Surgical Instrument Washer Sterilizers
Proper Sequence of Treatments
Study Results: After being cleaned in a properly designed Surgical Instrument Washer, that used an Ultrasonic Cleaner, an enzyme lubricating enzyme detergent: all instruments and utensils tested were sterile at the completion of the process.
APIC ABSTRACT Paper accepted for presentation at APIC
Eighteenth Annual Conference and International Meeting
Oral Presentation, Ann Drake, John Temple
Validation of the microbial safety of surgical instruments and utensils following automated cleaning by a properly designed surgical instrument washer disinfector
A. Drake, RN and L. Ayers, MD,
Ohio State University Hospitals
The application of universal precautions to instruments/utensils handling became an issue in the selection of replacement decontamination equipment for Central Sterile supply at our hospital. The new technology of an automated thermal disinfection Surgical Instrument Washer Decontaminator Washer Disinfector (TW)(CESCO TM, Mercersburg, Pa.) offered increased protection to our reprocessing staff due to decreased handling, but raised concerns about the efficacy of thermal disinfection as opposed to traditional washer sterilization. Because of the limited scientific documentation of this new technology, a study was undertaken to establish the microbial safety of finished products and to identify any feature or function failure which could adversely affect outcome.
The Surgical instrument Washer Proper Sequence of Treatments used was: cold water pre-wash, enzyme ultrasonic sonic bath, detergent wash, purified water rinses, surgical instrument lubricant rinse, and hot air drying at 240° F for 4 minutes. The Surgical instrument Washer was challenged with selected instruments and utensils that are considered to be very difficult to clean. Included were 30 each of stainless steel non-perforating towel clips and stainless steel and glass medicine cups. Each item was rinsed with a suspension of Staphylococcus aureus, Enterococcus fecalis and Candida albicans in nutrient media and then dried. The instruments were processed in the Surgical instrument Washer during times of high volume operation. All products were tested for sterility. Ten separate cultures were taken of the final rinse solution of instrument lubricant and de-ionized water prior to the drying cycle. A separate culture was taken of the instrument lubricant fluid. All instruments and utensils tested were sterile at the completion of the process. The Surgical instrument Washer is a valid replacement for the conventional washer-sterilizer.
The application of universal precautions for reprocessing became an issue in the selection of decontamination equipment for Central Sterile Processing, University of Ohio.