The keys to preventing spots, stains and pits.
Sharon Greene-Golden, CRCST, FCS
Just because surgical instruments are made of stainless steel doesn't mean they'll never stain. A lack of attention to care and handling at the point of use and during the decontamination process can result in surface marking, discoloration and corrosion. This damage renders instruments unfit for use in the OR. Follow these rules to make sure your surgeons can depend on their instruments.
Point of use pre-cleaning
Instrument damage often begins at the point of use. Blood, pus and other body fluids contain chloride ions that, with prolonged exposure, will corrode a stainless steel surface. It doesn't take long. Surgical residue can easily mark or stain an instrument, especially if it's allowed to dry.
This damage is preventable if OR staff conduct point of use pre-cleaning throughout and immediately after each case. As instruments are used, wiping their surfaces and flushing their lumens with sterile water will remove debris before it has a chance to dry.
Nurses and techs can also give reprocessing a head start by making sure that instruments stay damp when they're sent to central sterile. Covering trays with wet surgical towels is a good idea, but spraying the instruments down with an enzymatic cleaner is even better. The cleaner (which is also available as a gel) not only keeps the tray's contents wet, but also prevents bioburden from eating away at them. Gross contamination just rolls right off.
One thing that surgical staffers must never do, though, is wipe instruments down with or immerse them in basins of saline solution. As a compound of sodium and chloride, the solution can corrode stainless steel in 30 minutes. The worst instrument corrosion I've ever seen was on items left in a pan of saline for an hour. The pitting was already visible.