appropriate. Steam will only sterilize the surface it can directly touch.
• Every effort should be made to protect sharp cutting edges and fine
working tips during all maintenance procedures. Avoid loading retractors
and other heavy items on top of delicate and hollow instruments.
Diagnosing Spots and Stains: It is common for instruments to become
stained or spotted despite the best efforts of the manufacturers and the
hospital staff. Adhering to proper technique during cleaning and sterilizing
procedures will prevent most staining occurrences. The following identifies
some of the various instrument-related problems hospitals may encounter.
Brown Stains: Detergents containing polyphosphates may dissolve copper
elements in the sterilizer. This results in copper being deposited on the
instruments by an electrolytic reaction. The hospital may try a different
detergent or check the quantities used. Usually a dull blue or brown stain is
simply a build-up of oxidation on the surface. This film is harmless and will
actually protect the instrument from serious corrosion.
Blue Stains: Blue stains are usually the result of cold sterilization
techniques. It is important to prepare the solution according to exact
proportions and to change the solution when recommended. Serious
corrosion may occur if the solution is used beyond the manufacturer's
specified time limit. The use of distilled water and a rust inhibitor in the
solution will help retard discoloration.
Black Stains: Black stains may be the result of contact with ammonia.
Many cleaning compounds contain ammonia and it will remain on the
instruments unless they are well rinsed.
Light or Dark Spots: Spots are often the result of condensation pooling and
then drying on flat and concave instrument surfaces. The mineral content of
the water remains on the instrument. Using "treated water" as the FINAL
rinse will help to remove the minerals found in water that can cause these
residual spots. It is also important to follow the sterilizer manufacturer's
instructions for preparing instrument sets for sterilization. Standing
instruments that have flat and concave surfaces "on edge" will enable the
condensate to drain off and more readily dry, usually without spotting. An
additional cause of spotting can be traced to the instrument wraps. During
laundering procedures, it is vital that detergents are thoroughly rinsed out,
and that the final rinse is prepared so that the wraps have a pH between 6.8
and 7.0. In addition, healthcare professionals should check the cleanliness
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