surgical instruments market

FAQ

What is Stainless Steel?  
Stainless steel is an alloy, which does exactly what its name implies: stains less than ordinary steel (iron). Yes, it can stain, discolor and rust, given the right circumstances. To make iron stainless, nickel and chromium are added in certain quantities, depending on the purpose it is being used for and the qualities required. The more chromium added to the mix, the softer the alloy becomes, something not desirable in a surgical instrument. Given that, quality medical stainless steel alloy is of a very specific, narrowly defined mix. A further aspect of making steel stainless is a repeated process of extracting surface impurities, mainly minerals. And the final high polish of the finished instrument puts a minute protective coating on it, also very important to make the instrument "stain less".Whether the final product is highly polished or mat finished will make no difference in its stainless ability.
Austenitic  
This is a non-heat treatable stainless steel with low carbon content. It is corrosion-resistant and malleable, which makes it ideal for hooks, specula, calipers and retractors.  
Martensitic  
A heat-treatable stainless steel, this material can be worked in a soft state and then be  hardened to increase strength. It will be found most often in forceps, scissors, rongeurs, curettes, trephines, knives and needle holders. Stainless steel resists rust and can be finely sharpened. Its name, however, is somewhat misleading, for stainless steel can spot, stain and pit or corrode if not properly cared for. Other materials can also be utilized in the manufacture of surgical instruments, including silver, titanium and other alloys. Each has properties and characteristics that require vigilance in care and handling. Proper care, cleaning, handling, inspection and sterilization are the key to proper instrument performance and extended usefulness.
How should I clean my instruments?  
This depends on how sterile your protocol requires them to be. First rinse in pH neutral distilled water and remove blood and debris. Use a fresh neutral pH solvent and then a soft brush for the tough cleaning. If you steam autoclave, make sure that you use manufacturer's instructions for your autoclave (clean neutral pH distilled water), and that your high quality instruments are not mixed with instruments of inferior quality. Impurities from the lower quality instrument can start a corrosive action on your good ones. Be sure that the full drying cycle is used. Overlapping joints may have dampness within the joint, increasing the chance of corrosion. This can be prevented in three ways: assure the full drying cycle is complete, apply silicone grease inside the joint as a protective layer, or by use of an air canister or hair dryer to blow moisture out of overlapping parts. Instruments can also be cleaned ultrasonically but must be immediately rinsed and dried. It has been our experience that the longest lasting instruments are typically the ones soaked in 70% ethanol before and after use, then rinsed and dried.
I bought two of the same instruments and they are different!  
High quality surgical instruments are handmade which can lead to some minor variations in the dimensions of instruments, particularly between manufacturing sets. This is sometimes noticeable in the finest spring scissors and the tips in Dumont forceps.
My instruments are rusting. What should I do?  
Proper cleaning of your instruments right after use is the first step to prevent rusting. In most cases, what is perceived as rust is really dried blood, which, if left on the instrument will start corrosive action. Soak instruments right after use in a dish of pH neutral distilled water or a solution of neutral pH detergent. A soft toothbrush will help remove the softened materials. Soak up to an hour and never re-use solution. Rinse in distilled clean water and dry with clean lint free cloth. Be sure overlapping surfaces are completely dry; a hairdryer will help here. Ultrasonic cleaners can also be used, but be sure to follow manufacturers instruction fully, particularly in the concentration of the solution to be used. Instruments can also be steam sterilized; but follow manufacturers instructions. Use only distilled water; be sure to run the drying cycle to its end, so that instruments are completely dry; never mix good quality instruments with those of inferior quality, as impurities from the poor quality instruments could settle on your good ones and start a corrosive action.
How can I prevent my stainless steel instruments from staining?  
Never remove the final polishing film by rubbing or sanding. Never leave it in tap water for any length of time. Acidic or alkaline pH will remove chromium oxide and chlorite ions will cause pitting. Copper, iron and manganese will cause brown and blue rainbow effects. Distilled water with a neutral ph can be used sparingly. Rubbing the instrument with Surgical Instrument Oil, (also called Instrument Milk) and putting a drop of it between overlapping surfaces, will aid in keeping your surgical instrument for years to come.
I work in salt water.

