Surgical Instrument Cleaning Protocols, Cleaning of Surgical Instruments Prior to Sterilization, Cleaning Surgical Instruments Process, and Cleaning and Disinfecting Surgical Instruments. Manufacturers of surgical instruments recommend the use of neutral pH enzyme detergent cleaners. Neutral pH all-in-one or combination enzyme surgical instrument cleaner detergent concentrates have  been shown to be effective in optimizing the efficacy of the passive oxide layer.

This will provide a longer life for stainless steel surgery instruments. Cleaning concentrates with a high or low pH have been shown to erode the passive layer. The most common of these cleaning concentrates utilize an alkaline detergent with an acid neutralizer. Virtually all manufacturers of surgical instruments and surgical instrument containers recommend against using these detergents and recommend using a neutral ph detergent. Virtually all manufacturers of surgical instruments and surgical instrument containers recommend against using these detergents and recommend using a neutral ph Surgical Instrument Cleaner. Your first-line-of-defense against Preventing Corrosion is the passive oxide layer of your Surgical Instruments. Stainless steel surgery instruments are made of corrosion resistant high-grade specialty steels. One of the special characteristics of these steels is that the manufacturer forms a passive oxide layer on the surface, which protects them against  corrosion.  This makes surgery instruments as corrosion resistant as possible.  It is imperative that you maintain the passive oxide layer to prevent corrosion and  maintain your surgery instruments in optimal condition. If this is not done the stainless steel will be more susceptible to corrosion, pitting and stains.This will reduce the life of the surgery instruments and/or  render it useless. Initially, all stainless steel surgical instruments have the same corrosion resistance.

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Interpreting Rust Yellow-brown to Dark-brown Stains or Spots
when Cleaning Surgical Instruments and Cleaning Endoscopes
Yellow-brown to dark-brown stains or spots on surgical stainless steel instruments are frequently mistaken for "rust". These residue deposits (stains or spots arranged in groups or along edges or in crevices) are usually the instrument being exposed to result of high chloride content. They will lead to pitting of the surgical instrument surface if not removed. (see Avoiding High Levels of Chloride below) Excessively hard water can contain high levels of salt sufficient to cause stains or spots that appear as rust. Boilers used to generate the steam for steam sterilizers, if not cleaned properly, will produce contaminated steam which can deposit minerals onto instruments during the sterilization process. Use Surgical Instrument Cleaners containing Nonionic Surfactants whenever possible. Neutral pH Cleaning Concentrates recommended by Device Manufacturers. Virtually all manufacturers of surgical instruments, rigid scopes, flexible scopes, and instrument containers recommend the use of neutral pH Surgical Instrument Cleaners. The use of Surgical Instrument Cleaners that deliver an acid rinse will release nickel from the stainless steel and decrease the efficacy of  the passive layer. This is most critical on initial repocessing events of stainless steel surgical instruments. Measurable levels of nickel have been detected. It was also  shown that, as the number of subsequent uses increased, the level of nickel release diminished and reached a steady state (measured in the order of μg/l). These  observations reflect the changes that occur in the passive oxide layer on first immersion of stainless steels in aqueous media.
What is a Stainless Steel Surgical Instrument?
Stainless steel is essentially a low carbon steel which contains chromium at 10% or more by weight. It is this addition of chromium that gives the steel its unique stainless,  corrosion resisting properties. The chromium content of the steel allows the formation of a rough, adherent, invisible, corrosion-resisting chromium oxide film on the steel  surface. If damaged mechanically or chemically, this film is self-healing, providing that oxygen, even in very small amounts, is present. The corrosion resistance and other useful properties of the steel are enhanced by increased chromium content and the addition of other elements such as molybdenum, nickel and nitrogen. Stainless steel has  a passive film created by the presence of chromium (and often other alloying elements, nickel, molybdenum) that resists this process. When exposed in air, stainless steels  passivate naturally (due to the presence of chromium). But the time required can vary. In order to ensure that the passive layer reforms rapidly after pickling, a passivation  treatment is performed using a solution of nitric acid and water.
How is the passive oxide layer Manufactured and Maintained 
The passive layer or stainless steel is intended to prevent or resist corrosion. The process is called Passivation. Passivation and Polishing eliminate the carbon molecules  form the instrument surface. This forms a layer which acts as a corrosive resistant seal. Passivation is a chemical process that removes carbon molecules from the surface  of the instrument. This chemical process can also occur through repeated exposure to oxidizing agents in chemicals, soaps, and the atmosphere. Polishing, by the manufacturer, is a process used to achieve a smooth surface on the instrument. Surgical Instruments are polished because the passivation process leaves microscopic pits where the  carbon molecules were removed. Polishing also builds a layer of chromium oxide on the surface of the surgery instrument. Proper cleaning, handling, and sterilization will build up the layer of  chromium oxide and protect the Surgical Instrument from corrosion and /or pitting. In some circumstances older instruments have higher resistance to corrosion than new ones. The newer instruments have not had the time to build up the chromium oxide layer. Improper cleaning and sterilization can cause the layer of chromium oxide to disappear or become damaged thus increasing the possibility of corrosion and/or pitting. Proper cleaning and sterilization can cause the layer of chromium oxide to improve over time thus decreasing the possibility of corrosion and/or pitting. Second only to the financial asset value of the working staff, the surgery instrument and scope inventory is the single most financially valuable asset of the healthcare facility. It is important to properly clean, sterilize, handle, and store your instruments.