After being cleaned in a Surgical Instrument Washer delivering the "Proper Sequence of Washer Treatments", including ultrasonic cleaning and a combination enzyme detergent cleaning concentrate: "evaluation of Surgical Instruments confirmed that the efficacy of disinfection was 100%". "All instruments and utensils tested were sterile at the completion of the process."
Properly Designed Surgical Instrument Washers
Provide the Prerequisite for Sterilization
John Prohonic
Product Development
Summary : Properly Designed Surgical Instrument Washers are designed to clean all surfaces thoroughly, thereby providing the critical prerequisite for the safe handling, disinfecting, and the sterilizing of surgical instruments.
Surgical Instrument Washers perform pre-wash, ultrasonic (optional), detergent washing, purified water elevated temperature rinsing, lubrication and high temperature drying in such a manner as to provide thoroughly clean, stain free and lubricated medical devices. Surgical Instruments cannot be sterilized (be sterile) unless all exposed surfaces are properly cleaned, prior to sterilization, to remove soil (debris, bioburden) and properly rinsed to prevent staining.1,2,3 Not all Washer Decontaminators Washer Disinfectors provide adequate pre-rinsing, pre-cleaning, purified water rinsing, and thereby render higher rejection rates of processed surgical instruments. 4,5.
Design Secures Performance when:
- Cleaning Surgical Instruments hand washing,
- Cleaning Surgical Instruments automated washer decontaminators,
- Cleaning Surgical Instruments washer disinfectors,
- Cleaning Surgical Instruments washer sterilizers.
The Surgical Instrument Washer proper sequence of treatment and the correct choice of time, temperature and the components used are necessary to render surgical instruments that are critically clean, safe to handle, and have the prerequisite for sterilization. 6,7,8.
Surgical Instrument Washers employ a cold water pre-wash to remove gross debris. This removes proteins and lipids, preventing them from being baked onto devices during the high temperature treatments to follow. 9, 10. Then, the ultrasonic process creates millions of micro implosions to loosen and free debris from lock boxes, hinge pins, serrations and other difficult-to-access surface areas.
The Surgical Instrument Washer detergent wash then applies high flow low pressure water with a cleaning concentrate (at ~ 135 degrees F) in such a manner as to evenly reach all areas of the load and strip bioburden from the surgical instruments. The elevated temperature (at ~ 194 to 209 degrees F) purified water final rinse secures the biocidal process, removes mineral deposits from prior cycles and lubricates the instruments. The high temperature (at ~ 158 to 230 degrees F) dry cycle presents heated, forced air which dries each device. The critical cleaned medical devices are now clean, safe to handle, have the prerequisite for sterilization, and are properly prepared for further reprocessing.
Complete Removal of Pathogens when:
- Cleaning Surgical Instruments hand washing,
- Cleaning Surgical Instruments automated washer decontaminators,
- Cleaning Surgical Instruments washer disinfectors,
- Cleaning Surgical Instruments washer sterilizers.
The Washington University School of Medicine at Washington University Medical Center examined the performance of a properly designed Washer Decontaminator Washer Disinfector (CESCO washer Decontaminator Model 520) and found that it removed all organisms from the surgical instruments tested. 11
Surgical Instrument Washers were tested for its ability to complete remove pathological organism from surgical instruments.
Pure cultures of the following organisms were grown on appropriate agar plates:
1. Staphylococcus aureus;
2. Pseudomonas aerations;
3. Escherichia coli;
4. Bacillus species
Kelly clamps, tweezers and scissors wee placed on these plates of organism, taking care to ensure that all serrated edges were packed with all the organisms. Each contaminated instrument was then dipped into the tube of Thiogycolate medium before being placed in all the washer baskets. The instruments were then processed through the complete Washer Decontaminator Washer Disinfector cycle. At the end of the drying cycle, the instruments were allowed to cool and then dipped into another tube of Thioglycolate medium.
Results when:
- Cleaning Surgical Instruments hand washing,
- Cleaning Surgical Instruments automated washer decontaminators,
- Cleaning Surgical Instruments washer disinfectors,
- Cleaning Surgical Instruments washer sterilizers.
All tubes of the Thioglycoate medium tested before the wash grew the appropriate organism within six to 18 ours after testing. All tubes tested at the end of the wash showed no growth after 14 days of incubation. This Washer Decontaminator Washer Disinfector removed all organisms from the instruments.
