Surgical instruments are a necessary expenditure of hospitals and health centers around the world must make to run a successful healthcare organization. Without them, they would not be able to function. Whether it is a specialized instrument like an endoscope, or a more general tool like a clamp, surgical instruments are a necessity that cannot be overlooked. Because of this, and because of the large price tag that is often associated with such instruments, utmost care has to be devoted to their maintenance. In doing so, not only will their useful lifespan extend, but the safety of the patients exposed to them will also improve.
How to Maintain Surgical Instruments
When surgical instruments are properly maintained, the doctors using them know with certainty that any procedure they perform will encounter less complications in the operating room. For example, imagine using an endoscope that was previously damaged. The damage was minimal, but it was damaged nonetheless. And because proper maintenance protocols were not established or adhered to, the damage went undetected. Without going into detail about what could happen if the endoscope is used in surgery—suffice to say that it could include a surgical site infection and a hefty lawsuit—everything could have been avoided with a proper inspection followed by a trip to get endoscope repair services from organizations like Surgical Solutions.
- Cleaning, disinfection and/or sterilization
- Inspecting
- Testing
Cleaning and Sterilizing
- Autoclave sterilization
- Ethylene oxide sterilization
- Dry heat sterilization
- Microwave sterilization
- Etc.
Inspecting
- Cleanliness
- Corrosion
- Damage or defects
- Missing or loose parts
- Proper alignment and functioning mechanisms
Testing
- Scissors
- Hold the scissors as a surgeon would.
- Open the scissors half-way and close on the test material or glove. The cut should be smooth and even to the tip, without snagging.
- Open the scissors and gently drop one handle. The scissors should engage with tension at ½ to ⅓ of the closure point.
- Rongeurs
- Cut a 3×5 index card, business card or material of similar weight. Two-thirds of the cutting edge of a bone rongeur must cut the test material smoothly, without tearing. The bite should be clean without snagging or tearing (except Pituitary Rongeurs).
- Pituitary Rongeurs should make an even, uniform impression on the test material.
- Cut a 3×5 index card, business card or material of similar weight. Two-thirds of the cutting edge of a bone rongeur must cut the test material smoothly, without tearing. The bite should be clean without snagging or tearing (except Pituitary Rongeurs).
- Osteotomes
- Using a plastic testing rod or dowel, or a plastic syringe barrel, place osteotome at a 45° angle. The cutting edge should not “slip,” but will engage evenly on the rod.
- Needle Holders
- The jaws of the needle holder should come together at the tips, without having to apply closing pressure on the first ratchet.
- Close the jaw to one ratchet and assure that light cannot be seen through the jaws.
- Close the jaw to one ratchet onto test material (e.g. aluminum foil). Check for the outline of the jaw and impressions of serrations (if present).
- Open the needle holder and drop one side of the handle gently. It should be ½ to ⅓ closed.
- Clamps
- Close the clamp on the first ratchet and hold it up to the light while continuing to close the ratchet. No light should be seen passing through the jaws, with the exception of vascular clamps.
- As with the needle holder, drop one side of the handle gently. It should be ½ to ⅓ closed.
- Vascular Clamps
- To test the atraumatic “teeth”, fill a zip lock bag with water.
- Close the clamp at one corner of the bag to test if the liquid is protected from flowing into the clamped corner.
- Remove the clamp and check that there are no holes or perforations.
- Forceps
- Toothed forceps should engage evenly when being closed. The teeth should be sharp and equally sized.
- When closing or opening thumb forceps with a guide pin, the pin must slide centrally into the guide hole and the pin must not jam or rub.
- Most ratcheted instruments should open completely and hold test material at each step of the ratchet (with the exception of vascular clamps).
- Curettes
- Test sharpness on a plastic rod or dowel or syringe barrel, as with the osteotome.
- Assure the cutting edge is clean, smooth and intact.
How to Repair Surgical Instruments
Final Thoughts
Author: Raynetta Stansil
Raynetta earned her BA in Healthcare Administration from University of Phoenix in 2016. In 2019, she will be completing her Master’s in Healthcare Administration from Ohio University. When not immersed in some form of healthcare education, Raynetta enjoys spending time with her husband and two sons in their hometown of Gary, IN.
