The Principles of Medical Device Decontamination

Decontamination (Special considerations for complex devices)

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Preparation of devices for reprocessing

Preparation of surgical instruments for decontamination starts at the point of use. Intraoperative manual cleaning is paramount by either the nurse specialist or assistant surgeon during the procedure. Immediately post-operatively the tips of the Endowrist i should be contained within an enzymatic solution, this will commence the protein breakdown prior to decontamination. This can be done using distal tip soakers that contain enzymatic solution. Instruments should remain moist after the surgical procedure and during transport to the decontamination department by wetting instruments in water or a pH neutral pre-cleaner or foam. This is especially important for electrocautery instruments where the heat of cauterisation can leave surgical eschar on the working end of the instrument, which is more difficult to remove if the soil is allowed to dry. It is important any such agents used to retain devices in a moist environment, must be compatible with the device and not degrade any critical components that may be part of the device or control mechanism. Some manufacturers of surgical devices describe manual pre-cleaning steps as part of the instructions to prepare devices for further ultrasonic or machine reprocessing in a washer disinfector. These steps may include soaking in a detergent solution, brushing, highpressure spraying using a water pistol, flushing of internal surfaces, rinsing, etc. Aggressive brushes, such as those made with steel or brass bristles, should be avoided to avoid damage to sensitive components or cutting surfaces. Consult the manufacturer’s instructions to confirm what is recommended and contraindicated. Complex medical devices should be inspected for visual soil after the manual pre- cleaning steps and prior to automated reprocessing in a washer disinfector. This inspection can be performed with the unaided eye or with a magnifying glass. The steps of the manual precleaning process should be repeated for devices with visible residual soil.

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