Successful instrument processing starts at point of use and continues with strategies for preventing dried soils during transport and holding. This includes instruments, devices and endoscopes. How does the lack of scrubbing and friction during transport and holding impact our choice of pretreatment and cleaning chemicals?
Detergents aid cleaning by reducing surface tension, allowing water and friction to remove soils. Without enzymes, a detergent needs mechanical force through friction, scrubbing and brushing plus direct access to each surface to break up soils.
By adding enzymes to pretreatment sprays and presoaking detergents, we reduce the need for direct friction and scrubbing. Picture enzymes as a tiny Mr. Clean working during transport and soaking, going inside channels and crevices where blood and fats are hiding. Enzymes have biochemical action to break up soils where access and friction are limited.
Strategies that work for short holds (wet towels or gel sprays) are less likely to protect instrumentation when delays over two hours are more common. Non enzymatic sprays and detergents cannot start soil breakdown in more challenging situations such as residual orthopedic soil, overnight Emergency or Labor/Delivery services, and off-site transport of contaminated items.
The importance of thorough device cleaning prior to disinfection or sterilization is reinforced by recent studies from cruise ships affected by the COVID-19 outbreak, suggesting the virus could survive over two weeks on uncleaned surfaces. More than ever, effective enzymatic sprays and detergents are needed to maximize cleaning efforts for every step and every item.