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FAQ - Instrument Processing - 2016
 FAQ -  Instrument Processing - 2016



Are there any recommendations in regards to the "bundling" of instruments with ties before they are placed in the ultrasonic cleaning solution/device? One would think that bundling would inhibit the cavitation process. However, I can't find anything that state instruments should not be bundled. I hope you can help.

As a matter of policy, Ask OSAP does not review, evaluate, certify, recommend or endorse products. Ask OSAP is also not in the position to provide technical support for specific products. If you have further questions about procedures and specific products it is recommended that you consult with the manufacturer’s written instruction manual and/or contact the manufacturer of your product directly. The manufacturer’s validated Instructions for Use (IFU) should be able to provide you with guidance on this matter.

In general, the 2003 CDC guidelines for infection control in dentistry states the following regarding instrument processing:

Transporting and Processing Contaminated Critical and Semicritical Patient-Care Items

DHCP can be exposed to microorganisms on contaminated instruments and devices through percutaneous injury, contactwith nonintact skin on the hands, or contact with mucousmembranes of the eyes, nose, or mouth. Contaminatedinstruments should be handled carefully to prevent exposureto sharp instruments that can cause a percutaneous injury.Instruments should be placed in an appropriate container atthe point of use to prevent percutaneous injuries during transport to the instrument processing area (13).

Instrument processing requires multiple steps to achieve sterilization or high-level disinfection. Sterilization is a complexprocess requiring specialized equipment, adequate space, qualifiedDHCP who are provided with ongoing training, and regularmonitoring for quality assurance (247). Correct cleaning,packaging, sterilizer loading procedures, sterilization methods,or high-level disinfection methods should be followed toensure that an instrument is adequately processed and safe for reuse on patients. 1


Preparation and Packaging

In another section of the processing area, cleaned instruments and other dental supplies should be inspected, assembled into sets or trays, and wrapped, packaged, or placed into container systems for sterilization. Hinged instruments should be processed open and unlocked. An internal chemical indicator should be placed in every package. In addition, an external chemical indicator (e.g., chemical indicator tape) should be used when the internal indicator cannot be seen from outside the package. For unwrapped loads, at a minimum, an internal chemical indicator should be placed in the tray or cassette with items to be sterilized (254) (see Sterilization of Unwrapped Instruments). Dental practices should refer to the manufacturer’s instructions regarding use and correct placement of chemical indicators (see Sterilization Monitoring).Critical and semicritical instruments that will be stored should be wrapped or placed in containers (e.g., cassettes or organizing trays) designed to maintain sterility during storage (2,247,255–257).

Packaging materials (e.g., wraps or container systems) allow penetration of the sterilization agent and maintain sterility of the processed item after sterilization. Materials for maintaining sterility of instruments during transport and storage include wrapped perforated instrument cassettes, peel pouches of plastic or paper, and sterilization wraps (i.e., woven and nonwoven). Packaging materials should be designed for the type of sterilization process being used (256–259). 1

In summary, the 2003 CDC guidelines does not specifically address the bundling of instruments by ties during instrument processing. If you have further questions about the specific ultrasonic unit product, it is recommended that you contact the product manufacturer regarding the product IFU. 


1)     Kohn WG, Collins AS, Cleveland JL, Harte JA, Eklund KJ, Malvitz DM, Centers for Disease Control and Prevention (CDC). Guidelines for infection control in dental health-care settings—2003. MMWR Recomm Rep 2003;52(RR-17):1-61.    Accessed on June 3, 2016.



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