How to Clean and Sterilize Surgical Instruments: A Care Guide

Good instrument care does two things: it makes sure every instrument is safe to use on the next patient, and it keeps expensive instruments working for years instead of months. This guide walks through the standard reprocessing cycle for reusable surgical and dental hand instruments, and the everyday habits that most often decide how long an instrument lasts.

This is a general overview. Always follow your facility's policies, the instrument manufacturer's instructions for use (IFU) and the instructions for your sterilizer and cleaning chemistry.

The reprocessing cycle at a glance

1. Point-of-use care: wipe off gross soil and keep instruments moist until cleaning.
2. Cleaning: manual, ultrasonic or washer-disinfector, with a suitable detergent.
3. Rinsing and drying: remove all detergent residue, then dry thoroughly.
4. Inspection and function testing: check every instrument before it goes back in a set.
5. Packaging: wrap, pouch, cassette or rigid container, with instruments open.
6. Sterilization: most stainless steel hand instruments are steam sterilized.
7. Storage: clean, dry, protected storage until use.

1. Point-of-use care

Dried blood and tissue are the hardest soil to remove and the most common cause of staining and corrosion. Wipe instruments during and after the procedure, open hinged instruments, and keep them moist (for example with an enzymatic spray or a damp towel) until they reach cleaning. Separate sharps and delicate instruments so they are not crushed in transport.

2. Cleaning

• Manual cleaning: use soft brushes of the right size, never steel wool or wire brushes, which scratch the passive surface layer and invite rust. Brush under the surface of the water to avoid splashing.
• Lumens and cannulas: clean the inside as well as the outside, with a brush or sponge sized for the channel. See our pre-soaked enzymatic tubular cleaning sponges.
• Ultrasonic cleaning: reaches serrations and box locks that brushes miss. Open instruments fully and do not overload the basket.
• Detergent: use a product intended for surgical instruments at the dilution the maker specifies. Harsh or wrongly diluted chemicals cause spotting and pitting.

3. Rinsing and drying

Detergent left on the surface causes stains once it goes through the sterilizer. Rinse thoroughly, ideally with treated water, then dry completely. Water left in box locks and lumens is a common source of rust spots.

4. Inspection and function testing

This is the step that protects both the patient and your investment. Check each instrument, ideally under magnification:

• Scissors: cut cleanly to the tip; no nicks or burrs.
• Forceps and hemostats: jaws meet evenly; teeth mesh; ratchets hold and release.
• Needle holders: a closed needle does not rotate in the jaws.
• All instruments: no cracks at the box lock, no corrosion, pitting or bent tips.

Take damaged instruments out of service. Lubricate hinged instruments with a water-soluble instrument lubricant (not oil) if your process calls for it.

5. Packaging

Package instruments open or unlocked, so steam reaches every surface. Put heavy instruments at the bottom and delicate ones on top, and protect sharp tips. Cassettes and containers keep sets organized and protect instruments between cycles:

• Sterilization containers, baskets and lids, such as the Mini Perforated Sterilization Container and Mini Stainless Steel Wire Basket.
• Dental sterilizing cassettes, for example the Sterilizing Cassette for Ten Instruments and Twenty Instruments.
• Stainless steel instrument trays and instrument cases.

6. Sterilization

Steam under pressure (autoclaving) is the usual method for stainless steel hand instruments. Cycle type, temperature, exposure time and drying time depend on your sterilizer and on the IFU for the instrument and the packaging, so follow those rather than a generic setting. Use chemical indicators in every package and monitor the sterilizer as your facility requires. Let packs dry completely before handling; wet packs are not considered sterile.

7. Storage

Store sterile packs in a clean, dry area, off the floor and away from sinks, and handle them as little as possible. Do not stack heavy trays on top of pouches.

Habits that shorten instrument life

• Using fine scissors on sutures, wire or dressings.
• Letting blood dry on instruments before cleaning.
• Soaking in saline or bleach, which pits stainless steel.
• Processing instruments closed or locked.
• Mixing instruments of different metals in the same ultrasonic bath.

Frequently asked questions

Why do new instruments sometimes develop brown spots?

Spotting is usually a deposit from water, detergent or another corroding item in the load rather than a fault in the steel. Check water quality, rinsing and detergent dilution first.

Can titanium and stainless steel instruments be processed together?

Many can, but check the IFU. Keep them apart in ultrasonic cleaners, where contact between different metals can cause marking.

How often should instruments be sharpened?

It depends on use. Test cutting instruments at every inspection, and send them for sharpening as soon as they fail the test rather than on a fixed schedule.

Related guides

Choosing new instruments? Read our guides to types of surgical forceps, Metzenbaum vs Mayo scissors, surgical retractors and needle holders.

DDP Elite USA is a Miami-based supplier with over 7,000 surgical and dental instruments online. All US orders ship free, and every instrument carries our 3-year warranty.