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All sterilized items should be labelled with the date that sterilization was performed.

Repeated use of clipper blades without sterilization not surprisingly results in higher levels of bacterial contamination of blades. Abrasions or microabrasions can facilitate colonization and proliferation of various opportunistic bacteria. If skin lesions are noted at the time of clipping or after surgery, the incident should be recorded and investigated in order to determine whether instrument cleaning, maintenance or replacement, or personnel training is required.

Weese, J.S. (2008) A review of post-operative infections in veterinary orthopaedic surgery. Veterinary and comparative orthopaedics and traumatology, vol.21, pp.99-105.

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Delicate instruments should be packed with protective tips and silicone storage box inserts or in suitable racks to stop them rattling around. Heavy instruments should not be stored on top of lighter equipment.

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Delicate instruments should be packed with protective tips and silicone storage box inserts or in suitable racks to stop them rattling around. Heavy instruments should not be stored on top of lighter equipment.

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Manual washing should be done with hard plastic brushes, with the instruments immersed in demineralised or distilled water with enzymatic detergent at a neutral pH, under 45ºC, in order to avoid the coagulation of protein substances.

https://www.veterinary-practice.com/article/surgical-instruments-care-and-handling

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Washing should remove all the dirt and biological debris from the surface of the materials and should be performed within 30 minutes of the end of the surgical procedures. To prevent blood from drying on the materials we suggest covering them with a damp towel.

The instruments shouldn't be overexposed to physiological saline solutions, since prolonged contact promotes oxidation.

At the beginning of the washing process the material should be rinsed under running water, while opening and closing the instruments. Manual washing should be done with hard plastic brushes, with the instruments immersed in demineralised or distilled water with enzymatic detergent at a neutral pH, under 45ºC, in order to avoid the coagulation of protein substances. We recommend always using new detergents and washing solutions since the overuse increases chemical concentration due to evaporation, favouring the corrosion of the materials and reducing the effectiveness of the disinfection.

Ultrasonic cleaning by cavitation is the most effective cleaning method.

Disinfection can be effectively achieved by immersing the instruments in enzymatic detergent, at neutral pH, for 90 minutes at 25°C. At the end the instruments should be rinsed with demineralised or distilled water and dried with paper towels. Do not use alcohol when cleaning materials.
2. Lubrication
Cleaning may render instrument's joints stiff due to mineral deposits and other impurities in the water system and regular metal to metal friction causes corrosion. Blue recommends applying a spray lubricant to all surfaces and instrument joints after each cleaning cycle.
3. Inspection
Before carrying out the sterilisation inspect each instrument and confirm the correct function of the joints, cleanness and general condition of the material.
4. Sterilisation
Sterilisation is essential to ensure that surgical instruments do not act as pathogen vectors. The most common method is autoclaving.

In the autoclave the instruments must always be in the open position to allow the steam to reach all surfaces. Do not overload the autoclave trays, which would block the steam penetration. The temperature, cycle duration and pressure should be those recommended by the manufacturer.

Regardless of the steriliser class, complete drying of all instruments and implants should be assured to prevent their degradation. The use of dry heat is not recommended for the sterilisation process.

Unpackaged instruments should be used immediately. Packaged instruments should be stored in a dry, closed and warm place.

Cold sterilisation, with prolonged immersion in enzymatic detergents, can impair delicate instruments. Avoid using solutions with benzium ammonium chloride on instruments with tungsten.

Most problems with the instruments can be attributed to one or more of the following causes:

Improper cleaning and drying immediately after use;

Prolonged exposure to sterilisation solution or use of corrosive solution;

Using normal running water instead of demineralised or distilled water in the cleaning and sterilisation processes;

Using non-recommended detergents or lubricants;

Some sort autoclave failure.

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1. Cleaning and Disinfection Washing should remove all the dirt and biological debris from the surface of the materials and should be performed within 30 minutes of the end of the surgical procedures. To prevent blood from drying on the materials we suggest covering them with a damp towel.

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all biological debris and blood should be washed within 30 minutes to prevent biological matter drying on the instruments- should place damp cloth on equipment to prevent this.

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all biological debris and blood should be washed within 30 minutes to prevent biological matter drying on the instruments- should place damp cloth on equipment to prevent this.

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Users of ultrasonic cleaners should be aware that the cleaning fluid could result in endotoxin contamination of surgical instruments, which could cause severe inflammatory reactions

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In the autoclave the instruments must always be in the open position to allow the steam to reach all surfaces. Do not overload the autoclave trays, which would block the steam penetration

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Care

Instruments should only be used for the purpose for which they were designed. Allis tissue forceps should not be used as bone holders and Metzenbaum scissors should not be used for cutting sutures!

Instruments should always be placed on surfaces, not dropped or thrown.

Heavy items should not be placed on top of, or adjacent to delicate equipment.

Instruments with cutting blades should be protected to avoid dulling of the edges.

Protective sheaths should be left in place until the instrument is ready for use.

During surgery, the scrubbed nurse (if utilising this role) should ensure that the instruments are kept free of blood and debris by wiping with a sterile moistened swab after each use.

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Cold sterilisation, with prolonged immersion in enzymatic detergents, can impair delicate instruments. Avoid using solutions with benzium ammonium chloride on instruments with tungsten

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https://bvna.org.uk/blog/care-and-maintenance-of-surgical-instruments-by-linda-capewell/

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Rust and contaminants in the steam pipes of your autoclave will transfer to your instruments, so autoclave maintenance is important

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Rust and contaminants in the steam pipes of your autoclave will transfer to your instruments, so autoclave maintenance is important

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Sterilisation is essential to ensure that surgical instruments do not act as pathogen vectors.

