Surgical Instrument Care,
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Prevent Surgical Instrument Corrosion
Corrosion Resistance Surgical Instruments Passive Layer   
Stainless steel surgical instruments are made of corrosion resistant high-grade specialty steels.  The key word here is “resistant”. Corrosion resistant does not mean  corrosion proof. One of the special characteristics of these steels is that the manufacturer forms a "passive oxide layer" on the surface, which protects them against  corrosion.  This makes surgical instruments as corrosion resistant as possible.  It is imperative that you must maintain the passive oxide layer to prevent corrosion and  maintain your surgery instruments in optimal condition.  If this is not done the stainless steel can corrode or stain which can reduce the life of the surgical instrument or  render it useless. All “stainless steel” surgical instruments have the same corrosion resistance. When strength and hardness requirements are important factors for  instrument function, corrosion resistance is generally lower. Increasing the corrosion resistance would soften the stainless steel. Manufacturers of surgical instruments and  surgical instrument containers recommend the use of neutral pH cleaning concentrates. Newly developed neutral pH all-in-one or "combination" cleaning concentrates have  been shown to be effective in optimizing the efficacy of the "passive oxide layer". This will provide a longer life for stainless steel surgical instruments. More information and studies regarding the "passive oxide layer" of Surgical Instruments is below.
Passive Layer and Cleaning Surgical Instruments cleaner. Cleaning Surgical Instruments passive layer renders stronger resistance. Passive Layer and Cleaning Surgical Instruments cleaner. Cleaning Surgical Instruments passive layer avoids Surgical Instrument pitting.
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Neutral pH Cleaning Detergent recommended by Manufacturers Surgical Instruments
Virtually all manufacturers of surgical instruments, rigid scopes, flexible scopes, and instrument containers recommend the use of neutral pH cleaning concentrates. Generic  Example of this recommendation: Do not use high acidic (pH <4) or high alkaline (pH >10) products for disinfection or cleaning, since these can corrode metal, cause  discoloration or stress fractures.
Do not use abrasive pads or cleansers for optimal surgical instrument care, which will scratch the surface allowing dirt and water deposits to collect. Abrasive cleaning will remove the protective passive layer. Do not use high concentrations of chlorine bleach to clean or disinfect stainless steel instruments, as pitting will occur. Never use bleach to clean any surgical instruments.  The high pH of bleach causes surface deposits of brown stains and might even corrode the instrument.  Even high quality stainless steel is not impervious to an acidic  bleach solution. Sort instruments by similar metal for subsequent processing so that electrolytic deposition (galvanic corrosion) due to contact between dissimilar metals will not occur.
Rinsing Instruments - Tap or "Source" Water for optimal surgical instrument care.
Tap water can contain many minerals, which may discolor and stain surgical instruments.  It is recommended that de-ionized water be used for the final rinsing to prevent  spotting. all-in-one or "combination" cleaning concentrates can be effective in treating unacceptably hard source water and removing hard water encrustation from surgical  instruments and equipment.  If untreated tap water is used for final rinsing, then the instruments must be dried immediately to avoid staining.
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Cleaning, Conditioning, Disinfection & Sterilization  of Surgical Instruments. 
Clean instruments as quickly as possible after use. Do not allow blood and debris to dry on the instruments.  If cleaning must be delayed, place groups of instruments in a  covered container with appropriate detergent or enzymatic solution to delay drying. The use of pre-soaking enzyme foam sprays has been shown to reduce the time  expended for manual cleaning and render higher quality outcomes. After surgery, open all box locks and disassemble instruments with removable parts. This will limit blood  drying on instruments that may cause them to corrode. The "all-in-one" pre-soak & cleaner foam spray delivers a chemical complex to: maintain hydration of bioburden,  prevent corrosion, clean the surface, and condition instruments & scopes. This will significantly reduce manual cleaning and facilitate cleaning lumens inside-and-one.  Enzymatic foam sprays and/or all-in-one "combination" cleaning concentrates render excellent outcomes and facilitate cleaning instruments and scope inside-and-one,  effectively cleaning the surface while cleaning lumens and working channels. This can eliminate or reduce the manual labor expended, rendering lower reprocessing costs  and improving turnaround.
Cleaning is the Prerequisite for Sterilization of Surgical Instruments. 