Saline solutions are very hard on stainless steel instruments. Rinsing them in acetone immediately after every use will help. Keeping them immersed in instrument milk when not in use is recommended. But salt water will eventually take its toll. Therefore consider buying titanium instruments.
When I should ask for titanium instrument?  
If you must use your surgical instrument in a corrosive environment, or you need a completely non-magnetic instrument, or it has to tolerate heat of up to 440 C or 824 F, an instrument made from titanium alloy can be your answer. Other benefits are: 40% lighter than stainless steel; better strength to weight ratio than stainless steel; better flexibility than stainless steel; it exhibits bactericidal and non-allergenic properties. Artery clamps made of titanium alloy (90% Titanium, 6% Aluminum, 4% Vanadium), are now being used in MRI's with acceptable results. Consider that it will wear down faster than stainless steel.
How do I keep Dumont forceps tips from bending?  
The problem is that the smaller the tips, the more delicate they become and therefore are more prone to damage, while tips that last a very long time are quite often not fine enough for the microscopic procedures many researchers perform. If the user is experienced but occasionally hits the tips of the stage or the dish, we recommend getting the Dumostar alloy. The cost is just less than twice as much as Inox or Dumoxel alloy forceps but lasts up to 5 times longer. You can also attempt to re-sharpen the tips. The tools needed are a dissecting microscope, a sharpening stone, your thumbnail, and smooth needle-nose pliers. Most importantly you need a bit of practice. FST does not re-sharpen Dumont forceps, as the cost would be more than half the price of a new one. Please see our guide to sharpening forceps for.
What type of alloy should I choose for my Dumont forceps?  
Start with Inox, which is medical stainless steel, quite hard, but magnetic and can stain. If magnetism and or staining are a problem, try Dumoxel, which is more resistant to staining, but slightly softer and less magnetic. If you have stain or rust problems with your Dumoxel, choose titanium, which is completely stain-free, 40% lighter than regular stainless steel, completely non-magnetic, but is also the softest alloy. It is heat resistant up to 440?‹ C, or 824?‹ F. If you have problems with the tips breaking, the Dumostar series might be your answer. This alloy has corrosion resistance superior to that of any stainless steel alloys, has the highest hardness rating in Dumont forceps, is highly resistant to metal fatigue, has great elasticity and can tolerate up to 550?‹ C of temperature. It lasts much longer than any other alloy from Dumont.
What does the gold handle mean?  
A gold handle on scissors, forceps, or needle holders means they have tungsten carbide (TC) inserts on the working surfaces. TC is one of the hardest alloys used for surgical instruments. They are approximately twice as expensive as standard instruments, but can last five times longer, cutting the same tissue. This can be very cost effective in the long run.
Origin & Causes  

The corrosion resistance of stainless steel primarily depends on the quality and thickness of the passive layer. This is a protective layer of iron/chromium oxide that results from the chemical reaction between the chromium in the steel alloy (at least 12%) and oxygen in the ambient air. This layer is not affected by the specific surface finish of the product (matte or high-gloss). In fact its formation and growth are influenced by the following factors:

  • Composition of the alloy.
  • Microstructure of the material, which is influenced by heat treatment (e.g. forging, tempering, annealing, welding, soldering).
  • Surface finish and condition, e.g. roughness or smoothness.
  • Handling and reprocessing conditions.
  • The service life and number of reprocessing cycles.


But experience shows that these corrosion attacks decrease as the thickness of the passive layer increases over time. This is because a thicker passive layer reduces the probability of chlorides penetrating to reach the unprotected substrate beneath.

One of Chloride sources in the instrument usage and reprocessing cycle:

  • Laundry, textiles, packaging materials.

Pitting and stress corrosion cracking are seldom or never observed in a chloride-free or low-chloride environment. This is irrespective of the degree of gloss and the given passive layer of the instrument surface. If corrosion only occurs on new instruments processed in the same cycle with older instruments, the reason can probably be found in the instrument processing conditions.

Before using brand-new instruments, they must be sent through the entire processing cycle in the same manner as used instruments.

The cleaning step should never be skipped because residues (e.g from packing materials or care agents) could lead to the formation of stains or deposits during sterilization.

The passive layer of brand-new instruments is necessarily still thin and so these instruments tend to be more sensitive to critical treatment conditions than are older instruments.

When using only stainless steel instruments, contact corrosion has so far been observed only after the washing cycle. Micro friction at the contact points leads to partial abrasion of the passive layer. Thus the

corrosion protection is temporarily removed in these places, which in turn leads to the surface changes described above. (This surface change could also easily be classified as "fretting corrosion".)

In the classic material combination (stainless steel in contact with non-ferrous metals) when, in other words, the instrument stock typically contains old and new instruments, this type of corrosion occurs

during cleaning as well as during sterilization, due to a damaged and/or incomplete chromium or nickel layer (e.g. in the case of hollow handles or retractors).

Treatment recommendations

When only stainless steel instruments are used, there is no need to remove contact corrosion symptoms because such surface changes due to their low severity (i.e. quantity of deposits involved), pose no

risk either to the affected instruments or to other, unaffected items.

Experience shows that such surface symptoms usually disappear after a few processing cycles. If acid media (neutralizing agents) are used, these deposits usually dissolve at once, which in turn accelerates the passivation process.

References:  

The German ″Betreiberverordnung" (Operator Regulations).

Proper maintenance of instruments (AKI organization “Aesculap, Ecolab, MMM,Martin”)

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To our country, to the entire world and to the future, we founded lifeCare Surgical. Starting from where others ended, adding the value of 20 years experience in the field of instrumentation. Offering products with the best quality that appreciate health care and doctors needs.