Care & Cleaning of microsurgical instruments

Surgical instruments should be stored in the sterilizing trays of proper size lined with soft silicone mats. Instruments should not touch each other. Protective tips made of soft silicone tubing of the proper size and thickness should be used. Do not use rubber or plastic protective tips, which can melt during autoclaving and cause damage of instruments.

Be sure to inspect every microsurgical instrument at the end of your surgical day. Please conduct this inspection under a microscope or magnification lens. If a damaged instrument is detected, replace it or have it repaired.

Use a mild soap solution and a soft brush to clean instrument and remove any stains. Never use abrasive powders or steel wool to remove stubborn stains — these can damage the superfine finish of an instrument and can actually help cause corrosion of stainless instruments. Use distilled or demineralized water to rinse instruments thoroughly, and then carefully dry them with a hot air blower or lint-free cloth.

This is the best method of cleaning for surgical instruments. Use only cleaning solutions recommended for stainless steel (demineralized or distilled water) and change the solution frequently. Heat water to 150° Fahrenheit (62°C) using an immersion heater, or in a separate stainless container if your unit does not have an automatic built-in water heater. Be sure that you and members of your staff are completely familiar with the manufacturer’s instructions, which came with your ultrasonic cleaner. Instruments should not touch each other in the wire basket. Rinse the instruments under running water first, and then rinse in clean demineralized or distilled water. Dry with a lint-free cloth or hot air blower.

Normally the microsurgical instruments do not require lubricating baths. However, it is recommended to lubricate all moving parts after each cleaning. Use only silicone or Teflon lubricants, which can hold up under autoclaving. We recommend using Instrument Milk (16-IM). Never use ordinary lubricants. Never cover up even the slightest corrosion with a lubricant.

Stainless steel and titanium instruments can be sterilized via steam autoclaving; chemical disinfectants, ethylene oxide gas, or even dry hot air. Gas and dry chemical sterilization are the best methods for instruments, but they take a lengthy time period to accomplish the desired result. The most practical method of sterilization is heat or steam, which require less time. However, these methods can be damaging to delicate stainless steel instruments. And, once again, be sure that you and members of your staff have read and understand the instructions supplied by the manufacturer of your particular sterilizer.

The diamond blade should be examined under high magnification prior to each use. Care should be taken to ensure the diamond blade never touches any metal surface. After each use the diamond should be immediately retracted into the handle. A technique should be developed between the O.R.personnel and the surgeon such that the knife is passed only when the diamond blade is retracted into the handle.