CARE AND

HANDLING OF
SURGICAL
INSTRUMENTS
The use of shortcuts in instrument care
can lead to:

Rust
Stains
Spotting
Corrosion
 CORROSION

The gradual wearing away of material

that will eventually impair the function of
the instrument
 CAUSES
1. Inadequate cleaning and drying after
use
2. Corrosive chemicals or sterilizing
solutions
3. The use of ordinary ‘tap’ water rather
than distilled water in the cleaning
process
4. Laundry detergent residue remaining in
operating room linens

5. Harsh detergents

6. A malfunctioning autoclave
 PREVENTION
Cleanliness
Lubrication
Correct handling and storage procedure
Regular inspection
Will ensure an instrument’s proper
performance and can actually lengthen
the life of surgical instruments
 RUST
Real rust is rare
A pencil eraser can be used to remove
the rust
Check to see if it is ‘pitted’ beneath the
surface erased
A pitted rusting instrument should be
taken out of the set immediately to
prevent a rust problem for the entire set
It is more common for an instrument not
actually rusting but shows some rust
deposits

Can be refinished by the manufacturer

 CAUSES
Chrome or nickel plated
When the plating wears off the carbon steel
below becomes exposed and is subject to
immediate corrosion during autoclaving or
soaking solutions
Lesser grade instruments may not have been
made corrosion resistant by the manufacturer
Not using distilled deionized water in the
autoclave
 DETERGENTS
High alkaline content in detergents
produces the brown/orange stain during
the autoclave cycle
Best detergent for instrument washing
are those that are neutral pH 7
Thorough rinsing will ensure detergent
is no longer on the instrument
 WATER
Traces of minerals or metals may be
contained in ‘tap’ water
It is best to use distilled deionized water
to clean and for the use in the autoclave
to ensure the exclusion of minerals and
metals
 DRIED BLOOD
Results in dark-brown stain that can be
rubbed off
Blood should be removed from the
instrument surface as soon as possible
It will break down the surface by
chemical reaction if left on the
instrument
 SURGICAL WRAPPINGS
If laundry uses too much detergent or a
cheaper detergent that contains a lot of
phosphates
May contain enough remaining
detergents to cause a reaction during
autoclaving
A tell-tale sign is the brown stain on the
towel
 CONCLUSION
Meticulous care during surgery will
prolong the life of surgical instruments

Blood and saline are the most common

causes of corrosion and pitting
 Instrument contact should be
avoided if at all possible with the
following solutions:
Aluminum chloride Mercury salts
Barium chloride Phenol
Carbolic acid Potassium
permaganate
Chlorinated lime
Potassium
Dakin’s solution thiocynate
Ferrous chloride Sodium hypochlorite
Lysol Stannous chloride
Mercury bichloride Tartaric acid
 DETRIMENTAL EXPOSURE

Aqua regia (a mixture of nitric acid and

hydrochloric acid)
Ferric chloride
Diluted sulphuric acid
Hydrochloric acid
Iodine (not to exceed 1 hour)
 CLEANING
Thoroughly cleaned immediately after
use
Toothbrush is helpful
Never let blood or debris dry on the
instrument
Instruments with removal parts should
be disassembled
Instruments should be dried quickly
after cleaning to avoid water stains
A helpful machine is the ‘ultrasonic
cleaner’
Ultrasonic cleaning uses acoustic
vibration at high frequencies through a
liquid medium
The vibration of the fluid is so rapid that
it forms bubbles
The bubbles adhere to and collapse on
the surfaces of the instruments
This causes the foreign matter on the
surface to be dislodged, gently but
totally
The mini vacuum created by the
bubbles removes up to 90% of all
foreign matter from the instrument
Particularly in the hard to reach areas
such as the scissor locks, pores, tight
joints and other crevice like areas
 LUBRICATION
Cleaning removes all lubrication from
instruments
Instruments should be lubricated after
cleaning process to guard against
mineral deposits and other water
impurities
An antimicrobial water-soluble lubricant
is the only lubricant recommended
 INSPECTION
Must be inspected before packaging
Hinged instruments checked for
alignment of jaws, meshing of teeth and
stiff or cracked joints
Check the cutting capability of scissors
 PREPARING A SET OF
INSTRUMENTS
Do not let sharp instruments touch
Tips can be protected with tubing
placed on tips
Gauze can be used to protect smaller
instruments
All instruments should be in an open
position
Don’t overload trays