4 6 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E M A Y 2 0 1 6
the physician is finished using a surgical instrument, it gets handed off to a nurse
or tech responsible for pre-cleaning. Surgical instruments are wiped down to
remove gross soil and then sprayed with an enzymatic cleaner.
Some facilities just rinse instruments in water or throw a wet towel on top
and consider this first step satisfied. However, enzymatic sprays specifically
designed for this task boost your decontamination process, because the solu-
tions start removing bioburden as soon as they contact the instrument, which
makes cleaning it even easier for techs down the line. Some sprays can even
keep instruments moist for up to 72 hours, a benefit that we rely on at our facili-
ty since some of our off-campus clinics send their instruments to our central
sterile department once a day.
Make sure the enzymatic spray you use is non-aerosol, which lets your
staffers safely spray instruments immediately after use in the OR, even if a
patient is still in the room.
2. The right cleaning agent
After used instruments are pre-cleaned, they are brought to the decontamination
area in a closed container or cart. This starts our assembly line process to get the
instruments ready for sterilization.
We start by placing the instruments into mesh baskets where we rinse off the
enzymatic pre-cleaning solution. This step is crucial — we use one type of enzy-
matic cleaner for the point-of-use cleaning and different agents for the pre-soak-
ing and washing steps in the decontamination area. You don't want the
chemistries of the different enzymatic solutions to mix or dilute the next step's
agent, which could compromise the decontamination process or leave a chemi-
cal residue behind.
The type of cleaner and enzymes you need depends on your instrument
manufacturers' instructions for use (IFUs). There are several different types of
enzymes available in detergents:
• Protease enzymes treat proteins such as blood, mucous, feces and albumin. They take large
