Matthew Peskett, MD at Peskett Solutions asks: is a lubricant a contaminant or a crucial necessity for maintaining the proper operation of a surgical instrument?
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. This definition does not apply to a water-soluble lubricant; a residue would be a more precise definition.
You can use a water-soluble lubricant before sterilization; however, the use of oil-based lubricant is discouraged. 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. By not using a lubricant we are running a greater risk of the instruments failing in use, than the risk from lubricant residue on the instrument causing contamination of the operation site.
• Only use a water-soluble lubricant.
• Ensure the product has been tested to be totally steam sterilizable and steam penetrable.
• Check the lubricant’s COSHH(SDS) sheet, section 3 -Hazard Identification Signs/Symptoms of Exposure, to ensure that the product will not react with tissue.
• Restrict the use of the lubricant to the area of the instrument requiring lubrication.
• Test the action of the lubricated joint to ensure penetration.
• If the lubricant dislodges dried contaminants from the joint, return to the decontamination /wash area for reprocessing.
• When introducing a lubricant into the department, ensure that the manufacturer of the lubricant supplies a method of residue testing following steam sterilisation.
• Most importantly ensure the manufacturer backs up any claims with independent test results
To find out more, please visit www.peskettsolutions.com
