While washing surgical instruments in a washer, before packing and sterilization, fluids containing enzyme or alkaline substances can be used. What are the appropriate conditions for the effective use of each fluid (enzymes or alkaline)? Please mention any kind of comparison available

For most applications, mild alkaline detergents in the pH range 8-->11 are preferred, alkalinity improves the efficacy of detergents and assists enhances the cleaning capabilities. Cleaning agents should be: liquid to facilitate accurate dispensing, non-abrasive, lowfoaming,free rinsing,and biodegradable.

It is worth noting that acid based detergents should only be used for stainless steel applications and ai processes were hard water is present. Most modern automatic machines are fitted with a second pump for acid-based detergents.

Enzymatic cleaners are themselves proteins and may be sensitising or allergenic agents. A similar adverse reaction is produced by some people by domestic powders. Enzymatic formulations for cleaning surfaces come in two forms: pre-soak which is used to digest proteins soil and a combined enzyme and detergent formulation.

Most modern automatic washers are programmable and the amount of assisting detergents are established and pre-set during performance qualification (programs are edited for measured amounts).

You require three pumps for detergents and final rinse using sterile water or a compatible chemical for thermolabile instruments. The concentration and the compatibility of the chemical used is important as it is essential for effective processing and the most efficient way to establish the percentage of detergents, rinse aids etc. is by carrying out cleaning efficacy tests. (Htm2030)