Care and maintanance
of surgical instruments

Information on disinfection, cleaning and sterilization of surgical instruments

Treatment of brand new instruments

Brand new instruments must be cleaned before the first sterilization or use. Protective caps and protective films must be removed completely, for example in the case of chisels, raspatories or microsurgical instruments.

Cleaning-Disinfection-Sterilization of motor systems and handpieces

Aesculap motor systems and the handpieces require maintenance and are renowned worldwide for their reliability. Premature wear and malfunctions can be avoided by following the instructions for care listed below and the lubrificating instructions for the handpieces in the respective instructions for use. If the devices need repair or maintenance after all, please contact your local Aesculap representative.

• For machine cleaning, place instrument in a wire basket suitable for the cleaning process (make sure cleaning solution and rinse water from maschine comes into contact with all parts of instrument).
• Completely dismantle any dismantable instruments.
• Preferably dry disposal.
• For wet disposal, use an active cleaning disinfectant. Rinse the instrument thoroughly with clear, flowing water before machine cleaning and disinfection.

If necessary, treat with ultrasound according to the manufacture's instructions:

• For effective mechanical support during manual cleaning
• For pre-treatment of instruments with dried-on grime before machine cleaning
• Microsurgical instruments and instruments with fine working ends should not be treated with ultrsound. They should be cleaned either manually or in the washing machine. In case of cleaning in a machine please use a suitable storage rack.
• Clean manually or in a machine. Follow manufacturer's instructions. 

• Place instrument into a suitable disinfectant with active cleaning properties so that all surfaces, inner cavities, lumens and openings come into contact with the solution. Follow the disinfectant manufacturer's instructions. 
• After chemical disinfection, always rinse thoroughly with clear, flowing water. Follow the instructions provided by the manufacturer of disinfectant. 
• Remove any dirt still clinging to the instrument with a soft synthetic brush. Do not use a scouring or metal brush. 
• Clean any lumens and conduits with soft, round, synthetic brushes. Please note, the lumen and the brush must have the same diameter. 
• Final rinsing to be done with distilled or deionized water. 
• Dry instrument with an absorbent, soft and lint-free cloth. 
• Dry lumens and conduits with compressed air.

Care/testing

• Let instrument cool down to room temperature.
• Lubricate movable parts (e.g. joints and ends) slightly with special sterilization-capable, vapor-permeable lubricant (e.g. STERILIT oil spray JG 600 or Lubricant JG 598, physiologically safe according to DAB and § 31 LMBG).
• After each cleaning, disinfection process, check the instrument to make sure it is clean, it functions properly and it has not suffered any damage, e.g. bent, broken, factured or worn parts.
• Discard any damaged and defective instruments and replace.

Storage

• Place instruments with the fine working end and/or microsurgery instruments in a suitable storage racks.
• Secure instruments with lock in the first detent.

Steam sterilization must be carried out according to a validated stream sterilization process (e.g. with a sterilizer meeting the specifications of EN 285 and validate according to EN 554).
When using the fractionnal vacuum method, use the 134°C/2-bar program for sterilization with a minimum hold time of 5 minutes.

Statement of the working group instrument preparation concerning treating instruments for reuse in cases where Creutzfeldt-Jakob disease is suspected.
Reusable instruments that have been used on patients with suspected Creutzfeldt-Jakob disease must be subjected to special treatment processes when preparing them for reuse.
The "Working Group Instrument Preparation" is not in a position to assess the effectiveness of the various recommendations made so far. As, however, all these treatment processes have a more or less considerable influence on the retention of the value of reusable instruments, the Working Group recommends establishing a procedure which complies with the following criteria:
No sodium hypochlorite (chlorine bleaching lye) may be used for soak treatment, as irreversible corrosion damage would be done to instruments by such a solution. 
When using caustic soda lye, materials such as aluminium are unsuitable due to their low corrosion resistance and may therefore not be used in such a case. 
A cleaning process including the necessary rinsing must be carried out between immersion treatment and sterilization in order to completely remove the bath residues prior to sterilization. A machine cleaning process is recommended.

Information on disinfection, cleaning and sterilization of B. Braun medical products

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• Select the program according to the material (e.g. stainless instrument steel, aluminium) of the instrument to be cleaned. Follow the machine manufacturer's instructions.
• Final rinsing to be done with deionized water.
• Leave sufficient time for drying.
• Remove the instrument from the machine immediately after the program is done.