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The Proper Care And Repair Of Surgical Instruments

Surgical instruments: How to repair and keep in great condition.

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To Katherine Traland, a licensed veterinary technician, taking good care of surgical instruments just makes sense.

“You need to be able to trust that your instruments are going to do what you need them to do. Scissors won’t work correctly if they’re dull; a clamp that does not close properly is going to cause problems,” says Traland, who works at Red Bank Veterinary Hospital in Tinton Falls , N.J .

Plus, Traland adds, her practice spends thousands of dollars annually to buy good instruments, “So you want them to last.”
 
Yet many veterinary professionals have received little formal education as to the proper care and repair of surgical instruments, or have formed bad habits over the years, says Alex Vrancich, vice president of Spectrum Surgical Instruments in Stow, Ohio. 
 
The good news: It takes only a few minutes daily to properly care for instruments, and good habits are as easy to learn as bad ones.
 

Instrument Care

The most crucial step, Vrancich says, is to deal with instruments immediately after use. Even though instruments are made of stainless steel, that in itself is a misleading name; instruments can and do stain if not handled properly.
 
“If you let blood dry on instruments, this can cause staining, and that leads to rusting, and that forces you to have to purchase new instruments prematurely,” Vrancich says.  
 
Within 10 minutes after use, instruments should be rinsed under running water, to remove debris. If you can’t rinse them immediately, keep instruments from drying out by placing a wet towel on top of them. 
 
When you wash the instruments, take care to use a neutral pH cleanser. Even in a pinch, Vrancich warns, never use dish soap, saline Chlorohexidine, surgical scrub or anything with a high chlorine content, because that will break down stainless steel and lead to spotting and corrosion.
 
Next, ultrasonic cleaning is the benchmark for optimum care. Studies have shown that ultrasonic machines clean 16 times better than manual washing. And that means instruments work better and last longer.
 
“Surgical instruments have a lot of moving parts, a lot of hinged areas where dirt and debris can hide out, places that we just can’t clean by hand,” Vrancich says. “Ultrasonic energy really blasts that dirt off the instruments.”
 
After 10 to 20 minutes in the ultrasonic cleaning machine, the instruments should be rinsed again, and then it’s time to dry them off, another crucial step. Rather than allowing instruments to air-dry –which can cause spotting and rusting— place each instrument on a clean towel and gently blot with another towel. 
 
When the instruments are dry, spray each with a lubricant made exclusively for surgical instruments before sterilization. Lubricating instruments, Vrancich says, not only helps the equipment perform better, it can help avoid unnecessary repair costs: “Many times, people send things in for repair because an instrument has ‘seized up’ and won’t function,  and we merely lubricate it and that fixes the problem. It can be an easy fix. Lubrication will extend the life of your surgical instruments.”

Instrument Repair

But eventually, even well-cared-for instruments will probably need repairs. 
 
“It’s like your car: the more you drive, the faster you need to replace brakes and tires,” Vrancich says. “The more you use your instruments, the more you will need to have them sharpened and maintained.”
 
Instruments that are used daily may need to be refurbished once a year, he says. For instruments used less frequently, it’s a good idea to pay close attention to how they’re working, perhaps by setting up a regular schedule for visually inspecting tools.

Send them in for repairs when efficiency starts to slip or blades start to dull, rather than waiting for the tools to quit working altogether.
Even though skilled professionals can cut with dull scissors or function with a needleholder that doesn’t grip as tightly as it should, work is easier and more efficient with well-tuned instruments.
 
“Many veterinarians seem to put up with the instruments they have, not knowing that it really doesn’t cost much or take long to get them in better working order,” Vrancich says.
 
For instance, Vrancich says Spectrum can repair a needleholder for about $20, and sharpen scissors for about $5. If you use a professional repair service, work can also be turned around quickly, usually within a few days, so you can schedule repairs for a week when your office is closed for vacation or a conference, when you won’t even miss them. Depending on the size of a practice, it may be a good idea to buy an extra set of instruments and rotate their use; that limits overuse and delays the need for sharpening and other small, routine repairs

Professional repairs and maintenance, done by a professional who has the right tools and replacement parts, can also extend the life of instruments.

If you allow a ronguer to go too long without service, for instance, you may end up squeezing it too hard and either breaking the jaw or causing it to slip out of alignment. The expensive end result: Instead of paying a few dollars for a simple sharpening, you may have to buy a $200 replacement.
 
“If cared for properly, a good German-made stainless steel instrument should last for 20 years,” Vrancich says. “One of our missions is to help people protect their investments. An instrument is an asset that helps you do your job, and if an instrument is sitting in a drawer, not working, what good is it to your practice?”

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