Care of Surgical Instruments  
The Importance of Cleaning   
cleaning surgical instruments
The primary purpose of cleaning surgical instruments and scopes is to remove all inorganic and organic material from the internal and external surfaces of flexible endoscopes. The secondary purpose of cleaning surgical instruments and scopes is to maintain and improve the “passive Layer” of stainless steel. The passive layer is provided by the manufacturer of surgical stainless steel to resist (prevent) corrosion. Proper cleaning will maintain and improve this passive layer. (for more information go to: Prevent CorrosionImportance of Cleaning) If the manual cleaning, brushing and rinsing steps are not properly carried out, protein debris can harden and lead to formation of biofilm on the biopsy channel of the endoscope. The optimal cleaning protocol will break down bioburden and clean the surface. Inadequate cleaning can thus result in material remaining on the endoscope surfaces which prevents disinfection and sterilization fluids or gases reaching all parts of potentially contaminated surfaces. Inadequate sterilization or disinfection may in turn result in transmission of infectious organisms when the endoscope is reused. The intricate design, delicate materials and susceptibility to damage of flexible endoscopes further complicates their decontamination.
Cleaning is the Prerequisite for Sterilization
The reprocessing decontamination process, whether done manually or automatically in a washer-decontaminator- disinfector, can only be effective if cleaning is adequate.  Effective disinfection or sterilization: (Generic Sterilization with a Pre-Vacuum Sterilizer (HI-VAC): 270-272° F (132-134° C), 16-minute exposure time, with 4 pulses and a  30-minute dry time. Generic Sterilization with a Gravity Displacement Sterilizer: 270-272° F (132-134° C), 30-minute exposure time, with a 30-minute dry time.) Sterilization of an inadequately cleaned instrument is not possible. Cleaning is the prerequisite for sterilization.

All disinfection processes, whether done manually or done automatically in a washer-disinfector, can only be effective if prior cleaning is adequate. Effective disinfection or sterilization of an inadequately cleaned surgery instrument or scope is not possible. Endoscopes should be cleaned with an enzymatic detergent compatible with the endoscope immediately after use and before manual or automated disinfection. Cleaning involves the entire endoscope, including valves, channels, connectors and all detachable parts. High level enzymatic formulations (Enzymatic Surgical Instrument Cleaners), in combination with a high level surfactant chemical complex, have been shown to be more effective in removing stains, hard water deposits, and encrusted bioburden, while being safe to use for rigid or flexible scopes.

Enzyme Cleaning Concentrates
Manufacturers usually recommend that Enzyme Cleaning Concentrates should be discarded after each use as these products are not microbicidal and will not retard microbial growth. Some manufactures of "combination" or all-in-one cleaning concentrates include a bacteriostatic agent which will prevent the growth of microorganisms. Some detergent complexes contain antimicrobial-microbicidal substances. These agents do not replace disinfection but are intended to reduce the risk of infection to reprocessing personnel. The cleaning function efficacy of enzyme cleaning concentrates is determined by the ratio of enzymes to bioburden. The higher the proportion of enzymes the higher the efficacy. As a result, if the cleaning solution becomes laden with bioburden from previous cleaning, the efficacy of the enzyme cleaning concentrates is lower. When a cleaning concentrate states that is it "multi-tiered", the inference is that is contains: proteases (enzyme) which break protein debris into smaller, more soluble subunits, amylase (enzyme) which catalyses the breakdown of starch, and lipase (enzyme) which breaks up fat-containing debris and carbohydrates. When a cleaning concentrate states that is it "high-level", the inference is that is contains a high concentration of enzymes. When a cleaning concentrate states that is provides "enzyme activity" the inference is that is contains enzymes but this is usually is a misrepresentation of ingredients for a cleaning concentrate that does not contain enzymes. Enzymes are effective and they are costly for manufacturers to include in the formulation. As is true for all cleaning concentrates, the most effective test is against your most difficult cleaning challenge. The two most common tests for cleaning concentration efficacy that are commercially available are the "TOSI Test" and the "film test".