The reprocessing decontamination process, whether done manually or automatically in a washer-decontaminator- disinfector, can only be effective if cleaning is adequate.  Effective disinfection or sterilization: (Generic Sterilization with a Pre-Vacuum Sterilizer (HI-VAC): 270-272° F (132-134° C), 16-minute exposure time, with 4 pulses and a  30-minute dry time. Generic Sterilization with a Gravity Displacement Sterilizer: 270-272° F (132-134° C), 30-minute exposure time, with a 30-minute dry time.) Sterilization  of an inadequately cleaned instrument is not possible. Cleaning is the prerequisite for sterilization.
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Ultrasonic Cleaning Surgical Instruments 
Ultrasonic cleaners are very effective when used with hot water per manufacturer’s recommended temperature and specially formulated detergents. It is recommended that  all visible debris and blood be removed from the instrument prior to ultrasonic cleaning. Contact between dissimilar metals can cause corrosion when ultrasonics is applied.  Sort surgical instruments according to similar metal types to prevent corrosion. (electrolytic deposition - galvanic corrosion) It is not recommended to clean plated  instruments in an ultrasonic cleaner since the ultrasonic vibration and the presence of other sharp instruments may crack or rupture the plating. Ultrasonic Cleaners are not  as effective as washer decontaminators in providing the complete "proper sequence of treatments" i.e. final rinse(s) that are purified and/or have temperatures elevated to  disinfection levels. Ultrasonic Cleaning can effectively remove: long term encrustation and surgical cements or glues that have dried onto instrumentation. Overloading, and  low water temperature, will decrease the effectiveness of ultrasonic equipment.
Ultrasonic cleaners are effective when used with hot water per manufacturer’s recommended temperature and specially formulated detergents. It is recommended that all  visible debris and blood be removed from the instrument prior to ultrasonic cleaning. Sort instruments by similar metal for subsequent processing so that electrolytic  deposition (galvanic corrosion) due to contact between dissimilar metals will not occur. It is not recommended to clean plated instruments in an ultrasonic cleaner since the  ultrasonic vibration and the presence of other sharp instruments may crack or rupture the plating.
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Surgical Instrument Lubricants 
To maintain moving parts and protect instruments from staining and rusting during sterilization and storage, they should be lubricated with a water-soluble, preserved  lubricant after each cleaning. Most automated washer decontaminators provide the option for lubrication at the end of the final rinse treatment. Since effective ultrasonic  cleaning removes all lubricant, re-lubrication is important. A complete "all-in-one cleaner" will provide lubrication. The lubricant should contain a chemical preservative to  prevent bacterial growth in the lubricant bath. The bath solution should be made with de-mineralized water. A lubricant containing a rust inhibitor helps prevent electrolytic  corrosion of points and edges. Immediately after cleaning, instruments should be immersed or rinsed for 30 seconds and allowed to drain off, not wiped off. A lubricant film  will remain through the sterilization to protect them during storage.
Prevent Surgical Instrument Stains and Surgical Instrument Spotting
Staining and spotting may result if residual chemicals are not completely rinsed from instruments that are subjected to steam sterilization. Following the manufacturer’s  recommendations for the proper sequence of treatments (cold water pre-wash, enzyme/detergent wash, purified water rinse/lubrication, and drying) is critical in preventing of  staining and spotting. Cleaning concentrates should be "free-rinsing" to avoid spotting instruments.
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Studies regarding the "passive oxide layer"  of Surgical Instruments. 
(Guidelines on metals and alloys in contact with food; Council of Europe; published 11.10.2000. Systemic nickel: the contribution made by stainless steel cooking  utensils; Contact Dermatitis, Volume 32:2, 1994) of the stainless steel passive layer to prevent corrosion have revealed a reduction in corrosion prevention with the use of  cleaning concentrates that are not neutral pH. The use of cleaning agents that deliver an acid rinse will release nickel from the stainless steel and decrease the efficacy of  the passive layer. This is most critical on initial reprocessing events of stainless steel surgical instruments. Measurable levels of nickel have been detected. It was also  shown that, as the number of subsequent uses increased, the level of nickel release diminished and reached a steady state (measured in the order of μg/l). These  observations reflect the changes that occur in the passive oxide layer on first immersion of stainless steels in aqueous media.
What is the Stainless Steel  of Surgical Instruments?
