Maintaining and Cleaning Surgical Instruments

Official Guide:MAINTAINING & CLEANING SURGICAL INSTRUMENTS

813-889-9614www.sharn.com


Table of Contents

18 BoneCutterInspection

3 CausesofCorrosion,Staining,PittingandMarking

4 CleaningandSterilization

24 CustomerService

2 EnemiesofSurgicalInstruments

15 HemostatInspection

6 InstrumentLubrication

7 InstrumentStaining

8 InstrumentStringers,RepairTags,TipProtectors 9 InstrumentMarking/IdentificationTape

1 Introduction,ProperCareofInstuments

17 LaminectomyandCervicalRongeurInspection

19–23 LapInstrumentInspection,Testing,andCleaning

12 NeedleholderInspection

14 RetractorInspection

10 StainlessSteelInstrumentBrushStudy

11 ScissorTestingandInspection

13 SuctionDeviceInspection

16 TissueandDressingForcepInspection

5–6 UltrasonicCleaning

Contact Sharn

813-889-9614Email:[email protected]

www.sharn.com

4517GeorgeRoadSuite200Tampa,FL33634

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About This Guide

Asamedicalprofessional,youwanttoensuretheutmostqualityandintegrityofyoursurgicalinstrumentsatalltimes.Youalsowanttoprotectyourconsiderableinvestmentinthesehigh-grademedicaldevices.

Thecostofreplacingsurgicalinstrumentsisfargreaterthanthecostofmaintainingthem.Forthisreason,acomprehensivemaintenanceprogramisextremelyimportant.ThisguideprovidedbySharnwillhelp.

Proper Care and Scheduled PreventativeMaintenance

Propercareofsurgicalinstrumentsbeginswithpropercleaning.Thisguidediscussesproperwashing,cleaningandsterilizationofmanytypesofsurgicalinstruments.PropercarealsomeansmaintenanceofGerman-madeinstrumentsonaregularbasis,consistingofsharpeningandrestoration.AgeneralruleofthumbforbusyO.R.’sistoschedulemaintenancequarterly.Instrumentsthatmayrequirethismaintenanceinclude:scissors,needleholders,bonecutters,hemostats,osteotomes,rongeurs,chisels,bonecurettes,knivesandpunches.German-madesurgicalinstrumentsaredesignedtobere-sharpenedandrestored.Performingthismaintenancewillallowtheinstrumentstolastformanyyearsandperformflawlessly.

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The Look and Feel of New Instruments

Mostprofessionalswillrecognizethatnewinstrumentsfeeldifferent.Newinstrumentstendtobeharderandhaveastifferfeeltothem.Asinstrumentsage,theysoftenwithuseandsterilization.Withpropercare,theseinstrumentscanlastalifetime.Itisimportanttorealizethatallsurgicalinstrumentswillexperiencesofteningovertime.Remember,newinstrumentsaredesignedtobestiffattheonsetofuse.Theideaistousethemfortheirdesignedpurposeandalwaysproperlyclean,lubricate,andperformpreventativemaintenance.

Enemies of Surgical Instruments

Inadditiontogivingtipsonthecareandcleaningofinstruments,thisguidewilldiscussseveralenemiesofsurgicalinstruments.Waterandmoistureofanykind(especiallyblood,pus,surgicaldebrisandchlorhexidinesolutions)aretheprimarycausesofstainingandpittingofsurgicalinstruments.Allowinganytypeofmoisturetoair-dryonyourinstrumentswillcauseseveredamage.Otherenemiesincludecoldsoakingorwashinginstrumentswithinappropriatesolutions.Examplesofthesesolutionsaredishorlaundrysoap,bleach,iodine-typesolutions,generaldisinfectants,surgeon’shandscrubandmostimportantly,anysolutionthatcontainschlorhexidineorisachloride-basedsolution.Surgicalinstrumentsaremadefrom300and400seriesstainlesssteel.Despiteit’sname,stainlesssteeldefinitelystainsanditcanalsorustandbecomepitted.

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Stainedandpittedinstruments


3

TIP:Extendthedryingcycleofyourautoclave,especiallywhenasterilizingtrayisfullyloaded.Thiswillhelptoreducecondensationontheinstruments.

