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Instrument maintenance and sterilization
Instrument maintenance and sterilization
Careful instrument maintenance and sterilization are critical to ensure functional equipment and provide patient safety. After surgery, the instruments should be cleaned. First, all debris must be removed from the instruments. Organic debris may allow for the growth of micro-organisms, and may interfere with sterilization. This is most commonly performed by soaking followed by hand scrubbing. Ultrasonic cleaning may also be used. Next, the instruments should be dried and treated with lubricant such as instrument milk. The instruments are then packed in a self-sealing pouch, metal box, or plastic tray. They should be loosely packed, with needle drivers and scissors in the open position. Surfaces in close contact may not be fully treated during the sterilization process. The pack should then be sterilized by steam autoclave. Though other systems, such as gas, dry heat, and chemical sterilization, are theoretically possible, these are generally less reliable and not frequently used by the dermatologic surgeon. The autoclave should be routinely tested to ensure adequate sterilization.
With appropriate maintenance, many surgical instruments may last for the career of the surgeon. Scissors may be sharpened by the manufacturer or by companies that will
provide on-site service. Tungsten carbide inserts in needle drivers, scissors, and forceps may be replaced. Stiff instruments can be lubricated or cleared of mineral deposits with a solution of vinegar and water.
A basic instrument setup for dermatologic surgery procedures