Stainless steel is essentially a low carbon steel which contains chromium at 10% or more by weight. It is this addition of chromium that gives the steel its unique stainless,  corrosion resisting properties. The chromium content of the steel allows the formation of a rough, adherent, invisible, corrosion-resisting chromium oxide film on the steel  surface. If damaged mechanically or chemically, this film is self-healing, providing that oxygen, even in very small amounts, is present. The corrosion resistance and other  useful properties of the steel are enhanced by increased chromium content and the addition of other elements such as molybdenum, nickel and nitrogen. Stainless steel has  a passive film created by the presence of chromium (and often other alloying elements, nickel, molybdenum) that resists this process. When exposed in air, stainless steels  passivate naturally (due to the presence of chromium). But the time required can vary. In order to ensure that the passive layer reforms rapidly after pickling, a passivation  treatment is performed using a solution of nitric acid and water.
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How is the passive oxide layer of surgical instruments manufactured ?
Why should we enhance the passive layer of surgical instruments for  for optimal surgical instrument care? The passive layer or stainless steel is intended to prevent or resist corrosion. The process is called “Passivation”. “Passivation” and Polishing eliminate the carbon molecules  form the instrument surface. This forms a layer which acts as a corrosive resistant seal. Passivation is a chemical process that removes carbon molecules from the surface  of the instrument. This chemical process can also occur through repeated exposure to oxidizing agents in chemicals, soaps, and the atmosphere Polishing is a process  used to achieve a smooth surface on the instrument. It is extremely important to polish an instrument because the passivation process leaves microscopic pits where the  carbon molecules were removed. Polishing also builds a layer of chromium oxide on the surface of the instrument. Through regular handling and sterilization the layer of  chromium oxide will build up and protect the instrument from corrosion. In some circumstances, that is why you will notice older instruments less corrosive than new ones.  The newer instruments have not had the time to build up the chromium oxide layer. However, improper cleaning and sterilization can cause the layer of chromium oxide to  disappear or become damaged thus increasing the possibility of corrosion. That is why it is so important to properly clean, sterilize, and store your instruments.
John Temple
Product Development
Surgical Instrument Care,
Cleaner Surgical Instruments,
Cleaning Surgical Instruments,
Surgical Instrument Care,
Cleaner Surgical Instruments,
Cleaning Surgical Instruments,
The all-in-one Enzyme Detergent easy Foam Spray delivers long lasting hydration and immediately begins to break down blood, fat, and protein. The Enzymatic Detergent Foam Spray keeps instruments moist, prevents bio-burden from drying/encrusting surgical instruments, inhibits bacterial growth, and prepares the instrumentation for reprocessing. The neutral pH Enzyme Detergent easy Foam Spray is safe for flexible and rigid scopes, stainless steel, tungsten carbide, aluminum, brass, plastic materials and delicate eye surgery microsurgical instruments. Compare all-in-one instrument cleaning to other enzymatic cleaners and cleaning chemicals.
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The multi-tiered Enzyme Detergent Surgical Instrument Cleaner
all-in-one 4 Enzyme-Detergent easy Foam Spray.
prevent corrosion
The High Level multi-tiered Enzymatic Complex used in the all-in-one 4 Enzyme-Detergent easy Foam Spray  is designed to deliver high quality outcomes with rapid results. The all-in-one will lower reprocessing costs and render high quality results. Compare all-in-one instrument cleaning to other enzymatic cleaners and cleaning chemicals
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The all-in-one High Level multi-tiered enzymatic-detergent cleaners are powerful against bioburden yet safe for all rigid and flexible instrument materials.  The High Level multi-tiered enzymatic complex, available in ergo-Logistics products, rapidly breaks down and removes bioburden, prevents incrustation, and protects surgical instrumentation.
Custom Stainless Steel Casework and Standard Stainless Steel Casework Products include:
Ergonomic workstations 
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TBJ-SPD Surgical Case Carts transport shelving and create space.
Surgical Case Carts that Transport shelving that can be used as a Surgical Setup Table or Surgical Back Table. TBJ-SPD Surgical Case Carts Reduce the space used 80%.
4 Enzyme Detergent easy FOAM-it delivers the enzymes needed for removing bioburden.
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ONE gallon of the highly concentrated all-in-ONE Surgical Instrument Cleaner will deliver 512 gallons (1938 liters) of  Surgical Instrument Cleaner with Conditioners.
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