Causes of Corrosion–Staining, Pitting and Marking

Surgicalresiduessuchasblood,pusandothersecretionscontainchlorideionswhichleadtocorrosionmostoftenappearingasdarkspots.Ifbloodisleftontheinstrumentsforanyperiodoftime(20minutesorlonger),theinstrumentwillmarkandstain,especiallyiftheseresiduesareallowedtodry.Therefore,alwayscleananddryeveryinstrumentthoroughlyafteruse.Onlysterilizeacleaninstrument.Themostdamagingprocedureistoallowdried-onbloodtobecomebaked-onstainsintheautoclave.Thetemperatureoftheautoclave(250º–270ºFor121º–132ºC)willcausechemicalreactionsthatcanmakethestainpermanent.Remember,anautoclavedoesnotclean;itwillonlysterilize.

Thecleansersandcleaningagentsyouusecouldalsobeasourceofcorrosion.Strongsubstances,aswellasthosecontainingachemicalmake-upofacidoralkaline-basedsolutions,canleadtopittingandstaining.WashinstrumentswithaneutralpHsoap(between7pH-8pH)thatisdesignedforsurgicalinstrumentsforoptimalresults.AnythingwithahigherpHmaydamagetheinstrument.Donotusedishsoap,Iodine,bleach,cold-soaksolution,chlorhexidine-basedsolutions,laundrysoaporsurgeonshandscrub.Theseproductswillcausespottingandcorrosion.Usinganinstrumentcleaningbrushisrecommended,especiallyforjawserrations,teethandhingedareas.

A Word on Cannula Cleaning Brush Tips…

Spectra-Soap®Order#SS2

Fan-tip

Acrylic-tip

Scraper-tip(Helpsremovebaked-onbioburden)

NylonbristlecleaningbrushOrder#45-303N

StainlesssteelbristlebrushOrder#45-303SS

Double-endednylonbristlebrushOrder#M-16

Double-HeadedbrushOrder#45-202NS

Box-lockinstrumentbrushOrder#45-7000

InstrumentbrushOrder#45-8000


TIP:Ifmoretimeisneeded,keeppost-opinstrumentsmoistsothatblood,tissueandotherdebrisdoesnotdryontheinstruments.Thebestwaytokeepyourinstrumentsmoististoplaceawettowelovertheinstruments,oruseSpectra-Moist®availablefromSharn.Thiswetting-agentkeepsbloodfromdryingforhours.

Spectra-Moist®Order#SS6

Cleaning After Surgery

Thewashingprocessshouldbeginwithin20minutesaftersurgery,evenifsterilizationwilltakeplacemuchlater.Washinginstrumentswithinafewminutesofsurgerypreventsbloodfromdryingandisyourbestdefenseagainstcorrosion,pittingandstaining.

Onlyuseapprovedsolutionsforwashing,disinfecting,andlubricating.Non-approvedsolutionsareanythatdonotspecificallystate,“forsurgicalinstruments”onthelabel.

Approvedsolutionsarespecificallydesignedforsurgicalinstrumentsandthesterilizationcycle.Theirproductlabelswillstatethisuse.

Sterilization

Allsurgicalinstrumentsmustbesterilizedpriortosurgerytopreventinfection.Butevensterilizationcanleavecontaminantsbehindifnotproperlycleaned.Sterilizeinstrumentswiththeratchetsopen.Thisallowsforbettersteampenetration.Plus,itpreventstheboxlocks(hingearea)fromcracking.Ifusingapanortray,werecommendonewithperforations.Thiswillalsoenablebettersteampenetrationandaidsinmoreeffectivedryingaswell.Forefficiency,placeheavyinstrumentsatthebottomandlighter,moredelicateinstrumentsontop.Ifsterilizinginpaperorplasticpouches,donotstackpouchesontopofoneanotherduringsterilization.Whenpossible,pouchesshouldbesterilizedontheirside,leaningagainstapackorsterilizerchamberwall.

Sterilizewiththeratchetsopen

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5

TIP:Aheatedtankdoesnotsignificantlyimprovecleaning.Generallyspeaking,thereisnomeasurableimprovementincleaningwhenheatisappliedtothesolution.

