Why do surgical instruments require pre-treatment?

Thorough cleaning of surgical instruments is the key to ensuring successful sterilization. It can extend the life of instruments and ensure surgical safety. It is also an important factor in controlling hospital infections. And the starting point of all this starts with an often overlooked link - preprocessing.

What is preprocessing?

Instrument pretreatment refers to the preparation work performed on the instrument before cleaning, disinfection and sterilization in the sterilization supply room, including instrument moisturizing, classification, disassembly and pre-cleaning. Its purpose is to Ensure the functional quality of instruments and the quality of disinfection, sterilization and reprocessing 。

What are the hazards of substandard pretreatment?

Once the residual organic matter on the equipment solidifies, it will greatly increase the difficulty of cleaning and disinfection, making it very difficult to clean again, thus affecting the cleaning, disinfection and sterilization effects. Residual blood, body fluids and other organic matter can easily cause various bacteria to grow and multiply, forming bacterial pockets, leading to the growth of bacterial biofilms on the surface of the equipment, resulting in failure of disinfection and sterilization, thus causing cross-infection.

At the same time, insufficient pretreatment will also affect the service life of the equipment, cause serious problems of equipment rusting and re-rusting, increase the risk of occupational exposure, and endanger the personal safety of workers.

Where is the initial pretreatment of reusable surgical instruments done? By whom?

Generally, after use, reusable surgical instruments are initially pre-processed on-site by the using department, and then sent to the sterilization supply room. That is to say, The user is responsible for completing the initial preprocessing 。

What is the best time to pretreat reusable surgical instruments?

Research shows that surgical instruments must be preprocessed within 1 hour after surgery, and the instrument cleaning pass rate meets the requirements. However, Pretreatment within 0.5 hours will give the best results . The longer it takes, the easier it is for stains to dry out and solidify, making subsequent cleaning more difficult.

Operating technical principles of pretreatment

1. Pretreatment should be carried out on site between uses or immediately after use.
2. The device manufacturer's instructions or instruction manual should be followed.
3. Medical devices that are closed and collected in a centralized manner will be cleaned and pre-processed in the decontamination area by the staff of the sterilization supply center.
4. The principle of device protection should be implemented throughout the entire device handling process.
5. Instruments that cannot be sent to the sterilization supply center in time should be moisturized.
6. Methods that are corrosive to instruments should not be used.
7. Specially infected medical devices should be handled in accordance with WS/T 367-2012.

What is the content of preprocessing of reusable equipment?

1. For reusable instruments and items after use, disposable parts, such as blades, needles, threads, gauze, cotton balls, chemical indicators, internal and external packaging materials, absorbent paper and other disposable items, should first be removed to reduce the spread of contamination and reduce the risk of occupational exposure.
2. Empty the liquid from the container. Even if there are no stains visible to the naked eye, containers holding physiological saline and disinfectants should be rinsed with running water to prevent chloride and disinfectants from corroding and damaging the containers.
3. Rinse immediately under running water to thoroughly remove stains and blood stains visible to the naked eye. Pay special attention to removing stains and blood stains in the lumen of lumen instruments.
4. Keep the contaminated equipment moist to prevent dirt from drying on the surface of the equipment. Spray the equipment with special moisturizer (neutral or multi-enzyme moisturizer) or cover it with a wet towel. Store it in a closed storage box, place it in a fixed place, and keep it closed.
5. Contaminated instruments with special infections should be double-sealed and double-tied in a double-layer yellow special plastic bag, and the type of infection should be noted.

Proper equipment pretreatment is to ensure the safety of staff and the environment; to improve the cleaning pass rate and equipment turnover rate; to protect valuable equipment; and to prevent blood from drying up, costs can be effectively controlled.