How Do You Sterilise and Clean Surgical Instruments?

Surgical instruments are used exclusively in sterile spaces, and they’re specifically designed to penetrate a patient’s skin or mucous membrane.

In this post we’ll discuss some best practice techniques for cleaning and sterilising surgical instruments.

Benefits of Effective Cleaning and Sterilisation of Surgical Instruments

Infection Prevention and Control
As such, cleaning and sterilising surgical instruments before use is an essential part of infection prevention and control in hospitals.

Prolong Surgical Instrument Lifespan
Effective cleaning and sterilisation can also prolong the lifespan of surgical instruments, keeping them as sharp and effective as possible for as long as possible.

Decrease Turnaround Time
And an efficient cleaning and sterilisation process can help streamline your entire department, helping to reduce the turnaround time between procedures.

The Difference Between Cleaning and Sterilisation

There is a difference between cleaning a surgical instrument, and sterilising a surgical instrument:

  • Cleaning – Using water and disinfectant to remove organic matter.
  • Sterilising – Using chemicals or specialist equipment to remove all microbes from an object.

A surgical instrument must be sterilised before use. But it must be visibly clean before it’s ready for sterilising.

How to Clean and Sterilise Surgical Instruments

Different instruments may go through different cleaning and sterilisation processes depending on their material, and their frequency of use. But this is the general process that the majority of instruments will go through between uses.

Step 1 – Preprocessing

Following a surgical procedure, surgical instruments are treated with transport gels at the point of use. These gels prevent the drying of bioburden, which can make later cleaning and sterilisation processes faster and more effective.

Step 2 – Manual Cleaning

Once treated with transport gel, the sterile instruments are taken to a dedicated decontamination area. All instruments will then go through a manual cleaning process. Some instruments may have to be disassembled first, to ensure that all of their surfaces can be cleaned.

Ideally, the manual cleaning team will have access to a three bay sink:

  • Bay 1 – Pre-rinsing instruments with cold water to remove transport gel, and organic matter such as blood and bone.
  • Bay 2 – Immersing instruments in a solution, which will be either neutral detergent or enzymatic depending on the instrument. Following immersion, the instruments are brushed by hand.
  • Bay 3 – Final rinsing. Depending on the instrument, manufacturers may recommend different treatments for the rinse water. If the water’s too hard, it can lead to spotting. Chloride levels can also damage instruments, and microorganism levels can lead to cross-contamination.

Step 3 – Automated Washing

Following the manual cleaning, surgical instruments will go through a specialist automated washing process. This is the sterilisation stage, where any microorganisms will be removed and killed.

Different instruments will require different equipment and processes, including:

  • Disinfectors – The instruments are sprayed with pressurised water at a predefined temperature, flow, and chemical concentration. Manufacturers will recommend the optimum parameters for each instrument.
  • Ultrasonic Cleaning – Some surgical instruments have delicate, hard-to-reach features including hinges and crevices. Automatic disinfector machines may not effectively clean these areas, so ultrasonic cleaning processes are used instead. This involves using high-frequency sonic waves to clean the entire surface of an instrument, often alongside low-foaming enzymatic cleaning agents. Instruments must be thoroughly washed with soft water following ultrasonic cleaning.

Step 4 – Storage

Following the cleaning process, surgical instruments are labelled to indicate the date they were cleaned. They are then carefully transported to, and stored within, a sterile environment until they’re ready for use again.

Essential Tips For Caring For Your Surgical Instruments

You’ll find many guides on our site to help you keep your surgical instruments sterile and in good working order for as long as possible:

We also specialise in supplying high quality instruments for use in all surgical disciplines. If you’d like to discuss your surgical instrument requirements, get in touch to talk to an expert today.

Types of Surgical Instruments – Names and Instrument Selection

If we classify them according to their function, there are three main types of surgical instruments:

  • Cutting surgical instruments – Such as blades, knives, scissors and scalpels.
  • Grasping surgical instruments – Anything you use to hold something in place, such as forceps.
  • Retracting surgical instruments – For holding incisions open, or for holding organs and tissues out of the way while you operate.

Types of Surgical Instruments For Cutting

These are some of the most common surgical instruments for cutting:

Blades, Knives and Scalpels

We categorise scalpels by their size and shape, and each type is good for a different sort of application. For example, surgeons usually choose a number 10 blade for making smaller incisions in skin and tissue. Whereas a number 15 blade, with its small curve, is better for making short and precise incisions, such as when removing a skin lesion or opening a coronary artery.