Ultrasonic Cleaning

Amethodofcleaningthatisanecessityisultrasoniccleaning.Thismethodisthemostefficientandeffectiveavailabletoday.Infact,ultrasoniccleaningis16timesmoreefficientthanmanualcleaningalone.Placeinstrumentsintheultrasonicunitfor10-15minutesanduseaneutralpHultrasonicsolution.Hereareafewtipsforultrasoniccleaning:

1)Beforeplacingintotheultrasonicunit,cleaninstrumentsofall visibledebrisbyhand-washingtheminaneutralpHsoap.2)Beforeplacinginstrumentsintotheultrasonicunit,turnonthe ultrasonicmachineandletitrunfor10minutestode-gasthe solution.Thisprocessremovesanygasorairbubblesinthe solution.3)Thecleanertheinstrumentsgointotheultrasoniccleaner,the cleanertheywillcomeout.4)Aswithalltypesofcleaning,openallinstrumentssoratchetsand boxlocksarefullyexposedtothecleaningprocess.5)Makesureinstrumentshaveplentyofroom.Don’toverloadyour ultrasoniccleaner.6)Donotmixdissimilarmetals(suchasaluminumandstainless)in thesamecycletopreventcross-plating.7)Uponcompletionofthecycle,removeinstrumentsimmediately andrinsethem.8)Dryinstrumentsthoroughlywithatowel,ensuringthatno moistureisleftontheinstruments.

UsedistilledwaterortapwaterwithaneutralpHultrasonicsolutiontoproperlyfillthetankofyourultrasoniccleaner.Neveruseamanualsoapintheultrasoniccleanerandalwaysfollowproperdilution.AneutralpHultrasoniccleaningsolution,whenproperlymixed,effectivelyreducesthesurfacetensionofthesolutionandincreasestheultrasoniccavitationprocess.Thesolutionshouldbechangedatleastdailyorsoonerifthesolutionappearsdirtyormurky.OnlypluganultrasonicmachineintoaGFIoutlet.

Spectra-Sonic®Order#SS1

UltrasonicCleaningKit

Order#1235KIT


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(PhotoA)

(PhotoB)

(PhotoC)

Testing Your Ultrasonic Cleaning Machine

Todetermineifyourmachineisworkingproperly,simplyputwaterandproperlymixedultrasonicsolutioninthetank.Turnonmachineandviewthesurfaceofthewater.Ifyousee“sonic”waves(photoA)yourmachineisworking.Ifthesurfaceofthewateristotallyflat,yourmachinemayhaveaproblemwiththetransducer(s).

Thesecondtestiscalledthefoiltest.Simplyplaceasmallpieceofaluminumfoil(photoB)inthebottomofafilledtankandrunfor5-8minutes.Removefoilanditshouldbepeltedwithsmallholesanddents(photoC).Thisverifiesthattheultrasonicmachineisworkingproperly.

Lubrication

Oneoftheeasiest,yetmosteffectivewaystokeepinstrumentsinexcellentconditionistolubricatethemaftereverycleaning.Properlubricationkeepsthemovingpartsofinstrumentsfromrubbingandscraping,thuspreventingdullingandstraintojointsandhinges.Movingpartsoninstruments,suchasjoints,boxlocks,ratchets,andscrewjoints,shouldbelubricatedregularly.Beforeautoclaving,lubricateallinstrumentsthathavemovingparts.Onlyusewater-basedsurgicallubricantsbecausetheyaresteampenetrable.

Spectra-Lube®Order#T2Q


Rust vs. Stains

Stainscanberemoved,whereasrustwillleavepermanentdamage.Todetermineifabrown/orangediscolorationisastainorrust,usetheerasertest.Rubapencileraseraggresivelyoverthediscolor-ation.Ifthediscolorationisremovedwiththeeraserandthemetalunderneathissmoothandclean,thisisastain.Ifapitmarkappearsunderthediscoloration,thiscorrosionisrust.

Trouble Shooting Stain GuideBrown/Orange Stains-Mostbrown/orangestainsarenotrust.ThisstaincoloristheresultofhighpHsurfacedepositscausedbyanyofthefollowing:chlorhexidineusage,impropersoapsanddetergents,cold-steril-izationsolution,baked-onblood,soakinginsalineorusinglaundrysoap.

Dark Brown/Black Stains-LowpH(lessthan6)acidstain.Maybecausedbyimproperdetergentsandsoapsand/ordriedblood.

