Cleaning, sterilising and caring for surgical instruments

Why the process starts right after use

Blood and other soil that dries on instruments is hard to remove and shields microorganisms during sterilisation. The rule is simple: remove gross soil at the point of use and keep instruments moist until cleaning.

In Brazil, good practice for reprocessing health products is set out in ANVISA RDC 15/2012 — check it and follow your institution's protocol.

Step by step

• Pre-cleaning: remove excess organic matter and keep items moist (pre-soak or enzymatic detergent).
• Cleaning: by hand with soft brushes, or in an ultrasonic washer, with enzymatic detergent and joints open.
• Thorough rinsing, ideally with treated water, so no detergent or mineral residue remains.
• Complete drying: leftover moisture causes stains and corrosion.
• Inspection: check edges, tip alignment, ratchets and joints; remove damaged pieces.
• Lubricate joints with an instrument lubricant (water-soluble, steam-compatible).
• Wrap and steam-sterilise (autoclave) using the equipment's validated parameters.

Autoclave: what to watch

The most common cycles use saturated steam at 121 °C or 134 °C, with times that depend on the autoclave type and load. Always use the equipment maker's validated parameters, chemical indicators in every pack and regular biological tests.

Don't overload the chamber, and keep instruments open and unlocked so steam reaches every surface.

Mistakes that ruin stainless steel

• Soaking in saline, bleach or chlorine products: causes pitting and corrosion.
• Steel wool or wire brushes: scratch the surface and strip its protective layer.
• Washing instruments of different metals together.
• Storing items damp, or locked on the ratchet for long periods.

Storage

Store in a clean, dry, protected place, in boxes or trays that stop pieces rubbing together. Delicate tips need protectors. Well-kept instruments stay precise for many years.