Instrument Reprocessing Process
Correct processing of reusable medical devices is a crucial measure
in infection control management. The priority is protection of the
patients, the staff and the material being processed. Additional factors
are economical processing costs and environmental concerns during
processing.
Principal Steps
 Cleaning of instrumentation to allow for sterilization
 Decontamination to protect the staff
 Sterilization
Thorough cleaning is imperative for effective decontamination and sterilization. All soils, protein and biofilms must
be removed in order to ultimately achieve sterilization. Thus, enzymatic cleaners and detergents must be used in
order to achieve clean instrumentation. You cannot achieve sterilization on dirty instruments.
7 Steps Recommended Most hospitals will accomplish the complete process.
Physician’s offices or small volume processing areas usually will use steps 1, 2, 5 & 6.
STEP 1 Pre-preparation (Presoak)
Reason Instruments should have gross soil removed as soon as possible
after use. Allowing blood and tissue to dry can cause the
instrument to rust and pit. Enzymatic presoaking increases the
life of the surgical instruments, reduces the risk of cross contamination
and provides the most complete cleaning.
Surgical
Instruments
Delicate Instruments
& Scopes
YES
YES
Surgical
Instruments
Delicate Instruments
& Scopes
YES
YES
Solution C h o i c e Cuts-It® Gel Instrument Pre-soak: BC32G
ENZYCLEAN® Protease Enzyme Low Suds Detergent: EBL1
ENZYCLEAN® II Dual Enzyme Detergent: B9
MicroZyme-D® Dual Enzyme Detergent: MZD04-128
MicroZyme-M® Multi-Enzyme Detergent: MZM04-128
STEP 2 Manual Cleaning
Reason When an ultrasonic cleaner or automatic washer is not available or
the instruments are very delicate, manual cleaning should be
performed. An effective cleaner which is free rinsing should be used.
Solution Choice
MicroKleen-LSD® Low Suds Detergent: MKLSDS04-128
High Suds Neutral Liquid Detergent: B2
High Suds Neutral Powder Detergent: B3
ENZYCLEAN® Protease Enzyme Low Suds Detergent: EBL1
ENZYCLEAN® II Dual Enzyme Detergent: B9
MicroZyme-D® Dual Enzyme Detergent: MZD04-128
MicroZyme-M® Multi-Enzyme Detergent: MZM04-128
Instrument Reprocessing Process
STEP 3 Ultrasonic Cleaning
Reason This is the most efficient cleaning method. Ultrasonic cleaners create
bubble formations known as cavitation. This process removes even the
tiniest particles from box locks, cracks and crevices. Enzyme
detergents offer superior cleaning but a low sudsing, neutral pH
detergent or an alkaline detergent with chelating agents can be used.
This allows the proper amount of cavitation and allows for excellent
rinsing. Note: Too high a pH detergent without proper buffering can
damage an instrument’s passivation layer.
Solution Choice
Solution Choice
Instruments should be decontaminated for the protection of the hospital
worker and to allow for the sterilization process. The washer/
decontaminator will remove the majority of soil on the instrument and
prepare it for cleaning. A low sudsing, neutral pH detergent or a
buffered alkaline detergent should be used in a washer/
decontaminator; otherwise the instrument can spot, stain, freeze up
and corrode.
YES
WHEN POSSIBLE
Surgical
Instruments
Delicate Instruments
& Scopes
YES
NO
Surgical
Instruments
Delicate Instruments
& Scopes
YES
WHEN POSSIBLE
ENZYCLEAN® II NS Dual Enzyme No Suds Detergent: ENF1
MicroKleen-LSD® Low Suds Detergent: MKLSDS04-128
ENZYCLEAN® Protease Enzyme Low Suds Detergent: EBL1
MicroZyme-D® Dual Enzyme Detergent: MZD04-128
MicroZyme-M® Multi-Enzyme Detergent: MZM04-128
ENZYCLEAN® Protease Enzyme Super Concentrate: EBL2.5C
Low Suds Super Concentrate Neutral Detergent: DM2.5C
STEP 5 Lubrication (Instrument Milk)
Reason
Delicate Instruments
& Scopes
MicroKleen-LSD® Low Suds Detergent: MKLSDS04-128
ENZYCLEAN® Protease Enzyme Low Suds Detergent: EBL1
ENZYCLEAN® II Dual Enzyme Detergent: B9
MicroZyme-D® Dual Enzyme Detergent: MZD04-128
MicroZyme-M® Multi-Enzyme Detergent: MZM04-128
STEP 4 Automatic (Washer/Decontaminator)
Reason
Surgical
Instruments
Cleaning, especially ultrasonic cleaning, removes all lubrication and may
cause frozen box locks. An instrument lubricant eases stiffness and does
not interfere with sterilization. It prevents electrolysis on points and edges
to help keep cutting edges sharp. It also helps prevent rust. Lubrication
extends the life of stainless steel instruments.
Solution Choice Instrument Lubricant: T2
Instrument Lubricant Super Concentrate: SP2.5C
755 TRI-STATE PARKWAY, GURNEE, IL 60031
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Instrument Reprocessing Process
STEP 6 Sterilization (Steam, ETO, Gas Plasma
or Chemical)
Surgical
Instruments
Delicate Instruments
& Scopes
STEAM
ETO, GAS PLASMA
OR CHEMICAL
Surgical
Instruments
Delicate Instruments
& Scopes
YES
NO
Reason After lubrication, instruments should be sterilized for the next patient
procedure. Steam is the most preferred method but when the instruments
are heat or moisture sensitive they should be sterilized with ethylene
oxide gas or gas plasma. When neither is available, a high quality cold
chemical sterilant should be used.
Solution Choice MicroCide28 HLD: MC28-04-128
STEP 7 Stain Removal (Use only if necessary)
Reason
Often instruments have been improperly cared for and therefore develop
rust and stains. By using a stain remover, the instruments can be restored.
After using a stain remover, steps 2 through 6 should be repeated.
Solution Choice Cool Soak Stain & Rust Remover: T5
Stain-Away Instrument Wipes: IW20
755 TRI-STATE PARKWAY, GURNEE, IL 60031
•
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