Practice Sharing: How to Ensure the Cleaning Quality of Orthopedic Instruments
2026-07-09
This article shares practical insights on how to ensure the cleaning quality of orthopedic instruments. It provides a detailed introduction to the characteristics, classification, and cleaning workflows of orthopedic medical devices. The primary focus is placed on guaranteeing the cleanliness and sterility of these instruments, with special emphasis on the cleaning and disinfection processes required for implantable devices.
1. Characteristics of Orthopedic Instruments
◈ Wide Variety: Since the skeletal system spans the entire body, the variety of orthopedic instruments is extensive.
⚙ Complex Design: Orthopedic surgery integrates medicine, engineering, mechanics, and computer technology. Some instruments have complex design principles, and blind handling can lead to damage or wear.
🔬 Minimally Invasive Technology: With updating concepts in orthopedic treatment, the development of minimally invasive surgical techniques has made instruments increasingly fine and complex.
🛡 High Cleanliness Requirements: Orthopedic implants remain in the human body for a long time, demanding the strictest standards for cleanliness and sterility.
2. Classification of Orthopedic Instruments
- Basic Instruments: Includes bone hammers, bone gouges, curettes, bone rongeurs, Kirschner wire cutters, pliers, retractors, etc.
- Implants: Includes screws, bone plates, intramedullary nails, Kirschner wires, etc., used for fracture fixation and long-term retention in the body.
- Auxiliary Tools: Used for clamping, cutting, assisting, and shaping. They are mainly divided into wire/pin tools, screw tools, and plate tools.
3. Cleaning of Orthopedic Instruments
Cleaning Process for Basic Instruments
Counting and Verification: Count the quantity and types, and check small parts.
Disassembly and Manual Pre-washing: Open the instrument joints, use enzymatic solution and high-pressure water guns for cleaning, and treat residual blood and rust stains.
Handling Small Parts: Place them into a fine-mesh basket and check the quantity.
Machine Washing: After manual initial washing, perform ultrasonic cleaning followed by automated cleaning, disinfection, lubrication, and drying in a washer-disinfector.
Lubrication: Spray with specialized lubricant to ensure proper functionality.
Cleaning of Power Drills
- Surface Treatment: Spray with surfactant, soak in a multi-enzyme cleaning solution, scrub the gears, rinse and wipe/blow dry, and lubricate the tip with specialized lubricating oil.
- Handle Treatment: Wipe clean with a specialized cleaning agent and blow dry with a high-pressure air gun, ensuring no water enters the battery terminal.
Critical Control Points in Cleaning
- Joint Cleaning and Maintenance: The cleaning and maintenance of instrument joints are critical.
- Tightness of Bundling: The tightness of rubber band bundling directly affects the cleaning quality.
Cleaning Process for Implants (Loaner Instruments)
- Instrument Reception: One day prior to surgery or 8 hours pre-operation, the operating room nurse and Central Sterile Supply Department (CSSD) nurse jointly count the instruments and fill out the registration form.
- Cleaning and Disinfection: Disassemble detachable instruments to the smallest components, place small parts into fine-mesh baskets, remove and clean instrument trays layer by layer, and tie Kirschner wires neatly with rubber bands.
- Inspection and Packaging: Count the quantity, inspect the cleaning quality and functionality, and pack after confirming everything is correct.
- Sterilization, Monitoring, and Traceability: Strictly adhere to volume and weight requirements, perform high-temperature and high-pressure steam sterilization, and conduct biological monitoring. Release and archive records only after qualifying. For emergency surgeries, early release is permitted once chemical indicators pass.
4. Summary and Reflections
Summary: Standardized processing of orthopedic loaner and basic instruments ensures their safe application in patients, promotes limb function recovery, and reflects the value of this work.
Reflections: The development of modern medical technology has elevated the importance and professionalism of disinfection and supply work. Continuous research and exploration enrich professional knowledge, providing safe and efficient services to clinical departments while bringing a sense of joy in fulfillment.