Surgical instruments are not only a valuable asset for healthcare providers, but by their nature they are also a primary front from which facilities can fight infection. Proper handling, cleaning and storage of surgical instrumentation are crucial to protecting that investment and helping to ensure patient safety.
Cleaning, however, can be a challenge because of the variety of biological soils and the complicated configuration of surgical instruments. Soils, such as blood and tissue, can become trapped in pinch points and box locks. In addition, the type of soil can itself be difficult to remove; for example, fatty soils are difficult to penetrate while protein-based soils can adhere to instruments when dried. To ensure the adequate level of care and cleanliness of surgical instrumentation, it is very important to identify and qualify the suitable mechanical and chemical treatments.
Although instrument reprocessing procedures are evolving at a rapid pace, the removal of organic debris on medical devices continues to be an issue. Soil remaining on instruments after cleaning can cause the sterilization process to fail, therefore jeopardizing patient safety. The purpose of this article is to provide an overview of how enzyme detergents work and best practices for cleaning instruments to support infection prevention.
With the variety and diversity of chemical treatments available to healthcare facilities, it can be difficult to know which chemistry removes a particular type of organic soil from the surface of surgical instruments. In recent years, enzymatic detergents have emerged as an effective way to remove stubborn organic debris such as protein-based stains, blood, fibrin, mucus and triglyceride-based stains such as oils and fats.
Enzymes are a class of proteins that consist of a long chain of amino acids held together by peptide bonds. Enzymes are present in the formation and degradation of all biological substances where they act as biocatalysts that accelerate or initiate reactions without being consumed in the process.1 According to The Behavior of Proteins, “Enzymes are the most efficient catalysts known; they can increase a rate of reaction by a factor of 10-2 over uncatalyzed reactions. Nonenzymatic catalysts, in contrast, typically enhance the rate of reaction by factors of 10-2 to 10-4.“2
Enzymes are produced by fermentations from biological systems such as yeast, fungi and bacteria and are considered renewable, environmentally friendly components.3,4
