The Best Soaking Solutions for Manual Pre Cleaning in Sterile Processing

Sterile processing plays a pivotal role in ensuring patient safety and the effective functioning of surgical instruments. The cornerstone of this process is manual pre-cleaning, as it lays the foundation for the subsequent steps of disinfection and sterilization. The importance of a thorough cleaning cannot be overstated, as a soiled instrument cannot be effectively sterilized.

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Choosing the Right Soaking Solution for Manual Pre-Cleaning

The effective removal of bioburden and proper sterilization of surgical instruments hinges on the selection of the appropriate soaking solution. Choosing a soaking solution entails considering factors like the type of soil, the instruments to be cleaned, the cleaning process, and the water for rinsing. There are various soaking solutions available, including enzymatic cleaners, detergents, and ultrasonic cleaners. Understanding the properties and applications of each solution, which has its own set of pros and cons, is of utmost importance.

Enzymatic cleaners are effective at eliminating bioburden but can be costly and require a prolonged soaking period. Detergents, on the other hand, are effective at removing soil but can be corrosive and necessitate a shorter soaking period. Ultrasonic cleaners are effective at removing soil from hard-to-reach areas but can be expensive and require a longer soaking period when using detergent solutions instead of a single detergent solution.

The choice of soaking solution is a balance between cost, efficacy, and compatibility with the specific instruments being cleaned.

Enzymatic Cleaners

Enzymatic cleaners utilize biological methods to decompose organic waste, stains, molds, and odors, making them an ideal choice for manual pre-cleaning of surgical instruments. They contain proteases, amylases, and lipases, which facilitate the breakdown of different types of soils, and are highly effective in breaking down organic material.

Adhering to the manufacturer’s instructions and guidelines for dilution and contact time is paramount to maximize the effectiveness of enzymatic cleaners. Furthermore, the correct concentration should be employed, and instruments should be thoroughly rinsed after use.

Utilizing personal protective equipment (PPE) when handling enzymatic cleaners is also imperative for the safety of sterile processing technicians.

Best Practices for Soaking Surgical Instruments

Adopting best practices for soaking surgical instruments is fundamental to guarantee their proper cleaning and sterilization. One of the recommended practices is to presoak or rinse the instruments to prevent drying of blood and to soften or remove blood from the instruments. Soaking the instruments in a tepid or lukewarm water or detergent bath for a minimum of 10 minutes is also advised.

Ensuring the correct dilution of cleaning solutions becomes necessary to assure the effectiveness of the cleaning solution and to prevent potential damage to the instruments. A three-bay sink arrangement is suggested for manual cleaning, where instruments can be soaked, washed, and rinsed in separate compartments. Moreover, maintaining the instruments moist after use helps stop blood, tissue, and other body fluids from drying and making the instruments harder to clean.

Following these best practices for soaking surgical instruments can significantly improve the overall effectiveness of the manual pre-cleaning process, ensuring that instruments are properly cleaned and sterilized before use.

Assessing the Effectiveness of Manual Pre-Cleaning

Employing various assessment methods, such as visual inspection with a lighted magnifying glass and following manufacturer’s instructions, is key to ensuring the effectiveness of manual pre-cleaning in a manual or mechanical process. Visual inspection can help identify residual soil on delicate or complex devices, such as surgical instruments, which can pose several risks, including potential for transmission to patients and degradation of the device’s surfaces or impaired functionality.

Adhering to guidelines set forth by governing agencies such as AAMI/ANSI, FDA, and AORN can also help ensure the thorough cleaning of surgical instruments. These guidelines provide comprehensive information on cleaning and disinfection, including manual or mechanical processes.

Maintaining Compliance with Sterile Processing Standards

The safety and effectiveness of surgical instruments hinge on compliance with sterile processing standards. Ensuring operator competence is achieved through training and certification, adherence to standard operating procedures, and performance monitoring. Adherence to standard operating procedures is maintained through the development and documentation of procedures, training of staff, and monitoring of compliance.

Validating sterilization processes is another key aspect of maintaining compliance with sterile processing standards. This can be accomplished by testing and monitoring the disinfection or sterilization process, utilizing biological and chemical indicators, and performing routine maintenance. Ensuring accurate documentation by documenting all steps of the steam sterilization process, tracking instruments, and recording maintenance and repairs is also vital for compliance.


It is crucial for healthcare facilities to remain vigilant in their commitment to implementing these best practices and maintaining compliance with sterile processing standards. Doing so will not only ensure the proper functioning and longevity of surgical instruments but, most importantly, protect the well-being and safety of patients.

Frequently Asked Questions

What type of solution should be used during manual cleaning of surgical instruments?

For manual cleaning of surgical instruments, it is best to use a neutral or near-neutral pH detergent solution that contains enzymes in order to provide optimal material compatibility and effective soil removal.

What kind of solution is adequate to clean equipment prior to disinfection?

For adequate cleaning prior to disinfection, patient-care items should be meticulously cleaned with water and detergent or enzymatic cleaners. For instrument cleaning, a neutral or near-neutral pH detergent solution is recommended for best material compatibility and soil removal, with enzymes sometimes added to assist in organic material removal.

What is the appropriate soak time to disinfect an instrument in cold sterilization?

For cold sterilization, a soak time of 10 minutes or more is sufficient to disinfect instruments.

What are the benefits of using enzymatic cleaners in manual pre-cleaning?

Enzymatic cleaners provide an effective solution for manual pre-cleaning of surgical instruments, breaking down organic material and helping to minimize the potential for cross-contamination. They are also safe to use on a variety of surfaces.

What is the importance of point of use pre-cleaning techniques in manual pre-cleaning?

Point of use pre-cleaning techniques are essential in manual pre-cleaning as they prevent the drying of bioburden and make cleaning easier.