lumens with an enzymatic solution at the point of use, as well as wipe
away gross soil with a single-use enzymatic sponge. Make sure employ-
ees use the correct concentrations of the detergent, or use pre-moist-
ened options that already include the precise amount. For longer pro-
cedures, you may even want to consider new pre-cleaning enzymatic
formulas that promise to keep instruments wet for up to 72 hours.
The right enzymes for the job
Enzymes are a protein that can clean heavily soiled surgical items by
breaking down large organic molecules — like blood — to facilitate
easier removal. There are several different types of enzymes, with 3
especially important for surgical cleaning.
• Protease. This family of enzymes breaks down proteins like blood,
mucus, feces and albumin. They take large, insoluble molecules and
break them down into smaller, more water-soluble ones that are easi-
er to clean and rinse away.
• Lipase. These enzymes break down fatty deposits and lipids.
Though the fat and oil molecules they attack aren't as large as pro-
teins, they tend to be insoluble in water. Lipase can make these more
water-soluble for better removal.
• Amylase. These enzymes catalyze starches. While they are less com-
mon in enzymatic detergents used on surgical instruments, they can
be found in ones marketed for "heavy-duty" cleaning.
Before using an enzymatic cleaner, determine the most suitable
enzyme by evaluating what kind of instrument you're using. Surgical
soils typically contain a variety of substances, though the most com-
mon are proteins and lipids.
Protein-based soils, such as blood, are found in most surgeries,
while lipids are often discovered on instruments used in orthopedic
surgeries, since there are lipid-based solutions around the joints, as
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