Recommendation

Transcription

1

2 1 Instruments reception Reception of a new instrument MUST be performed by a person aware of proper procedures. After control of order conformity, this material can be unpacked and it will be advisable before any treatment to ensure its proper operating condition. Any instrument appearing defective will have to be shipped back in its original packing while abstaining any attempt at do-it-yourself under penalty of cancellation of guarantee. Test with copper sulphate as recommended by AFNOR/ISO (N ) does not have any value to validate the quality of a Martensitic stainless steel and can only induce in error by wrongfully positive results. Test with boiled water does not have interest if supply was carried through a qualified supplier. Should the instrument not be brought into service immediately, store it : - in a dry and clean room, - out of its plastic packing, - far from any acid solution, even in a closed container, - far from any metal of different composition especially ferrous ones (like an old chrome box, in contact with a chrome instrument, etc.), - without any overload, - accordingly to a classification allowing an easy identification.

3 2 Getting into service Before any use, a new instrument must be deterged effectively. The better the cleaning, the less traces from oil of machining and mineral contamination will remain. This cleaning is done either : - by immersion in a solution of concentrated degreasing detergent containing phosphates, polyphosphates and fatty alcohols, for 2 to 12 hours long. Properly rinse the instrument with very hot water, dry it, then go through a sterilization cycle. - Or in auto washer for 2 or 3 regular instruments cleaning cycles. If the instrument keeps a normal aspect, it can be brought into service. If brown traces appear particularly at the joints, renew operation until cleaning is complete. Caution: sandpapering or polishing oil residues badly deterged give, after sterilization, a rusty aspect to the instrument. Whatever method used, you must : - never wash chrome and stainless instruments together - avoid contact with aggressive solutions based on halides ions, chlorides, iodide, iodized polyvinylpyrrolidone : Betadine - make the choice of a good detergent product : containing neither chlorine nor chlorides, containing no acid, containing no abrasive. Best results are obtained with detergent-grease-removers containing : - phosphates, - polyphosphates, - polyethoxyles fatty alcohols, - rock salt with plugged alkalinity. The water used for washing must be : - filtered drinkable, - with few limestones ions thus softened if needed between 6 and 8 Th. A too hard water will inhibit the detergent and will leave after drying, a white powder on the material, - weak in chlorinates or chlorides : < 20 mgr/l, - weak in biogenic salts (copper and iron mainly), - Beware of too much softened water containing very corrosive sodium chlorides : (BE CAREFUL OF TWO SOFTENERS IN CASCADE), - Prefer permuted or demineralized water for rinsing, to any other system of purification.

4 3 Predesinfection Prohibit products containing of phenols, active chlorines or chlorides : they're corrosive products. Exclude aldehydes as they reinforce Prions resistance to steam, their allergenic capacity and their corrosive capacity. For predesinfection : - Treat separately chrome instruments, - Predesinfection be done as soon as possible after instrument use, - Water hardness must lie between 4 TH and 8 TH. A hard water inhibits antimicrobic effectiveness and can produce sediments layers on material during use of certain products types, - Chlorine concentration in water must be lower than 20 mgr/litre to avoid any risk of corroding surgical instrumentation, - Water Content in mineral salts : iron, copper, manganese, must be the lower possible, avoiding risk of deposit on the instrumentation, conferring with as time goes by a bronzes or rusty patina, - Scrupulously respect concentration neither increase nor decrease it, avoiding risk to compromise effectiveness or increase unwanted effects, - Never mix products between them, never add any detergent, - Temperature of the bath must be, except for proteolytic enzymes, of approximately 20 C. If odour of the product is perceptible, temperature of water is too high and the active ingredients volatilize lowering its effectiveness. The immersion of instruments must be total so that decontamination is extended to its entire surface but also to avoid the cell effect between air and water, on the surface of the bath, which would induce a start of corrosion. Respect time of steeping. A time too short would compromise the decontaminating action, a time too long with certain corrosive substances, would induce an irreversible deterioration of the instrumentation. In general, whatever product selected, immersion time of the instruments will never have to exceed 30 minutes, scrupulously respecting concentration recommended by the laboratory.

5 4 134 C - 18 minutes (Circular DGS/DH n 100 of ) Sterilization Whatever the system of steam production, make sure by controls and analyses purity of water used for this production is correct. Its water must be : - of drinkable quality, filtered in all the cases, - with a hardness not over 5 to 7 TH (1TH = 10 calcium carbonate mgr/l. of water), deprived of chlorinates and chlorides elements : < 2 mgr/liter, - of a content phosphate < 0,5 mg/l, - with a concentration of mineral salts practically null : > Silica: < 1 mg/l, > Iron: < 0.2 mg/l, > Cadmium: < mg/l, > Lead: < 0.05 mg/l, > heavy Metals except lead, iron, cadmium: < 0,1 mg/l. This water should not contain : tanates, nor sulphites, nor amines, nor hydrazine, nor chlorides, nor permovapoline. Products usually used by heating specialists to prevent corrosion or to cure sedimentations in pipes. These products are very corrosive for surgical instrumentation but also for steam sterilizers.

6 5 Treatment when leaving the operating theatre According to local rules & regulations Steeping predesinfection (15 to 30 minutes maximum). Manual rinsing (hand shower - cold water). Rinsing in machine (mandatory). Washing in machine Material Control : - to eliminate the badly washed instruments, - to rewash by hand these instruments or by ultrasounds with LANDENE, - possibly, use LANDAX if traces of corrosion remain, - rinsing and drying with hands, - lubrication. Conditioning : - Hermetically-sealed sterilization wrap or container

7 6 We advise you Never wash instruments with a predesinfection product. Always carry out the two operations separately : 1) predesinfection 2) washing LANDENE can be used daily for (hand or ultrasound) washing of instruments according to instructions given on the technical chart. We advise you the following detergents for the washing of our instruments out of washing machine : ANIOS DL TRIENZYMATIQUE ANIOSYME DE NEODISHER FA NEODISHER MEDICLEAN DS2P ENZYMATIC (LABORATORIES PHAGOGENE) (this list of products is given as an indication and is not restrictive)

8 7 Beware We advise you not to use predesinfection products with : PHENOLS ACTIVE CHLORINES CHLORIDES UNDER ALL THEIR FORMS ALDEHYDES We advise you predesinfection products with proteolytic enzymes. Some predesinfection products selected by Landanger : SALVANIOS PH 10 ANIOZYME PHAGOLASE N D (Beware with plastics) DUROSEPT ESCULASE (Beware with anodized aluminium) For instruments going through a prolonged predesinfection (24 to 48 H) : NEODISHER SEP TO SF (this list of products given as an indication is not restrictive)