The Principles of Medical Device Decontamination

Where washer disinfectors are employed, it is imperative that dedicated loading carriages that promote device cleaning and channel irrigation are used. Appropriate connectors must be used to connect devices to connection ports.

The manufacturers of decontamination process chemicals provide many classes of products for use in soaking, disinfecting and washing medical devices. These include pH neutral, mild alkaline (<pH 11.0) and alkaline formulations. Both pH neutral and mild alkaline chemistries may also contain specialised enzymes that digest protein, carbohydrates lipids or other components of surgical soil. Process chemicals containing enzymes are optimised for performance according to the pH of the product, recommended final concentrations and recommended contact times. The recommendations of the chemical and medical device manufacturers should be adhered to.

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Cleaning Checks and Process Qualification Testing

Post cleaning inspection and checks of Minimally Invasive Surgery (MIS) and robotic assisted surgical devices may require a number of steps as indicated by the manufacturer’s instructions, including the following:

• Drying of instruments and lumens using medical grade compressed air • Visual inspection (possibly requiring magnification) of devices for cleanliness, signs of defects or damage and careful inspection of any articulating joints and lumens • Lubrication of moving parts using a lubricant compatible with the sterilisation process

• Inspection of any insulated devices for cracks and defects • Function testing of articulated joints or moving parts

Semiquantitative protein measurements such as commercially available swab tests or devices for In Situ surface assessment may be used for routine quality control purposes for simple medical devices. These types of protein tests can provide an estimate of daily, weekly or monthly variation in total cleaning performance (of

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