disinfection only is needed, cold sterilization is recommended as disinfection takes place in about 10 minutes.

Remember: Sterile means no living organism survives; Disinfected means basically clean. Always use the proper sterilization and cleaning technique.