What are the top considerations surgical professionals should make to ensure instruments are well-organized, maintained and secured during all phases of storage, cleaning and use?
Jerry Brown, CEO, Automated Medical Products, www.IronIntern.com 
August 15, 2011
Ensuring proper management of surgical instruments starts with instrument selection. For example, let’s focus on following a surgical retractor system through use. The system is chosen from the surgeon’s standpoint, based on the type of procedure that it will be used for. Once the system has been procured, however, you must be able to clean, sterilize and store it.
Most of surgical retractor systems are stainless steel, so they need to be cleaned. Some facilities have turned to an automatic cleaning system. Sometimes, an instrument will be coated with a lubricant called milk. You cannot put the milk on all instruments because it may interfere with the mechanics of the device. You have to be aware and careful of these considerations. There are guides and written standards available to refer to ensure proper cleaning, one of the best being Association for the Advancement of Medical Instrumentation (AAMI). It’s also a recommended to always have the manufacturer’s cleaning instructions available.
After cleaning, the instruments are checked for functionality, and then sorted into a specific tray to be delivered back to the surgery department in a manner in which the assistants can open up the kit and provide the instrumentation for it to be installed on the table to provide retraction. Instrumentation is usually marked with tape of different colors to separate each piece so it can be identified and sorted into a particular tray. All the pieces must be there, so it is important that somebody counts the instrumentation as it is leaving surgery to be cleaned and sterilized, and then counts again as it is prepared to be return to surgery.
Storage is critical. Trays or containers designed for the retractor system are also important. They facilitate sterilization, retractor system setup, recovery and safe secure storage.
So, when purchasing instruments, look for something that is easy to use and not complicated to use in surgery. You want to reduce the number of pieces you have to keep track of, and also be able to clean and sterilize them with a great deal of efficiency.
You may also wish to find instrumentation that doesn’t have tiny pieces, such as small screws, that must be dissembled, kept track of, and then reassembled. It can have screws in it, but they frequently don’t ever come out unless the instrument is sent back to the manufacturer for refurbishment. Also, think about what’s it made out of, such as stainless steel? Is it properly made? What is the reputation of the manufacturer?
Instrumentation such as a retraction system is re-used over and over again. Taking proper care of you instrumentation will ensure that it will last for a long time. This comes down to complete recovery of all the pieces used in surgery, proper cleaning and sterilization, and proper storage.