Bluish-Black Stains-Reverseplatingmayoccurwhentwodifferenttypesofmetalsareultrasonicallyprocessedtogether.Forexample,stainlesssteelinstrumentsprocessedwithchromeinstrumentsmaycauseastaincolorreaction.Exposuretosaline,bloodorpotassiumchloridewillcausethisbluish-blackstaintooccur.

Multi-Color Stains-Excessiveheatcausedbyalocalized“hotspot”intheautoclave.

Light and Dark Spots-Waterspotsfromallowinginstrumentstoair-dry.Withslowevaporation,mineralsfromwaterareleftontheinstrument’ssurface.

Bluish-Gray Stains-Coldsterilizationsolutionbeingusedoutsidemanufacturerguidelines.

Black Stains-Possibleexposuretoammonia.

Stain Removal

Toremovelocalizedstaining,dipamoistenedcleaningbrushinSpectra-Scrub®andbrushthestainaway.Usetapwaterordistilledwatertorinse,thendrywithatowel.

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Spectra-Scrub™StainRemoverOrder#SS7

Stainedinstrument

Erasertest








Instrument Stringers

Instrumentstringersallowforsaferhandlingofinstruments,fasterset-upofsterilefield,andmoreefficientorganizationofthetrayassemblyprocess.Instrumentstringersareproducedinvariouswidthsandlengths.Themostcommonwidthis2.5inchesandthemostcommonlengthbeing10inches.Afterselectingsize,thereareseveralstringerclosurestylestochoosefrom.

Repair Tags

Theuseofrepairtagsfacilitatesprecisecommunicationbetweentheoperatingroomandthesterileprocessingdepartment.Placing3–5newrepairtagsineachsetpriortosterilizationallowsthetagstobeavailableonthesterilefield.Onceadullordamagedinstrumentisdiscoveredduringaprocedure,asterilerepairtagcanthenbeplacedontheinstrument.Thissystemclearlyidentifiesthedefectiveinstrumentandpreventsunnecessaryrepairs.

Tip Protectors

Theuseoftipprotectorsisagoodpracticethatprotectsvaluableinstrumentsandscopesfromdamage.Manytimesthedamagetoaninstrumentfromnotusingtipprotectorsisnotrepairable,makingitnecessarytoreplacetheinstrument.Tipprotectorsareavailableinvented(withholes)ornon-vented(withoutholes)styles.Ventedtipprotectorsaresafertouseduetothefactthattheyareeasiertoremovefromtheinstrument,whichreducespossiblefingerinjuries.Theotheradvantageoftheventedtipprotectoristheimprovedexposureofthedevicesurfacetothesterilant.Tipprotectorscanbeusedonthetipsofpointedscissorsandsharpinstruments,skinhooks,distaltipsofrigidscopesandtoguardthecuttingedgesofosteotomes.

10”QuickRackStringerOrder#10QR

Sharpen/RepairTagsOrder#HL-4(Blue)Order#HL-4R(Red)

Assortmentofventedtipprotectors

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Instrument Etching / Marking

Vibratingengravingdevicesarenot recommendedbecause:1)Theyscratchofftheprotectivesurfaceoftheinstrument.2)Theboxlockareaisweakened.3)Engravingcreatesa“bed”forbacteria.4)Interfereswithrestoration/refinishing.

Acid-baseetchingisrecommended.YoumaypurchaseanetchingmachinekitfromSharntoperformyourowninstrumentmarking(Order#256ASC).

Instrument Marking Tape Application

Howtoproperlyapply:1)Cleanfingerswithalcoholtoremoveoils,greaseanddirt.2)Wipetapesitewithalcoholtoremoveanylubricant.3)Tapelengthshouldbeonlyenoughtowrap1to1½timesaround instrument.4)Aftertapeisapplied,autoclaveinstruments.Theheatwillassist withthebondingofthetape.5)Tapetheshanksofallinstruments.Avoidinstrumentrings. Wrappingtape1to1½timesaroundwillnotinterferewiththe closingofmostscissortips.