Surgical Scissors

Surgical scissors come in a huge range of sizes. At the top end of the scale are heavy-duty surgical scissors, which can cut through thick tissue, muscle, and even bone. Mid-size surgical scissors use a combination of sharp and serrated blades to give precise cuts with minimal tissue damage. Surgical scissors with curved blades help you to make clean cuts without hitting any underlying tissue.

Smaller scissors include Vannas scissors and Castroviejo scissors, both of which are good for delicate applications such as ophthalmic and neurosurgical procedures. Finally, small sapphire blades can create precise cuts while applying a minimum of pressure, making them perfect for microsurgery.

Types of Surgical Instruments For Grasping

Like scissors and scalpels, surgical forceps come in a range of styles and sizes, each one suitable for different applications. Forceps can either have straight tips or curved tips. Straight tips provide more grip and precision, while curved tips provide more visibility.

Thumb Forceps

Some forceps you squeeze to open. These are thumb forceps, and they’re good for dressing wounds, removing dressings, and tying sutures.

Reverse Forceps

Other forceps you squeeze to close. These are reverse-forceps, and their design provides uniform tension for added precision, especially when you’re wearing gloves.

Locking Forceps (Haemostats)

Some forceps resemble scissors. These are called haemostats or locking forceps, and surgeons use them to securely hold tissues during delicate operations, and to compress blood vessels to obstruct the blood flow when operating on organs.

Types of Surgical Instruments For Retracting

In surgery, retractors can either hold a wound or incision open, or hold an organ or tissue out of the way so you can work underneath.

Hand Retractors

Hand retractors require someone – or something – to hold them in place for the duration of a procedure. Surgical assistants usually undertake this role.

Self-Retaining Retractors

As the name suggests, self-retaining retractors do not require anyone to hold them throughout procedures. They can use screws, ratchets or clamps to hold tissue in place. Alternatively, wire retractors use a spring system to keep things secure.

Choosing The Right Surgical Instrument For Your Application

Some surgical instruments are versatile. You can use them in a range of applications. But certain applications will demand more specific surgical tools – smaller, sharper, or more precise, for example.

Your surgical instrument supplier should help you choose the right instrument for your specific application. But here are some things you should consider to help narrow down your choice:

  • What procedure are you performing? Almost every procedure you could conceivably perform over the course of your surgical career will have been performed before. This means that there’ll be published research papers about almost every procedure. These papers will often list the surgical equipment used during the procedure. They may even make clear recommendations for which equipment to use for best results.
  • How often will you use the surgical equipment? Of course you’ll keep your surgical instruments clean between use. But it’s also important to remember that surgical equipment doesn’t stay sharp forever. If you intend to make heavy use of your surgical equipment, look for those made with more durable materials, as they’ll stay sharp for longer.

Need more advice in choosing the right surgical equipment for your application? We offer one of the most comprehensive ranges of surgical instruments in the UK, and our experts are always on hand to help you choose the equipment you need. Find out more about our surgical instruments.

Are Stille SuperCut Scissors Really a Cut Above the Rest?

If you are a surgeon with an eye for excellent surgical instruments, you may have noticed that SuperCut-type scissors are no longer made exclusively by Stille, except when it comes to micro scissors.

This is despite the fact that the Swedish instrument company actually invented and launched the original SuperCut scissors in 1982.

However, despite there now being other makes of SuperCuts on the market, several independent studies have shown that Stille SuperCuts are continuing to outperform other brands. In fact, the findings might surprise you.

So what’s so good about Stille’s SuperCuts?

There are four key areas that set Stille SuperCut scissors above other brands:

1. Unique design for cutting

Designed for cutting all types of soft tissue, Stille’s SuperCut scissors have two cutting surfaces that are sharp to the very tip and work together in a unique way.

That is because one cutting surface is a scissor blade and one is a knife blade. This means that the surgeon can use the scissors to cut with extreme precision, relying on an instrument that combines maximum cutting power with minimal force to produce the perfect cut.

All other brands of so-called ‘SuperCut’ scissors are made differently from Stille, usually with serrations on one blade that are allegedly designed to grip tissue. However, due to the way that Stille handcrafts its SuperCut scissors, they are actually much sharper than other brands of ‘SuperCut’ scissors.

2. Ergonomic, ambidextrous design

Stille has also put a lot of thought into the design and ergonomics of their SuperCut scissors to create a light but balanced instrument that minimises fatigue and maximises efficiency.

