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Ultrasonic Cleaners in Surgical Suites

Cleaning medical and surgical instruments is an exacting process that should be undertaken following a procedure in order to avoid blood, hemoglobin, synovial fluid and other contaminants from drying on instruments and thereby becoming extremely difficult to remove. That’s why all surgical and orthopedic instruments should be carefully washed and wiped immediately after use to remove gross contaminants then immersed in an enzyme soak solution to await ultrasonic cleaning and subsequent disinfecting or sterilizing according to accepted procedures.

How to Clean Surgical Instruments

Sonic cleaning is by far one of the most effective means of removing contaminants from medical and surgical instruments. Moreover, hand scrubbing the instruments, aside from being ineffective, can result in cuts and punctures that may lead to infection. Ultrasonic cleaning, in fact, is part of the recommended practices for cleaning surgical instruments issued by the Association of periOperative Registered Nurses. Section 10 of their recommendations states in part “Ultrasonic cleaners use a process called cavitation that facilitates removal of small particles and debris from instrument joints, crevices, and hard to reach places. Ultrasonic energy is passed through a water bath, creating bubbles that implode. This process of implosion creates a suction action that pulls debris away from instrument surfaces.”

Ultrasonic cleaners are available in a variety of sizes. A model ideally suited for smaller surgical suites is the 1.75 gallon capacity 37 kHz Elmasonic SH175EL surgical instrument cleaner that can accommodate instruments to 18 inches in length. This attractively styled unit is equipped with what is called a degas mode to remove trapped air from fresh cleaning solutions and a sweep mode to uniformly distribute sonic cleaning action throughout the bath.

A suggested cleaning solution formulation is MedClean C7 a mildly alkaline enzymatic non-caustic and phosphate-free medical and surgical instrument cleaner. It is supplied in 1 gallon containers and diluted to 1 to 3% with water. At a cleaning temperature of about 40?C it is safe for all commonly used surgical instruments except those that are chromium plated, which should not be cleaned ultrasonically.

While you should follow the recommendations of your professional association here’s a suggested procedure:

  1. Add water (distilled or DI recommended) to the tank and the correct amount of MedClean C7 depending on the capacity of the tank.
  2. Activate the degas mode that provides intermittent pulses of ultrasonic energy to drive off trapped air. This takes about ten minutes.
  3. Arrange pre-washed instruments in the separately provided tray in such a way to ensure minimum contact with each other. Cannulated or lumened instruments should be positioned at an angle to facilitate solution reaching internal surfaces.
  4. Lower the basket into the solution making certain that all instrument surfaces are immersed. Put the lid on the cleaner and set the timer for 10 minutes.
  5. At the end of the cycle remove the instruments and inspect them. If satisfied rinse instruments with DI water to avoid spotting and allow them to dry. They are now ready for sterilizing or disinfecting.

Consult your professional association regarding replacing used cleaning solutions. In some instances recommended replacement is after each use, or at least once daily. MedClean C7 is biodegradable but check with local regulatory agencies regarding proper disposal. Always rinse the tank with clean water before preparing and degassing fresh cleaning solution.

For more information on selecting and using ultrasonic cleaners for medical, surgical and dental practices contact the iUltrasonic experts.

Source: Recommended Practices for Cleaning and Care of Surgical Instruments and Powered Equipment

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