Surgical Instrument Washer Efficacy of Disinfection 100%
Another evaluation of Surgical Instrument Washers confirmed that the efficacy of disinfection was 100%. In this study, L.P. Jette and N.G. Lambert used two test methods.12 One method (N) was to test the effect of heat only within the disinfection process and the other test method (G) was to test the efficacy of both heat and washing. Each method gave reproducible results and confirmed the efficacy of the Washer Decontaminator Washer Disinfector.
Cleaning Surgical Instruments using automated washer decontaminators, Cleaning Surgical Instruments using washer disinfectors, and Critical Cleaners Will Work for You.
Surgical Instrument Washers demonstrated the ability to completely remove pathological organisms with effective repeatability. There operation is automatic, reliable, labor saving and easy to use. Central Processing departments rarely find the need to manually treat devices and report an exceptionally low rate of rejected devices.
Conclusion
The Surgical Instrument Washer, cold water pre-wash, ultrasonic cleaning, detergent washing action, final rinse and drying treatment of a properly designed Washer Decontaminator Washer Disinfector Critical Cleaner will provide critical cleaning, the prerequisite for safe handling, optimal disinfecting, and sterilizing of medical devices.
References
1. Peggy Ryan, RN, “Concepts of Cleaning Technologies and Processes,” Journal of Healthcare Material Management, (Nov./Dec. ’87), pp. 20-27.
2. Marimargaret Reichert, RN, “processing Reusable Medical Devices, “Journal of Hospital Material Management, p. 40.
3. Training Manual for Central Service Technicians, American Society for Central Services Personnel of the American Hospital Association, (Chicago, IL, 1986), p. 69.
4. Ryan, op. cit.
5. Training Manual for Central Service Technicians, op. cit.
6. Ryan, op. cit.
7. Interview with Charles A. Reed, Washington University School of Medicine, Washington University Medical Center, Dec. 1985.
8. L.P. Jette’and N.G.Lambert, “Evaluation of Two Hot Water Washer Disinfectors for Medical Instruments, “ Infection Control Hospital Epidemiology, Vo.1 9, No. 5, (1988), pp. 194-199.
9. Training Manual for Central Service Technicians, op. cit.
10. Ryan, op. cit.
11. Ryan, op. cit.
12. L.P. Jette’and N.G.Lambert, op.cit.
NOTE:
The goal of cleaning (decontaminating reprocessing) surgical instruments is to deliver Clean Surgical Instruments that are safe for the Reprocessing Staff and have received the prerequisite for disinfecting and/or sterilizing surgical instruments. It is a recognized risk of exposure to unidentified microorganisms that reprocessing personal endure during the decontamination, reprocessing, and cleaning of surgical instruments. Our goal is to minimize the amount and degree of reprocessing personal exposure to this risk and provide reprocessed surgical instruments that are clean: safe to handle, safe for patient care, and are cleaned (decontaminated reprocessed) at the lowest cost. The optimal decontamination cleaning-reprocessing of surgical instruments will secure the prerequisite for disinfecting surgical instruments and/or sterilizing surgical instruments, deliver surgical instruments that are safe to handle, and reduce reprocessing costs. Surgical Instrument Washers using the with all-in-ONE enzymatic enzyme detergent surgical instrument cleaners used in this research study were manufactured by CESCO, Mercersburg PA. The Surgical Instrument Washers are not currently available from CESCO. European Manufacturers have developed Surgical Instrument Washers with fully automated Ultrasonic Cleaning manufactured within the ISO/DIS 15883-1 Standard. Studies demonstrate the propensity for Surgical Instrument Washers with Ultrasonic Cleaning to deliver optimal cleaning results.
The instrument cleaners used in these studies are currently available in the form of the all-in-ONE enzymatic enzyme detergent surgical instrument cleaners. A critical component for optimal cleaning is using the best possible "surgical instrument cleaners". Recent European studies have illustrated and concluded that combination enzymatic enzyme detergent surgical instrument cleaners are more effective than conventional surgical instrument cleaners. The research was initiated to deactivate prions deactivating prions within the objective to prevent CJD (Creutzfeldt-Jakob Disease).
The "Proper Sequence of Washer Treatments" includes a series of mechanical and chemical treatments. The mechanical treatments include: cold water pre-wash, ultrasonic cleaning, detergent wash, purified water rinses, and hot air drying. The chemical treatments include combination of enzymatic enzyme cleaners, detergents, surface conditioners and lubricants.
Cleaning Surgical Instruments cleaner.
cleaning Endoscopes cleaner.
