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Instrument Decontamination
Methods that Prolong Instrument Life
Types of Discoloration and Corrosion
Some of the most common
discolorations include:
 | Oxidation tints--
iridescent discolorations with flowing edges on instrument surfaces resulting from water
containing heavy-metal ions or silicates.
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| Water spots-- similar
oxidation tints with more well-defined edges caused by hard water.
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| Surgical debris--
yellow-brown to dark brown sports found in areas not easily accessed, such as in box
locks. This process can lead to pitting and visible damage to instrument surfaces.
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Corrosion types and causes include:
| Surface-- etching over a
wide area caused by destruction of the chromium oxide layer from contact with heavy
metals, strong acids, or caustics.
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| Water spots-- similar
oxidation tints with more well-defined edges caused by hard water.
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| Pitting-- a localized,
often rapid corrosion, usually caused by failure to immediately clean off saline solution,
bleach, iodine, tinctures, protein residues, or cleaning agents.
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| Stress cracking-- caused
by wear or abusive handling. Corrosion can start from debris left in stress cracks
after cleaning. Higher quality instruments are less susceptible.
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| Crevice-- observed as a
rust blister in parts of the instrument joined together, such as tungsten carbide inserts
at the instrument jaw.
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| Abrasion-- caused by
damage to the passivation coating where parts move opposite each other, such as the box
locks. Made worse by insufficient cleaning.
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| Contact-- results from
electrolytic contact between different metals. Must be mechanically removed by the
device manufacturer.
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| Rust-- appears in
crevices, cracks, and contact areas. Rust particles may be transmitted to other
instruments during cleaning, causing surface corrosion.
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Following these Do's and Don'ts can prevent discoloration and
corrosion:
Do begin the cleaning
process as soon as possible, especially if blood is present.
Don't pre-rinse
instruments in disinfectant solutions more than 30 minutes. Today's disinfectants
work in 10 minutes or less.
Don't place instruments
in saline that causes pitting.
Do use an
enzyme/detergent manual cleaning solution to increase cleaning speed and efficiency.
Do rinse repeatedly.
Deionized or distilled water is best.
Don't overload instrument
trays
Do make sure instruments
a fully open during cleaning. Complete organic matter removal will prolong
instrument life.
Don't use cleaners
containing greater than 2% available alkalinity. Strive for the least aggressive
cleaner that gets the instrument clean.
Do separate instruments
of dissimilar metals.
Do assure that
instruments are properly lubricated.
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Conclusion
Investment in surgical instrumentation is
significant, whether you're a large hospital, small clinic, or even a private practice.
Regardless of your situation, taking steps to assure proper instrument handling and
decontamination process will save time and money.
References
1 Proper Maintenance of Instruments. 5th Edition, 1993.
2 Recommended Practice for Central Service - Decontamination
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