Surgical Instrument Cleaner with Conditioners
will deliver all of the cleaning & conditioning power you need in
ONE application.
Surgical Instrument Decontamination
Surgical Instrument Cleaning effectively AND fast.
Surgical Instrument Cleaner lower cleaning costs.
Enzyme Detergent
Surgical Instrument Cleaner with Conditioners
rinse clean
Enzyme Detergent
Surgical Instrument Cleaner with Conditioners
will cut the cost of cleaning and conditioning your Surgical Instruments.
Enzyme Detergent
Surgical Instrument Cleaner with Conditioners
Cut the clutter of Surgical Instrument cleaning and conditioning products.
Enzyme Detergent
Surgical Instrument Cleaner with Conditioners
deliver a unique formulation of: detergents, "multi-tiered" "high-level" enzymes, and a Neutral pH surfactant chemical complex to break down bioburden and clean the surface of surgical instruments, remove STAINS from surgical instruments, enhance the "passive layer" protection of surgical stainless steel, and lubricate the moving parts of surgical instruments.
Surgical Instrument Cleaner and Conditioners will deliver all of the cleaning and conditioning power you need in 1 application.
Surgical Instrument Decontamination
Surgical Instrument Cleaning effectively AND fast.
Surgical Instrument Cleaner lower cleaning costs.
Enzyme Detergent
Surgical Instrument Cleaner and Conditioners
rinse clean Enzyme Detergent
Surgical Instrument Cleaner with Conditioners
will cut the cost of cleaning and conditioning your Surgical Instruments.
Surgical Instrument Cleaner and Conditioners
Cut the clutter of Surgical Instrument cleaning and conditioning products.
Surgical Instrument Cleaner with Conditioners
deliver a unique formulation of: detergents, "multi-tiered" "high-level" enzymes, and a Neutral pH surfactant chemical complex to break down bioburden and clean the surface of surgical instruments, remove STAINS from surgical instruments, enhance the "passive layer" protection of surgical stainless steel, and lubricate the moving parts of surgical instruments.
all-in-ONE™
Surgical Instrument Cleaner
& Conditioners
Surgical Instrument Cleaner
for lower cost,
fast and effective cleaning.
Surgical Instrument Cleaner,
Surgical Instrument Cleaner,
easy FOAM-it™
Surgical Instrument Cleaner
& Conditioners
Cleaning Surgical Instruments with Neutral pH 
and "free-rinsing" Cleaners
all-in-ONE™
Surgical Instrument Cleaner
& Conditioners
Surgical Instrument Cleaner
for lower cost,
fast and effective cleaning.
Surgical Instrument Cleaner
Surgical Instrument Cleaner
easy FOAM-it™
Surgical Instrument Cleaner
& Conditioners
Surgical Instrument Cleaner
with Neutral pH 
and "free-rinsing" Cleaners
Enzyme Detergent Surgical Instrument Cleaners
Enzyme Detergent Surgical Instrument Cleaners Surgical Instrument Cleaners  Surgical Instrument Cleaners  Surgical Instrument Cleaners
Enzyme Detergent Surgical Instrument Cleaners
Enzyme Detergent Surgical Instrument CleanersSurgical Instrument Cleaners  Surgical Instrument Cleaners  Surgical Instrument Cleaners
Enzyme Detergent Surgical Instrument Cleaners
easy FOAM-it ™
UPS-1 Enzyme Detergent Cleaners with  Conditioners deliver a residue free surface for cleaning Eye Surgical Instruments.
Enzyme Detergent Surgical Instrument Cleaners
all-in-ONE™
UPS-1 Enzyme Detergent Cleaners with  Conditioners deliver a residue free surface for cleaning Eye Surgical Instruments.
Washer Disinfector Washer Disinfector Detergents
Enzyme Detergent Surgical Instrument Cleaners
Contact Customer Service for information that will deliver the Surgical Instrument cleaning and care that you and your Surgical Instruments deserve.

yourCEBA Customer Service: John Dan Doubroff
yourCEBA Technical Support: John Temple