A well-made, properly cared-for instrument can be expected to last 10 years. The most important considerations in extending the life of an instrument are appropriate use, careful handling, and proper cleaning and sterilization. Every instrument is designed for a specific purpose. Using it for an unintended purpose is a sure method of damaging an instrument. Examples of misuse include securing surgical drapes or opening a medicine vial with an instrument designed to grasp tissue. The proper cleaning of instruments during and after surgery can help to prevent stiff joints, malfunctions, and deterioration of the instruments’ material, including stainless steel. During surgery, instruments contaminated by blood or tissue should be properly wiped and rinsed in the sterile distilled water in the sterile field. Thorough rinsing is important to ensure removal of blood and other contaminants from hinges, joints, and crevices. Blood and foreign matter that are not removed or are allowed to dry and harden may become trapped in jaw serrations, between scissor blades, or in box locks, making final cleaning more difficult and the sterilization or disinfection process ineffective. It can cause instruments to become stiff and eventually break. Channels, or lumens, within instruments such as suction tips should be irrigated periodically to prevent blood from drying and adhering to the inside of the lumen. Neglecting this action can cause blood and other debris to remain in lumens throughout the postoperative cleaning, decontamination, and sterilization processes. A syringe should be present in the sterile field for the purpose of flushing lumens with water throughout the procedure. Flushing the lumen should be done below the surface of the water to prevent the aerosolization of debris. Instruments should be rinsed in distilled water. Saline should not be used for this purpose. Prolonged exposure to saline can result in corrosion and can eventually lead to the pitting of stainless steel. Pitting can permit entrapment of debris, interfere with sterilization, and result in the destruction of an instrument. Instruments should be handled carefully and gently, either individually or in small lots, to avoid possible damage caused by their becoming tangled, dented, and misaligned. During and after surgery they should be placed, not tossed, into the basin. Heavy instruments should be on the bottom, with the lighter, more delicate and fragile ones on top. Rigid endoscopes and fiberoptic cables should also be placed on top or separated. Fiberoptic cables should be loosely coiled, never wound tightly. When the procedure is complete, instruments that can be immersed are disassembled and all box locks are opened. Care should be taken to ensure that they are not tangled or piled high. Instruments should be returned to their respective containers or baskets to prevent sets from becoming incomplete, and they should be covered for transport to the decontamination area. All disposable blades and sharps should be removed and placed in a designated sharps container. Delicate instruments, endoscopes, and other specialty instruments may have to be separated and transported to the decontamination area in containers specifically designed to prevent damage to these devices. Instruments with cutting edges, pointed tips, or other sharp components should be placed in such a manner that sharp edges are protected and personnel responsible for cleaning and decontamination are not injured when reaching into the container.
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