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CompleteetchingkitOrder#256ASC

Markingtapeoninstrumentshanks


LaboratoryTestResultsBEFOREbrushing

HemostatClose-Up ScissorsClose-Up

New Afterseveraluses

Demonstratessoftnessofwirebristles

The Facts about Sharn’s Stainless SteelInstrument Cleaning Brushes

Ithasbeenreportedforyearsthattheuseofstainlesssteelcleaningbrusheswilldamageaninstrument’ssurfaceorpassivationlayer.Todispelthismyth,wehiredanindependenttestinglabtotestinstrumentsbeforeandafterbrushingwithaSharnstainlesssteel,bristledinstrumentcleaningbrush(order#45-303SS).Thetestemployedbeforeandafterphotos,takenwithanelectronmicroscopeat200Xmagnification.Inaddition,weexaminedthemetallurgicalpropertiesofthestainlesssteelbeforeandafterbrushing.Duringthetest,theinstrument’ssurfacewasbrushed60times.Asyoucanseefromthephotosbelow,thestainlesssteelbristlesdidnotharmtheinstrument’ssurface,provingthatusingSharn’sstainlesssteel-bristledcleaningbrushesWILLNOTHARMyourstainlesssurgicalinstruments.

Test: MetallurgicalLaboratoryStudyLaboratory: AnalyticalServices,Inc.Dateconducted: 2003Method: ScanningElectronMicroscope EnergyDispersiveSpectroscopy

A few words on wire brushes…

Thestainlesssteelbrushisdesignedtoremovebaked-ondebrisandstainsthatthenylonbrushcannotremove.Thedesignofthesoftstainlesssteelbristlesallowsthebristlestobendandremovedebrisatraumatically.Previously,wirebrushesthatdamagedsurgicalinstrumentswerebonecementbrushes.Theseverystiffbristlesoccasionallycauseddamage,whichledtothenegativeopinionofwirebrushes.Therecommendationistouseanylonbristlebrushfirst.Ifthedebrisisnotremoved,thenuseastainlesssteelbristledbrush.Thisbrushisintendedforuseonbonefiles,needleholderjaws,burs,reamers,vascularinstrumentserrationsandstubbornstains.

Notice:Insulated,coated,plated,orchromeinstrumentswillbedamagedbyusingastainlesssteel-bristledbrush.

LaboratoryTestResultsAFTERbrushing

HemostatClose-Up ScissorsClose-Up

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Scissor Testing, Inspection, and Quality Assurance

Visuallyinspectcuttingbladesforburrs,chipsorcorrosion.Thedistaltipsshouldmeetevenly.Inspectsharptipsforbendingordamage.Thecuttingactionofascissorshouldbesmoothasthescissorclosesandthescissorshouldnotgrind,“jump,feellooseortootight.Usetheguideatlefttotestscissorsharpness. •Forscissorslongerthan4½”useSharn’sStandardScissorTest Material(Order#621431ornon-latex,order#621531). •Forscissorsshorterthan4½”length,useSharn’sThinScissor TestMaterial(Order#621430ornon-latex,order#621530).

Post-Operative Care

Separatetheringsandbeginthedecontaminationprocesswithin20minutesaftersurgery.Theuseofspray-onmoisturizerssuchasSpectra-Moist®(Order#SS6)isalsoaveryeffectivewaytopreventthebloodfromdrying.Soaktheinstrumentsinanenzymaticsolution(Spectra-Matic™Order#SS9)orplaceamoisttowelsaturatedwithwaterovertheinstruments.

Test Your Scissors:

1Usingrighthandthumband middle(orring)finger,make surethatscissorsareheld likeasurgeon.

2Cutthroughmaterialusing ½ofbladetocutalltheway throughtothedistaltip.

3Afterseveralcuts,extract scissors.Ifscissorsdonot pinchorgrabmaterial, scissorsaresharp.

4Thefinaltestishowthe scissorsfeel.Scissors shouldopenandclose smoothlyandshouldnot “jump”,grind,orfeelloose.

CORRECT

INCORRECT

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RecommendedBrushes:45-202NS,M-16,45-7000


Needleholder Inspection and Quality Assurance

1.Visuallyinspectjawsforsignssuchaspartialsmoothnessor inconsistentwear.Ifwornscheduleforrepair.2.Holdneedleholdertoalightsourceandclosejawsalltheway.If youcanseelightbetweenthejaws,thisneedleholderisinneed ofrepair.3.Inspectjawsandboxlocksforcracks.4.Checkjawsforburrs.5.Theshanksoftheinstrumentshouldbestraight.6.Checkratchettoseeifjawsstayclosedonlastratchet.Test ratchetbyopeningandclosing.Withneedleholderratchets closedcompletelyalledgesshouldmeetevenly.