With smooth finger rings, shanks designed for feeling and balance and a strong screw joint for maintaining the correct tension between blades, the scissors provide the surgeon with a smooth fingertip feeling.

The scissors are also flexible for the needs of different surgeons. For example, due to the way in which the scissors are sharpened, they can be used by both left and right-handed surgeons.

What’s more, the scissors have larger finger rings than some other brands, which is useful for surgeons with larger hands or those that use a double glove technique.

3. A removable screw for effective servicing

Another unique feature of Stille’s SuperCut Scissors compared to other brands is that its joint screw can be removed by Stille’s technicians during servicing to inspect for corrosion.

Other SuperCut brands do not have this capability, meaning that both the cleanliness and longevity of these instruments can be compromised.

This was supported by a study(1)that compared two German brands of scissors with Stille scissors. The study found that only Stille’s scissors had a screw that could be removed during servicing; it was also the only scissor with no signs of corrosion under the joint.

What’s more, the removable screw design ensures that the SuperCut scissors can be sharpened back to their original condition by Stille’s expert craftsmen during servicing. This is because large amounts of blade material do not need to be ground away, something that would inevitably change the shape and size of the blades until they are no longer close enough for a good cut.

In addition, by removing the screw during servicing, the surface of the blades can be fully resurfaced, removing any crevices where pockets of dirt may hide.

4. An outstanding 30-year warranty

Unlike other brands, Stille guarantees that their SuperCut scissors will last for 30 years, providing that they are handled and sterilised correctly and that Stille’s own expert craftsmen carry out any servicing.

In fact, Stille offer the first service for free, which is typically required after three years of use, although the surgeon decides when his or her instruments are ready for servicing.

Whilst a 30-year warranty might sound very long, date codes on Stille instruments returned for servicing often show that they have been in regular hospital use for more than 40 years.

This was also shown to be the case in an independent study to test whether Stille hand-crafted surgical scissors really did deliver on the manufacturer warranty of 30 years. In fact, the study found that 74% of the Stille scissors used in a busy surgical centre were actually over 50 years old.(2)

Want to see Stille SuperCut scissors in action?

If you would like to find out more about our Stille SuperCut scissors just click here (Link to new SuperCut Scissors section on website).

You can also contact our Cairn instrument team on 0845 226 0185 to arrange for a demonstration of our Stille SuperCut scissors or to evaluate an instrument on loan.


(1) Anette Karppinen, ORN, Access to crevices critical for surgical instrument safety. Presented SEORNA, Swedish Operating Nurse Association, Conference Meeting, 29-30 November 2012.

(2) Dahl G, Ölveback T, Wiklung L. Quality surgical instruments best investment. Presented: SEORNA, Swedish Operating Nurse Association Conference Meeting, 29-30 November 2012

Why Buying the Best Surgical Instruments Can Save You Money

It might sound counterintuitive: How can an instrument that costs you several hundred pounds save you money compared to lower quality instruments that you can buy for a fraction of the price?

Below are four clear reasons why:

1.       Longevity

High quality surgical instruments are always manufactured with longevity in mind. Crafted by experts in instrument design and metallurgy, they understand how to create surgical tools that optimise performance and durability.

For example, top manufacturers will always choose the highest quality stainless steel rather than lower grade metal, as this will significantly enhance instrument longevity.

They are also likely to produce ceramic-coated instruments, which provide four to five times higher surface hardness than stainless steel, reduced abrasiveness and greater resistance to rust and corrosion.

They might also make instruments in Titanium, which is another high-performance metal that is recognised for its superior durability, being both fracture-proof and non-rusting.

What’s more, instruments that are hand-crafted, rather than made by machine, can have incredibly long life expectancy.

For example, in a study to test whether Stille hand-crafted surgical scissors really did deliver on the manufacturer warranty of 30 years, it was found that 74% of the Stille scissors used in a busy surgical centre were actually older than 50 years.(1)

2.       Cost-in-Use

Of course, whilst top surgeons and the sterilization services team might well value long-lasting surgical instruments, procurement teams charged with reducing operating room costs might find it hard to justify larger upfront costs for buying these products.

This is where a lifetime warranty comparison can really shine a light on the value of investing in higher quality instruments. By simply comparing the length of instrument warranties and dividing those time periods either by instrument cost or instrument use, it can be easily seen that the highest quality instruments will always be the star performers when it comes to value for money.

Obviously, high quality instruments with the longest warranties will prove the most cost-effective, so whichever instrument you are looking to purchase, make sure to research the various manufacturer warranties before buying anything. Whilst some will offer a 30-year warranty, others may only offer 1-5 years.

