This webinar is 33 minutes long and will cover all that you need to know about the care and maintenance of surgical instruments. It provides a detailed overview of the materials used to construct instruments and why you need a good maintenance schedule. It also provides information on how to properly clean and lubricate instruments to save damaging the materials, including how an ultrasonic cleaner works.

Finally, the webinar explains packing and sterilising your instruments and the use of sterilising indicators.

Instrument materials

Most surgical instruments are made of stainless steel, however, some are constructed using titanium especially the smaller dimension instruments such as ophthalmic types.

Stainless steel is a metal alloy, primarily chromium and carbon to give instruments its ability to resist corrosion and also its strength, respectively. Different instruments have different requirements of alloys; for example, scissors need a hard flat blade while artery forceps need a little bit of spring or give when being used. The manufacturing of veterinary implants and instruments is not regulated, but consider human specifications for implants.

Despite the name, stainless steel is not stainless, passivation of the instrument occurs over time causing the instrument to be easily damaged. The newer the instrument, the more likely they are to damage thus needing a good care protocol!

Causes of damage

Good quality instruments are expensive and need a good maintenance protocol to ensure the investment lasts a long time. Properly functioning instruments are also key to a successful surgery and ensuring the patient receives the best of care.

Tap water, cloth drapes, saline, blood and body fluids, damp cloth drapes, steam autoclaves and damp packaging causes corrosion of instruments! All of these are daily exposures for our instruments that damage the chromium layer and expose the instruments to rust and damage.

Instrument damage also includes fretting, caused by misalignment of the instrument such as scissors and also contact contamination, caused by a damaged instrument coming into contact, e.g. in a kit with a good quality instrument but then the corrosion spreads causing damage. We can prevent instrument damage by handling the instruments with care, use them for their designed purpose and correct handling when cleaning, sterilising and packaging.

Cleaning instruments

Instruments should be firstly rinsed in tepid plain water to remove the gross contamination; this should be done as soon as possible after use. When it comes to the cleaning, a proprietary instrument cleaner should be used, avoid chlorhexidine gluconate (e.g. Hibiscrub) or washing up liquid. Follow the manufacturer’s instructions when using the instrument cleaner paying special attention to dilution rates and contact times. Gently scrub the instruments with a soft nylon brush or toothbrush for smaller areas, it is best to use a brush specifically designed for instruments, these have round ended instrument cleaning brushes. Ideally using distilled water rather than tap water to clean, would be better for your instruments.

After cleaning rinse thoroughly in clear running water in three minutes to rinse all cleaning residues off the instrument. Following the ideal instrument care protocol, the instrument should then go through an ultrasonic cleaner. Ultrasonic cleaners use high-frequency sound waves that create tiny bubbles, these then implode on the instrument surface pulling any dirt.

Finally, rinse the instruments again and dry thoroughly and don’t leave them to air dry, this causes watermarking. Use a soft, lint-free cloth to dry instruments. Regular maintenance includes the use of a lubrication spray or milk bath around all joints and surfaces.

Packing and sterilisation

Visually check instruments for signs of damage before packaging to ensure they are properly functioning. There is a range of packaging materials available for use. However, fabric drapes will retain dampness, and the contamination of chlorine from washing powders on the cloth so should not be used. You should cover the tip of any sharp instruments for your safety and also for the maintenance of sterility, so they do not protrude through your packaging.

Ensure autoclaves are cleaned and maintained because this will ensure the best environment for your instruments. Ideally, you should not autoclave instruments of different metals together, e.g. scalpel handles with a surgical kit!

Take home messages

1.   Handle instruments gently at all times

2.   Be aware newer instruments are more prone to damage than older ones

3.   Use the described gold standard cleaning protocol for instruments

including using an ultrasonic cleaner

4.   Do not clean or autoclave instruments of different metal types together

5.   Ensure proper cleaning and maintenance of the autoclave


I will review our cleaning protocol for instruments following this webinar. I am going to look into specific instrument cleaners rather than using Hibiscrub and purchase a specific instrument cleaning brush. I will ensure we use our ultrasonic cleaner for each kit and the instruments are dried properly and not left to air dry. I am also going to create a schedule for the autoclave maintenance which will include cleaning the inside of the chamber and checking the seal around the door.

This webinar was kindly sponsored by Boehringer Ingelheim.

BVNA members are able to access the VN Knowledge webinars for free via the web page: www.vnknowledge.co.uk


Samantha Morgan Cert Ed DipAVN (Medical & Surgical) RVN

Sam qualified as a Veterinary Nurse in 1999 and worked in an orthopaedic veterinary referral practice in Birmingham. Sam returned to Cardiff in 2002 and became Head Veterinary Nurse at Park Vets.

Between 2003 and 2008, Sam gained both the Medical and Surgical Diplomas in Advanced Veterinary Nursing. She holds an Examiner's Certificate for the RCVS and spends part of the year assessing the practical examinations. In 2004, Sam gained an assessors qualifi-cation and in 2010 she was awarded the Professional Certificate in Education (Cert Ed).

Sam has previously taught at Filton College, Bristol and now she is one of the directors of Abbeydale Vetlink, Monmouth. Previously Sam has also been the South Wales regional coordinator for the BVNA, organising local CPD events before being elected on to the BVNA council.

Veterinary Nursing Journal • VOL 33 • November 2018