Reprocessing Power Tools in the Modern Age

Better designs and custom sterilization trays make sterile processing departments’ jobs faster and easier.

There was a time when all surgical power tools had to be handwashed (or, in sterile processing parlance, manually cleaned) because the devices weren’t designed to withstand the rigor of automated disinfection and/or sterilization.

Durability under duress

More and more of these saws, drills, reamers and other devices are now being designed to do just that. They can be submerged in water and withstand all the phases of a complete reprocessing cycle. That’s good for patients, doctors, facilities and sterile processing technicians alike.

• The fight against fluid invasion. The tools that still must be manually cleaned aren’t fully sealed against moisture. If submerged, fluid can seep through the devices’ joints and other openings and the mechanical parts inside the drill will corrode. “You can’t see it happening, so you won’t know until the drill stops working in the doctor’s hand — a nightmare scenario,” notes Casey Czarnowski, BA, CRCST, CSPDT, CIS, CER, a sterile processing consultant in Minnesota. “Suddenly, a doctor will say he needs a backup drill. When this happens, fluid invasion is often the culprit, and hopefully you’ll have a backup ready.” This used to be a common problem and facilities would have no working drills for short periods of time. Drills with internal erosion problems can sometimes be repaired, but there comes a point where the corrosion is too severe, and a new device must be purchased.

Sterile processing departments (SPDs) wanted to be able to put the devices through automated cycles, whether it was high-level disinfection or liquid chemical sterilization. Adding a thermal disinfection phase is a more consistent process than simply handwashing the devices and doing it with automation is faster and easier for SPDs as well. “The larger manufacturers listened and now most power tools are able to go through that automated process,” says Mr. Czarnowski.

The larger manufacturers listened, and now most power tools are able to go through that automated process.
Casey Czarnowski, BA, CRCST, CSPDT, CIS, CER

• Let IFUs be your guide. Now that the ability to use automation to reprocess is the norm, it’s more important than ever to read the Instructions For Use (IFUs) that come with the new tools. “There are some facilities that still don’t have automated washing systems, and that’s fine,” says Mr. Czarnowski. “Most instructions from manufacturers are going to say you can manually clean them if you must, providing, of course, you do a thorough job. But, if you can put them though an automated system, most current IFUs will tell you that you should.” The first order of business for some smaller ASCs is to actually read the IFUs so they’ll know that their new power fleet is capable of being submerged in water. Many sites might assume they can’t since the tools they’ve had for years had to be manually cleaned to prevent the insides of the tool from corroding.

Some manufacturers will recommend that their devices go through an automated reprocessing cycle, knowing that it was designed to withstand thermal disinfection and that it will be a more consistent way of ensuring that the tool will be sterile for the next case. Of course, any power tool that gets cleaned in an automated washer-disinfector will be rinsed in a sink first and then manually cleaned with a brush to remove any gross soil remaining from the last procedure.

• There’s a container for that. Some companies offer very effective rigid containers that are used to reprocess, not just transport the components of your power tool fleet. Rigid containers are Class II medical devices regulated by the FDA. They allow the sterilant to penetrate the container to sterilize the instruments and hold the sterile barrier while it’s on the storage shelf between cases. Some companies have custom carriers they require the tools to be placed in during automated reprocessing, that hold each tool and all its attachments in certain positions. Facilities can wrap that carrier or put it in an additional container, but it also needs to be in its custom carrier. Other companies, meanwhile, might have IFUs that are silent on whether their product needs to be reprocessed in the manufacturer’s case, in which case you can wrap it or use a rigid container. “Before using a third-party multitiered container, however, I caution facilities to read the tool’s IFUs and/or speak with the vendor rep to make certain it’s OK to do so,” says Mr. Czarnowski.

• Abide by duty cycles. Home power drills have vents, but surgical drills do not, because fluids and tissue could get into the tool’s internal motor. So they can overheat quickly, which is why surgeons sometimes request two or three of the same tools for one surgery. In a new power tool’s IFU, and sometimes etched onto the instrument itself if there’s room, are three numbers that constitute the device’s duty cycle. The first number tells the user how many minutes you can run it before it needs a break; the second number tells you how long the tool needs to be paused; and the third is how many times you can do that before the tool needs to be set aside for an extended break. Ignoring these guidelines would likely result in tools malfunctioning from overheating, cautions Mr. Czarnowski.

Thanks to modern designs and highly effective multitiered custom containers, the latest power tools can be cared for in a financially responsible way that will maximize their longevity. OSM

Note: This three-part article series is supported by ConMed.