MANUAL SCRUBBING
Instruments need to be cleaned prior to sterilising in a steam steriliser (autoclave). If debris remains on items after the precleaning process, steam cannot contact all surfaces of items during the autoclave cycle, and they are thus not completely sterilised. An instrument that comes out of the autoclave with debris still in place will not be sterile, regardless of the success of the autoclave cycle.
Precleaning of instruments according to the Australian Standards 5369:2023 must be done mechanically where possible according to the instrument manufacturer’s instructions. This can either be achieved with an ultrasonic bath or a thermal washer/disinfector. At Dental Boutique we use ultrasonic baths for mechanical precleaning. If instruments are visibly contaminated after a cleaning cycle in the ultrasonic bath, or if they are heavily contaminated prior to entering the bath, they will need to be manually scrubbed. Intruments that also cannot withstand mechanical precleaning will need to be manually scrubbed as well.
When we scrub instruments manually, it should be in a deep sink or under water to minimise splatter. If the item is sharp or the cleaning utensil required being utilised is sharp (as in metal scrubbing brushes and bur brushes), the item should be rested against a firm surface to allow safer cleaning.
Heavy duty gloves and full PPE must always be worn when manually scrubbing instruments.
They should be cleaned with neutral or mildly acidic detergent and rinsed in warm to hot water if not being placed directly into the ultrasonic bath afterwards.
SAFE DRYING OF INSTRUMENTS
Instruments must be dry before they are packaged for sterilisation. Drying sharp items is inherently dangerous. For this reason, we always wear heavy duty gloves when drying instruments. We place them on a firm surface and use a wadded-up towel to pat them dry. A short rinse in very hot water after cleaning helps to speed up the drying process.
BAGGING INSTRUMENTS
Instruments must be dry before they are bagged or wrapped for sterilisation. If wet instruments are processed through the autoclave, they have a higher risk of corrosion. Further, the minerals present in tap water precipitate onto the surfaces of the autoclave chamber, shelving and racks and further internally, which shortens the lifespan of the autoclave.
Wet bags can rip or tear more easily, and if this occurs prior to the autoclave cycle, the items will not be sterile once they are unloaded due to the break in the sterile barrier system (SBS).
Instruments should be loaded into bags with their working end visible so that they can be identified without opening or manipulating the autoclave bag.
Here is a video demonstrating bagging instruments prior to autoclaving (sterilising). Note that heavy duty gloves are worn when handling sharp items.
Once instruments are dried and bagged, they are loaded onto the autoclave trays for sterilising.
