Is a lubricant a contaminant or a crucial necessity for maintaining the proper operation of a surgical instrument?
As a manufacturer of high quality surgical instruments, we recommend for optimum performance of individually honed instruments, a lubricant should be used during routine reprocessing. This will also help eliminate down time, of potential future repairs. Particular attention should be given to box joints, Ruhof premixslip is ideal for this.
Guest blogger Matthew Peskett
Ruhof UK, Peskett Solutions Ltd – explains more…
Most instrument manufacturers recommend the use of lubrication to ensure the correct functioning of their surgical instruments and to minimise wear and tear, thus extending the life of the instrument. Unfortunately, there is a trend away from the use of lubricants on surgical instruments due to the fact that a lubricant is considered a contaminant.
The definition of contamination in the Nursing and Healthcare Dictionary is:
“Presence of pathogenic organisms on the body surface or in wounds, in food or drink and on inanimate objects”.
This definition does not apply to a water-soluble lubricant; a residue would be a more precise definition.
The HTM2030 Washer-disinfectors (Design Considerations, page 64) states:
8.35 The addition of oil-based compounds to the cleaning process is wrong in principle. They deliberately cause contamination over the entire cleaned surface. If they are to be used the water soluble type should be used. Mineral oils have poor biocompatibility and may inhibit the penetration of steam or sterilant gases on terminally sterilized product. 8.36 Lubrication should only be applied to those areas where it is required during the inspection/ packing process after thorough cleaning of the instrument.
The HTM2030 does not state that you cannot use a lubricant before sterilization. It just discourages the use of oil-based lubricants in favour of water-soluble lubricants. The ideal location for using the lubricant is the packing room before sterilization. However, if the lubricant dislodges dried contaminates, the instrument will require returning to the decontamination area for re-processing, which may include soaking in a lubricant bath until all traces of the soil lodged in the joint are removed.
By introducing the following safeguards into your lubricating routine, you will be able to reduce surgical instrument failures and extend their life span. By ensuring that only the minimum amount of lubricant required is used, the level of lubricant residue will be totally harmless.
1. Only use a water-soluble lubricant.
2. Ensure the product has been tested to be totally steam sterilizable and steam penetrable.
3. Check the lubricant’s COSHH sheet, section 3 -Hazard Identification Signs/Symptoms of Exposure, to ensure that the product will not react with tissue.
4. Restrict the use of the lubricant to the area of the instrument requiring lubrication.
5. Test the action of the lubricated joint to ensure penetration.
6. If the lubricant dislodges dried contaminants from the joint, return to the decontamination /wash area for reprocessing.
7. When introducing a lubricant into the department, ensure that the manufacturer of the lubricant supplies a method of residue testing following steam sterilisation.
8. Most importantly ensure the manufacturer backs up any claims with independent test results
By not using a lubricant we are running a greater risk of the instruments failing in use than we are of the lubricant residue on the instrument causing contamination of the operation site.