Post-Operative Care


Wornneedleholderjawinserts

Replacementneedleholderjawinserts

Acceptablecondition

Inneedofreplacement

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RecommendedBrushes:45-202NS,45-303SS,45-303N,M-16,45-7000








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Suction Device Inspection and Quality Assurance

1.Visuallyinspectallareasofsuctiontubesforsharpedges,dents andtrappedsurgicaldebris.2.Inspectshaftfordentsasaresultofbending.3.Inspectthetubingunionofthesuctioncontrolareaforcracks andpropersoldering.Verifythereisnobreakdownoftheunion.4.Inspectstyletteandseethatstylettecanbeinsertedsmoothly intoproximalend.Note:Styletteshouldnotbeinsertedduring sterilization.

Cleaning Instructions

Useacleaningbrushthatisthepropersizeforeachsuctiontube.Alwaysallowbrushtoenterandcompletelyexitsuctionchannel,andthendrawbrushbackthroughdevice.

TIP:Brushofpropersizeshouldcompletelyexitsuctiontubewhencleaning.

Recommendedcleaningbrushes:

Baron Suction Tube Brushes Order# Diameter Length45-904 3french(1.0mm) 9.75”45-905 5french(1.6mm) 9.75”

Frazier Suction Tube Brushes

Order# Diameter Length45-906 6french(2.0mm) 9.75”45-907 7french(2.3mm) 9.75” 45-908 8french(2.6mm) 9.75” 45-909 9french(3.0mm) 9.75” 45-910 10french(3.3mm) 9.75”45-911 11french(3.6mm) 9.75” 45-912 12french(4.0mm) 9.75”

CleaningBrushScale

AvailablefromSharnOrder#45-0001


Retractor Inspection and Quality Assurance

1.Visuallyinspectretractorforchippingorflakingofsurface.2.Inspectvisuallyandbyfeelfordents,burrs,bentbladesor prongs.3.Ifretractorhasreleaselever,flicktheleverandseethatitsprings backintoplace.Levershouldopenandclosesmoothly.4.Ifretractorhasaspringandscrewarea,inspectcloselyfor cracks.5.Ifretractorischrome-platedandfinishisflaking,remove instrumentfromserviceandreplace.

Post-Operative Care


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RecommendedBrushes:45-303N,45-303SS,M-16,45-7000,45-8000

Inspectchrome-platedinstrumentsforflaking



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Hemostat Inspection and Quality Assurance

1.Visuallyinspectserrationsofjawsandallsurfaces.2.Tipsofserratedjawsshouldmeetflush,withnooverlay.3.Teethofhemostatictissueforcepsshouldbepresent,alignedand fittogetherperfectly.4.Openandclosehemostat,checkingforstiffness.5.Carefullyinspectboxlockareaforcracksanddebris.6.Testratchetpriortoeachassemblyoftray.Totestifratchetis sprung/inneedofadjustment,closeratchetandgentlytaprings evenlyonahardsurface.

Post-Operative Care

Separatetheringsandbeginthedecontaminationprocesswithin20minutesaftersurgery.Theuseofspray-onmoisturizerssuchasSpectra-Moist®(Order#SS6)isalsoaveryeffectivewaytopreventthebloodfromdrying.Soaktheinstrumentsinanenzymaticsolution(Spectra-Matic™Order#SS9)orplaceamoisttowelsaturatedwithwaterovertheinstruments.Besuretothoroughlyrinseandcleantheboxlockareaandserrationsofthejaws.Thesearethemostdifficultareastoclean.

TIP: Ratchetsshouldalwaysbeopenwhencleaningandsterilizingforthefollowingreasons:

1.Allowsforadequatesteam/ sterilantpenetrationintobox lockarea.

2.Preventscracksby reducingstressonbox lockareaduetorapid expansionofthesteel duringthesterilization process.