In the autoclave the instruments must always be in the open position to allow the steam to reach all surfaces. Do not overload the autoclave trays, which would block the steam penetration. The temperature, cycle duration and pressure should be those recommended by the manufacturer.

Complete drying of all instruments and implants should be assured to prevent their degradation. The use of dry heat is not recommended for the sterilisation process.

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Use instruments to do what they were designed for! Artery forceps are not wire twisters.

A range of suitable brushes is useful. These should be soft nylon for most instruments, and include fine tube brushes for instruments with a lumen such as drill guides. Pipe-cleaners can also be useful.

Clean instruments should be visually inspected for signs of damage. Pay particular attention to joints for signs of cracking and cutting edges for damage and wear.

Strong, D. and Capewell, L. (2015) Design and care of surgical instruments. In Practice, vol.37, pp.359-364.

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Make sure the packaging you use is suitable for your autoclave, and use appropriate indicators to monitor the process. Fabric-wrapped packs in a non vacuum autoclave may result in poor steam penetration, so monitor the process very carefully.

The autoclave is a very hostile environment for your instruments. The combination of heat and moisture promotes corrosion and staining, particularly if there are residual detergents in wrapping materials. This is also true where tap water, instead of distilled or demineralised water, is used in the autoclave.

Mineral deposits on instruments are unsightly and can interfere with normal joint function. They are difficult to remove, so prevention is better than cure. Chloride ions from water treatments and laundry detergents, as well as those from organic contaminants, can build up and damage the surface of the instrument, causing pitting.

Rust and contaminants in the steam pipes of your autoclave will transfer to your instruments, so autoclave maintenance is important. Regular servicing ensures the autoclave is working correctly. Vacuum autoclaves help remove residual steam from packs but it is important that directions are followed and cycles are completed.

Regularly check that the door seal is undamaged, and replace it if necessary. Drain and refill the water tank regularly with distilled water, unless your machine does this automatically. You may well be surprised what comes out!

If your packs are coming out of the autoclave wet, then there is a cycle problem and you need to speak to your autoclave engineer for advice. Wet storage will result in corrosion and damage to your instruments.

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By placing instruments in an ultrasonic cleaner containing a neutral pH solution for 10- to 20 minutes, instruments can be cleaned 16 times more efficiently than by hand washing alone

https://www.isvma.org/wp-content/uploads/2020/10/AVSTAdvanceSurgicalSkillsSugicalInstrumentCareandSterilization.pdf

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For small metal instruments, autoclaved packages in double-wrapped linen or double-wrapped plastic-paper combinations can be stored safely for at least 96 weeks.

https://pubmed.ncbi.nlm.nih.gov/14530104/

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Long-term storage of small surgical instruments in autoclaved packages - PubMed

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For small metal instruments, autoclaved packages in double-wrapped linen or double-wrapped plastic-paper combinations can be stored safely for at least 96 weeks.

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Once items have been sterilised, they will not remain sterile indefinitely. The expiration date is dependent on the type of sterilisation used, packaging material, and storage. Certain types of packaging are time-limited, beyond which the pack is considered non-sterile. Any damage or changes to the packaging will also break sterility.

Porous packs, for example, those wrapped in material such as cloth drapes, should be re-packaged and re-autoclaved after 4 weeks if unused, or sooner if sterility is compromised due to a defect in the packaging. Packs that are contained in nylon or 'peel and seal' packs can be used for up to one year if stored correctly.

https://wvs.academy/learn/companion-animals/spay-neuter/preparation-and-principles/surgical-equipment/autoclaving

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There are various types of materials or containers that are suitable for use in an autoclave; all options must have the following properties:

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This study aimed to evaluate the sterility validity of surgical instruments stored in the sterilization center regarding the feasibility of their safe use over time. Fifteen surgical forceps were sterilized in aseptic (surgical grade) paper and polypropylene blankets packaging and stored in the arsenal of a large hospital. The materials were tested monthly in a laminar flow cabinet to test how long the surgical instruments remained sterile. Sterility tests showed no gram-positive or gram-negative bacterial or fungal microbiological growth from any of the samples evaluated according to storage time (30, 60, 90, and 120 days). Sterile instruments can be safely used for up to 120 days, thus saving costs by avoiding the repacking of those items.

Bezerra, G., de Santana, F.A., Silva, C.G. et al. Assessing the Validity of the Storage of Sterilized Surgical Instruments Steam under Pressure. Indian J Surg 83, 672–675 (2021). https://doi.org/10.1007/s12262-020-02432-3

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Supplies wrapped in double-thickness muslin comprising four layers, or equivalent, remain sterile for at least 30 days. Any item that has been sterilized should not be used after the expiration date has been exceeded or if the sterilized package is wet, torn, or punctured.

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Supplies wrapped in double-thickness muslin comprising four layers, or equivalent, remain sterile for at least 30 days. Any item that has been sterilized should not be used after the expiration date has been exceeded or if the sterilized package is wet, torn, or punctured.

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Sterile surgery packs or peel packs stored in open shelving are considered sterile for 6 months from sterilization date.

Proper storage of sterile supplies is in closed containers. All cloth/paper drape-wrapped packs stored correctly (e.g., in closed containers) are only good for one year from the date of sterilization until/unless an event causes them to become contaminated (see list below). Properly stored (e.g., in closed containers) unopened autoclaved or gas-sterilized peel packs are considered sterile indefinitely until/unless an event causes them to become contaminated