9 9
M AY 2 0 1 4 | O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
them all together and shake them up. Also, instruments such as scis-
sors or needle-holders should always be autoclaved in the open posi-
tion to ensure they're properly sterilized.
4. Arrange with caution. When you place instruments in
trays, make sure the tip covers are on them. And with very delicate
instruments, be sure to use a tray that has a silicone pad on the bot-
tom. The best pads feature finger-like holders; the instruments fit
between the fingers, so the tips aren't coming into contact with each
other.
5. Don't wait to wash. Flush cannulated instruments as soon
as they're done being used on the sterile field. Also, keep all instru-
ments moist on the sterile field, so the viscoelastics don't accumulate
in the cannulas, and debris doesn't accumulate on the blades of your
scissors or on the tips of your forceps. Once you're not using an
instrument, put it in sterile water on your back table, so its surface
remains moist.
6. Limit immediate-use sterilization. Some immediate-use
sterilization (flashing) will always be necessary. If you drop an instru-
ment and it's a one-only — or maybe you have 2, but you have doctors
working in 2 rooms — you have to do what you have to do. But if
you're wrapping and sterilizing your sets at the end of the day, and
using those instruments the next morning, you should be doing the
same for every one of your patients throughout the day. Every patient
deserves the same standard of care. If you're flashing under any other
scenario than the one described above, it probably means you don't
have an adequate number of instrument trays to meet surgeon needs
without cutting corners.
O P H T H A L M O L O G Y
OSE_1405_part2_Layout 1 5/8/14 2:24 PM Page 99
