8 best practices for surgical instrumentation protection


Surgical instruments are one of the largest dollar assets of a hospital. Proper use of instrument protection devices and packaging aids can ensure costly surgical instruments are kept in top working condition. 

In a Sept. 11 webinar hosted by Becker's Hospital Review and sponsored by Healthmark Industries, Cheron Rojo, sterile processing department educational coordinator for Healthmark, discussed surgical instrument design and best practices in instrument protection.

When Mr. Rojo entered the field as an SPD technician in the mid-1990s, first-generation laparoscopic instruments did not even come apart. "We've come a long way," Mr. Rojo said, "Now laparoscopic instruments can be completely taken apart — or they're disposables."

These changes were mostly driven by a shift from open to laparoscopic surgery across multiple specialties. More complex and delicate instruments led to surgical advancements and greater financial costs.

Stainless steel is the most frequently used metal in instrument trays, and stainless-steel instruments are preferred because they can withstand rigorous use and exposure to processing with steam sterilization.

Passivation is a chemical process that removes all iron particles, leaving a corrosion-resistant surface by forming a thin transparent oxide film. The process subjects the instrument to diluted acid and oxidizing salts.

Polishing protects the passivation layer and promoting its continued buildup. If the oxidized layer is destroyed or damaged, the instrument will have a greater tendency to rust.

"Protecting instrumentation will help you reduce your repairs, protect your instrumentation and make them last longer," Mr. Rojo said. During the webinar, Mr. Rojo detailed best practices for protecting surgical instruments.

8 best practices for surgical instrumentation protection

1. Inspect with enhanced visual magnification tools: Standards and guidelines support inspection with enhanced visual magnification tools. Before assembly, inspect instruments for pits, cracks, bent tips, misalignment and corrosion. Make sure moving parts work freely and the instruments are in perfect operating condition.

Depending on your department procedure, tag and remove rejected instruments from trays. Load instrumentation in a way to evenly dispense the weight in the tray. The total weight of the instrument set should not exceed 25 pounds or a weight documented by the manufacturer of the sterilizer or container system.

2. Wrap "like-metals" together: Wrap "like-metals" such as copper/brass and stainless steel/chrome-plated instruments together, using tray liners or towels to separate them where necessary.

3. Wrap small, delicate instruments separately: Wrap the smallest, delicate, and sharp-cutting instrumentation in woven or nonwoven towels, or other specially designed pouches. Use medical grade silicon ties to bundle instruments together. Rubber bands should not be used to hold instruments together.

4. Keep instruments organized and open: Place ring-handled instruments on stringers, pins or racks to keep them open. Point clamps with curved jaws in the same direction to protect tips. Position cupped or concave instruments to avoid water collection

5. Handle with care: Instrumentation should be carefully handled and removed from instrument trays and processing baskets. They should never be dumped onto work tables.

6. Choose the correct type of tray: Choosing the correct type of tray for the right reasons for all instrumentation types, procedures and sterilization methods will save money in the long-term.

7. Protect delicate tips: Protect sharp tips with protectors that can be sterilized. Make sure the OR knows which tip protectors are selected.

8. Involve your OR: The care of critical surgical instrumentation lies in the hands of the sterile processing technicians and the surgical team. Their attention to detail when following proper care and handling procedures will assure the safe use instrumentation, contributing to the best quality patient care outcomes.

Education is essential because SPD and OR teams must understand the importance of protecting instrumentation every time. Protection saves money in the long run. "It might increase your budget," Mr. Rojo conceded, "but it will reduce your repair costs as well."

Listen to the webinar recording here.

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