RecommendedBrushes:45-303N,45-303SS,45-202NS,M-16,45-7000








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Tissue and Dressing Forcep Inspection andQuality Assurance

1.Visuallyinspectforcepsfromtiptotip.2.Makesureallteetharepresent.3.Tipsshouldmeetevenly,withnooverlay.4.Teethofforcepsshouldbealignedandfittogetherperfectlywith outstickingwhentesting.5.Carefullyinspectforcracksanddebris.6.TissueandDressingForcepsshouldnot“click”andshouldnot “stick”whentesting.

Post-Operative Care


RecommendedBrushes:45-303N,45-303SS,45-202NS,M-16,45-7000,45-8000








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Laminectomy and Cervical Rongeurs

1.Closelyinspectrongeuratdistaltip,wheredamagemostoften occurs,significantlyreducingtheinstrument’sabilitytocut.2.Inspectchannelandinterlockingpartsforbioburden.3.Ifrongeursticks,lubricateorsendoutforrepairevaluation.4.Carefullyinspectspringsandscrewsforcracksanddebris.

Post-Operative Care

Beginthedecontaminationprocesswithin20minutesaftersurgery.Theuseofspray-onmoisturizerssuchasSpectra-Moist®(Order#SS6)isalsoaveryeffectivewaytopreventthebloodfromdrying.Soaktheinstrumentsinanenzymaticsolution(Spectra-Matic™Order#SS9)orplaceamoisttowelsaturatedwithwaterovertheinstruments.Besuretothoroughlyrinse,cleanandinspectthechannel/interlockingareasandcuttingportion.Thesearethemostdifficultareastoclean.

TIP:Sharpnessofarongeurcanbetestedbyusingastandard3”x5”indexcard.Therongeurshouldtakeacleanbiteoutofthecard.

RecommendedBrushes:M-16,45-303N,45-303SS,45-7000Nylonbristlecleaningbrush

Order#45-303N







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Bone Cutters

1.Closelyinspectbonecutter’sjawsatdistaltip,wheredamage mostoftenoccurs,significantlyreducingtheinstrument’sabilityto cut.2.Ifdamagetocuttingsurfaceisdiscovered,schedulethe instrumenttoberepairedimmediatelyanddiscontinueuse.2.Ifbonecuttersticks,lubricateorsendoutforrepair.4.Carefullyinspectallspringsandscrewsforcracksanddebris.

Post-Operative Care

Beginthedecontaminationprocesswithin20minutesaftersurgery.Theuseofspray-onmoisturizerssuchasSpectra-Moist®(Order#SS6)isalsoaveryeffectivewaytopreventthebloodfromdrying.Soaktheinstrumentsinanenzymaticsolution(Spectra-Matic™Order#SS9)orplaceamoisttowelsaturatedwithwaterovertheinstruments.

TIP:Sharpnessofabonecuttercanbetestedbyusingastandard3”x5”indexcard.Thebonecuttershouldcutcleanlythroughasinglethick-nessofthecard.

TIP:TestPinCuttersinthecenterportionofthejaw.Thisistheareaofthejawthatisdesignedtocut.

RecommendedBrushes:45-303N,45-303SS,45-202NS,M-16,45-8000








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Laparoscopic Instrument Inspection, Testing, and Cleaning

TIP:Totestlaparoscopicinsulation,visuallyinspecttheentireshaftforanynicksorcuts.Next,pullbackontheinsulation.Iftheinsulationslidesback,theinstrumentisinneedofreinsulation.



TIP:Laparoscopictipprotectorshelpprotectvaluablelaparoscopicinstruments.

TipprotectorsareavailableinseveralsizesfromSharn.

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Order#LTP-5-800 5mmdiameter .75”length (20/pkg)

Order#LTP-5-168 5mmdiameter 1.68”length (20/pkg)

Order#LTP-10-800 10mmdiameter .75”length (20/pkg)

Order#LTP-10-225 10mmdiameter 2.25”length (20/pkg)

Order#LTP-VN-750 VerresNeedleProtector .75”length (50/pkg)



Todetermineiftheinnerlinkageisworn,stretched,orfatigued,wigglethedriveringbackandforth.Ifthejawdoesnotmove,thelinkageisdamagedandisinneedofrepair.Astheringmoves,thejawshouldmoveaswell.