Studies have demonstrated how properly designed Tunnel Washers, Surgical Instrument Washers Decontaminators, Washer Disinfectors are able to deliver optimal cleaning using a combination of automated mechanical treatments and chemical treatments.
Enzymatic Enzymes Detergents Conditioners and Lubricants
in ONE cleaning concentrate.
After being cleaned in a properly designed Tunnel Washer, Washer Decontaminator, Washer Disinfector using a combination enzyme detergent cleaning concentrate: "evaluation of Washer Decontaminators Washer Disinfectors confirmed that the efficacy of disinfection was 100%". "All instruments and utensils tested were sterile at the completion of the process."
includes a series of mechanical and chemical treatments.
The mechanical Surgical Instrument Washer treatments include:
- cold water pre-wash,
- ultrasonic Surgical Instrument cleaning,
- Surgical Instrument detergent wash,
- purified water rinses,
- and hot air drying.
The chemical Surgical Instrument Washer treatments include:
- Surgical Instrument Cleaner enzymes,
- Surgical Instrument Washer detergents,
- Surgical Instrument surface conditioners,
- and Surgical Instrument lubricants.
The Goal Purpose of an Surgical Instrument Washers
The purpose of an Instrument Washer is to deliver surgical instruments that are "clean and safe to handle" for reprocessing and are clean so that they can be sterilized. Surgical instruments that are not clean cannot be sterilized. Surgical Instrument Washers properly prepare surgical instruments for sterilization by Terminal Sterilizers. Clean is the "Prerequisite for Sterilization".
It has been demonstrated that the complete removal of pathogens can be achieved through hand washing (manually cleaning) reusable medical devices or through the use of automated washer decontaminators (washer disinfectors). In the USA we refer to the washers as "decontaminators", worldwide they called "disinfectors".
Washer Disinfectors can avoid the risks associated with hand washing surgical instruments. Washer disinfectors can reduce the costs of cleaning surgical instruments.
Studies demonstrate that Washer Disinfectors that include using a 4 enzyme detergent disinfector detergent can deliver: the "complete removal of all pathogens" and “surgical instruments sterile at the completion of the process".
Properly designed Washer Disinfectors deliver the "Proper Sequence of Washer Treatments" that include a combination of mechanical and chemical treatments. After being cleaned in Washer Disinfectors that include using a combination 4 enzyme detergent Surgical Instrument Cleaner: "evaluation of Washer Disinfectors confirmed that the efficacy of disinfection was 100%". "All surgical instruments and utensils tested were sterile at the completion of the process."
The Washer Disinfector "Proper Sequence of Washer Treatments" includes a series of mechanical and chemical treatments.
The mechanical Washer Disinfector treatments include:
- cold water pre-wash,
- ultrasonic cleaning,
- detergent wash,
- purified water rinses, and
- hot air drying.
- combination of 4 enzyme cleaners,
- surfactant detergents,
- surface conditioners, and
- lubricants.
It is widely understood that "Washer Sterilizers" do not sterilize surgical Instruments. It has been demonstrated that Washer Disinfectors using the Proper Sequence of Washer Disinfector Treatments can deliver surgical instruments that are sterile. One research study states: "All instruments and utensils tested were sterile at the completion of the process." Click Here to review the APIC Abstract demonstrating the efficacy of automated Washer Disinfectors.
Cleaning using washer disinfectors and hand washing.
Cleaning Surgical Instruments automated washer disinfectors.
Cleaning Surgical Instruments washer disinfectors.
Washer disinfectors and washer sterilizers.
It is a recognized risk of exposure to unidentified microorganisms that reprocessing personal endure during the decontamination, reprocessing, and cleaning of surgical instruments. Our goal is to minimize the amount and degree of reprocessing personal exposure to this risk and provide reprocessed surgical instruments that are:
- clean safe to handle,
- safe for patient care,
- have received the prerequisite for sterilizing surgical instruments, and
- are decontaminated, cleaned, safely prepared, and sterilized at the lowest cost.
The goal of cleaning-reprocessing surgical instruments is to deliver Surgical Instruments that are safe for the Reprocessing Staff to handle and have received the prerequisite for disinfecting and/or sterilizing surgical instruments.
Washer Disinfectors
gentle yet aggressive.
Countertop Washer Disinfectors
Undercounter Washer Disinfectors
- boost productivity
- eliminate hand washing instruments
- improve worker safety, and
- render high quality cleaning outcomes.
Pre Wash Enzyme Detergent
Surgical Instrument Cleaner