Alternatively, if your procurement team is considering single-use disposable instruments, a cost-in-use comparison with a high quality reusable instrument will invariably show the latter to be the most cost-effective investment.

For example, one study of laparoscopic instruments showed that “the total cost for single-use instruments would have been more than seven times that for reusable instruments.”(2)

3.       Minimal servicing costs

Another cost advantage to purchasing high quality surgical instruments is that they will often only need servicing every couple of years and some brands even offer the first service free within the initial purchase price.

What’s more, some high-quality instruments will be designed to allow for the instrument parts to be dismantled during servicing by the manufacturer, allowing for thorough inspection of corrosion at the joints to help maximise instrument longevity.

Low-quality instruments will not only require servicing more regularly, causing greater cost and disruption to instrument availability, they are also more likely to develop hairline fractures and corroded surfaces that mean effective servicing is no longer possible.

4.       Less environmental cost

There is also an environmental cost benefit for choosing long-lasting quality instruments over cheaper reusables in many cases.

For example, a study that compared mainly German brand reusable scissors to both German and Pakistani disposable scissors revealed that the reusable scissors were better for the environment. (3)

This is because whilst they take more energy to come to market, the reusable scissors are used thousands of times more than the disposable ones.

In addition, there is less ongoing environmental impact from servicing high-quality reusable surgical instruments than low-quality ones, which will require much more documentation, packaging, labelling and transportation for servicing.

Hold out for high quality

As can be seen from the above, it is easy to justify the greater outlay for purchasing high-quality reusable surgical instruments, even in the face of significant budgetary pressures.

In fact, the rapidity with which poor quality instruments degrade means that, even if you have missed the boat for submitting instrument requests for this financial year, it is worth waiting until you have the budget to buy the best in twelve months’ time.

To view our range of high-quality surgical instruments.

You can also contact our Cairn instrument team on 0845 226 0185 to arrange for a demonstration of our surgical instruments or to evaluate instruments on loan.


(1) Dahl G, Ölveback T, Wiklung L. Quality surgical instruments best investment. Presented: SEORNA, Swedish Operating Nurse Association Conference Meeting, 29-30 November 2012

(2) Gabriel N Schaer, MD, Ossi R Koechli, MD and Urs Haller, MD. Single-use versus reusable laparoscopic surgical instruments: A comparative cost analysis. American Journal of Obstetrics & Gynecology Volume 173, Issue 6, Pages 1812-1815, December 1995

(3) 982_JGARG-Review_1-2012_Scissors_Aug2012_7g0i26.pdf

Titanium micro instruments benefits

Titanium micro instruments offer several clear benefits for the surgeon over standard stainless steel models.

For this reason, Swedish surgical instrument manufacturer, Stille, has introduced a range of titanium micro forceps and needle holders.

Designed for surgeons specialising in plastic, ENT, reconstructive or replantation surgery, they offer the following benefits:

·         They are lighter than stainless steel micro instruments, helping to reduce fatigue during lengthy procedures

·         They are made from the finest U.S. origin alloy, giving you better durability and fracture toughness than lower grade titanium instruments

·         As titanium is a non-magnetic metal, the instruments minimise frustration caused by magnetized needles

·         With the exception of the DeBakey models, the forceps and needle holders have Diamond Jaws for improved durability and proper gripping of fine sutures

·         They are very resistant to corrosion, meaning they can maintain their performance and integrity for longer

With a range of 17 titanium micro forceps and 21 titanium micro needle holders, the surgeon has a wide selection of straight and curved models to choose from.

These include micro forceps with a variety of features including tying platform, counter-balanced design, fine ring tips and 1.2mm fine atraumatic DeBakey tips.

The micro needle holder range includes models with fine 0.8mm Diamond Jaws, a regular box lock for sutures 7-0 and smaller, and optional ratchet. There is also a range with 1.2mm Diamond Jaws, a streamlined box lock for sutures 5-0 and smaller, and optional ratchet.


The above features offer clear benefits for helping surgeons during delicate and complex procedures.

What’s more, they also provide an excellent long-term investment, where the procurement department needs to be reassured that any upfront cost can be justified by instrument longevity.

If you would like to handle our Stille titanium micro instruments to see how they feel, please contact our surgical instrument sales team on 0845 226 0185. They will be happy to visit you and show you our range.

If you prefer, they can also show you our range of Stainless stainless steel micro instruments.