CRCST · Preparation and Packaging · 6 min read
Functional Testing, Damaged Instruments and Lubrication
- Perform accurate visual inspection and functional testing on clamping, cutting, bone-cutting, and laparoscopic surgical instruments.
- Identify mechanical defects, insulation failures, and structural damage, applying correct protocols for tagging, cleaning, and removing compromised instruments from service.
- Apply surgical instrument lubricant according to manufacturer instructions for use to preserve instrument function and ensure compatibility with sterilization.
Visual Inspection and Testing of Clamping Instruments
In the sterile processing department, the technician plays a central role in cleaning, decontamination, inspection, assembly, packaging, sterilization, and storage of surgical devices. After cleaning is complete, you must visually inspect every instrument under adequate lighting, using magnification whenever necessary, before performing any functional testing. Inspection is your frontline defense against delivering flawed tools to the operating room. Pay special attention to critical stress zones like the box lock, where fine hairline cracks and metal stress frequently develop.
A loose box lock pin can cause the jaws of an instrument to misalign or fail to close entirely. When inspecting hemostats and other clamping instruments, check that the jaws align and intermesh precisely. On forceps with serrated jaws, the opposing serrated portions must align and engage as designed; not every working end is serrated along its entire length. The tips of tissue forceps must align as designed; toothed tips should interlock properly, while tips that bypass or cross sideways indicate a defect. Think of forceps like precision tweezers; if the tips bypass each other even slightly, they will pinch or tear delicate tissue instead of grasping it firmly.
Ratchet mechanisms must engage smoothly through each successive locking position without sticking, slipping, or demanding excessive force. To test a ratchet, close the instrument to its very first ratchet tooth. If specified by the device manufacturer's instructions for use (IFU) or your facility policy, hold the instrument and gently tap it against the palm of your hand. Never strike an instrument against a hard surface, such as a metal prep table, which can bend or break delicate steel. A ratchet that springs open when tapped against the palm has failed functional testing and must be pulled from service immediately.
Common mistakes
- Striking a ratcheted instrument against a hard prep table during testing instead of gently tapping it against the palm of the hand as authorized by the IFU.
- Relying solely on visual checks to verify laparoscopic shaft insulation, ignoring electronic testing that detects invisible microscopic pinholes.
- Attempting to manually adjust, bend, or repair stiff box locks or misaligned forceps tips in-house instead of tagging them for an authorized repair facility.
- Wiping off instrument lubricant after dipping, or using oil-based/petroleum lubricants that block steam penetration during sterilization.
Key points
- Visual inspection under adequate lighting is required after cleaning and before functional testing; use magnification when needed or required by the device IFU or facility policy.
- Clamping instruments require proper jaw alignment, serration engagement, and ratchet function; use a first-tooth palm-tap test only when permitted by the device IFU and facility policy.
- Scissors require sharpness testing during every assembly cycle using size-appropriate elastomeric material (commonly red for 4.5 inches or longer, yellow for under 4.5 inches), cutting cleanly to the tip.
- Specialty cutting instruments have dedicated test media: Kerrisons are tested on index cards without tearing or leaving hanging chads, while biopsy punches are tested on paper media.
- Laparoscopic electrosurgical insulation must be inspected visually and electronically tested per IFU to prevent internal patient burns from microscopic insulation defects.
- Remove damaged instruments from clinical use, document the defect, and process and route them for authorized repair or disposal according to the manufacturer's IFU and facility policy.
- After cleaning, apply a lubricant approved for the instrument and steam sterilization according to the device and lubricant IFUs, with the instrument open and unlocked; do not wipe it off unless the IFU directs you to.
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