General surgical instrumentation may be processed in a washer sterilizer or washer decontaminator/disinfector. Some of these processes include an enzyme application phase and a lubrication phase that is designed into the cycle. Follow the manufacturer’s specifications when using automatic washer-sterilizers or washer decontaminators/disinfectors. They usually require the use of a low foaming, free rinsing detergent with a neutral pH (7.0). A high-foaming detergent may clean effectively but will often leave residual deposits on the instruments and do harm to mechanical washers. Automated washer sterilizers and washer decontaminator/disinfectors usually have adjustable wash and rinse times. Some washers enable the user to customize extra cycles to process heavily soiled surgical instruments more effectively.

Terminal Sterilization After following the decontamination recommendations, reusable instruments are ready for sterilization. AAMI standards recommend that the sterilizer manufacturer’s written instructions for cycle parameters should also be followed. Steam sterilization of lumened instruments requires that they be flushed with sterile water just prior to wrapping and sterilization. The water generates steam within the lumen to move air out. Air is the greatest enemy to steam sterilization, preventing steam contact if not eliminated. Medical device manufacturer’s exposure times to sterilization temperature may need to be longer than the minimum indicated by the sterilizer manufacturer but must never be shorter.