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Shallow Cannula Cleaning BrushesColor-codedhookhandles

Order# Diameter Handle Length45-0505 5mm Green 5” 45-0507 7mm Yellow 5” 45-0510 10mm Pink 5”

NEW BRUSH DESIGNS



TIP:Whencleaninganylaparoscopicinstrumentshaft,thecleaningbrushmustenterandcompletelyexittoproperlyclean.

Toproperlyflushandirrigatelaparoscopicinstruments,connectsyringetoirrigationportandwithdistaltipunderwater,drawupwaterfromcleaningsink.Forcecleaningfluidsinandoutofshaft.

TIP: Whensoakinglaparoscopicinstruments,soakingtheinstrumentsverticallyallowsfluidtoenteratthedistaltipandriseup.Fluidwillseekit’sownlevel,andthis,inconjunctionwithanenzymaticcleaner,willassistwiththecleaningprocess.

SoakingCylinderOrder#3662-4000

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Recommendedcleaningbrushes:

Laparoscopic Instrument Brushes Order# Diameter Length45-542 2mm 12” 45-543 3mm 12” 45-544 4mm 12”45-545 5mm 12” 45-546 6mm 12” 45-539 5mm 16”45-540 7mm 16” 45-541 10mm 16” 45-550 2.5mm 24”45-551 5mm 24” 45-552 7mm 24” 45-553 10mm 24”



Totestsharpnessofalaparoscopichookscissor,bladesshouldcutcleanlythroughastandard,1/4”widerubberband.Bladesshouldopenandclosesmoothlyandbefreeofnicksandburrs.

Totestsharpnessofastandardlaparoscopicscissor,bladesshouldcutcleanlythroughonethicknessoffacialtissue.Bladesshouldopenandclosesmoothlyandbefreeofnicksandburrs.

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Cleanables™ Instrument BrushesSingle-Ended

Order# Diameter Length45-1503 3mm 25” 45-1505 5mm 25” 45-1508 8mm 25”45-1510 10mm 25”

Double-Trouble Cleanables™ Instrument Brushes -Double-Ended

Order# Diameter Length45-2503 3mm 25” 45-2505 5mm 25” 45-2508 8mm 25”45-2510 10mm 25”

Reposables™ Instrument Brushes Disposablebrushtipswithreusable24”shaft

Order# Diameter Length45-2505 5mmDisposableBrushtip45-2508 8mmDisposableBrushtip45-2510 10mmDisposableBrushtip45-2400 24”ReusableHandle

Reposables™ Instrument Brush KitDisposablebrushtipswithreusableshaft

45-2499 24”Reusablehandlewith disposablebrushtips

NEW BRUSH DESIGNS


Customer Service

CustomerServiceisournumberonepriority.SHARNAnesthesia,Inc.hasawidenetworkofdealersacross36countries.Ifyouareanexistingcustomerofoneofourexcellentdealers,wethankyouforyourbusinessandhopetocontinuetoserveyouwithtopqualityproductsatcompetitiveprices.

Ifyouarenotyetacustomer,wewillbehappytoputyouintouchwiththedealerclosesttoyou.Ifyouareadealerandinterestedinsurgicalinstrumentcareproducts,wearehappytohearfromyou.Eitherwayyoucancontactusthroughcalling01-813-889-9614orviaemailatmailbox@sharn.com.PleaseaddressyourcommunicationstotheDirectorofInternationalSales.

Again,serviceisthewatchwordatSHARNAnesthesiaInc.Ourwholestaffandournetworkofdealersworkhardtoprovidethebestserviceforallourcustomers.

Thisguideiscompletelyprotectedbycopyright.Nopart,page,orimageofthispublicationmaybereproduced,scanned,stored,distributed,ortransmitted inany formorbyanymeanswith-out prior written permission from the author.The author has done everything possible toensurethattheinformationcontainedwithinthisbookisaccurateandup-to-dateinaccordancewithacceptedindustrystandardsatthetimeofprint. The author is not responsible for errorsoromissionsor forconsequences fromuseofthe guide, and makes no warranty expressedor implied regarding the content of this guide.Any practice or recommendation describedinthebookshouldbeappliedbythereader inaccordance with their facility’s professionalstandards and policies. Always consult yourfacility’spoliciesandalways refer toand followthe manufacturer’s cleaning and sterilizationguidelines.©2009SpectrumSurgicalInstrumentsCorp.

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Maintaining and Cleaning Surgical Instruments

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