Active electrosurgical accessories must be sterilized before use. Selecting the proper technique will help to preserve the function and extend the life of your surgical instruments.
ETO STERILIZATION
With a pressure reading not to exceed 12 psi, and a temperature not to exceed 68.3 degrees Celsius (155 degrees Fahrenheit), the electrosurgical accessories can be sterilized by ethylene oxide in any standard cycle.
Concerning humidification, vacuum, cycle time, gas concentration and temperature, we recommend following the manufacturer's instructions for the ETO sterilization unit.
STEAM AUTOCLAVING WITH PREVACUUM AND GRAVITY STERILIZERS
If a wrapping method is used, make certain that the instruments are individually wrapped or sealed in a sterile pack. Other metal objects should never come in contact with the insulating material of forceps and handles, or with RF-connection cables. Such points of contact may cause melting of the insulation.
We recommend the following values/parameters but we also suggest to follow the manufacturer's instructions for steam sterilization:
| Cycle | Sterilizing Temp. | Sterilizing Time | Drying Time |
| PREVAC | 270°F(132°C) | 5 min. | 30 min. |
| GRAVITY | 250°F(121°C) | 20 min. | 15 min. |
It is important that the longest drying cycle possible is employed, to prevent build up of moisture inside the instrument and RF-cables. If the cycle of your autoclave allows a 30 min dry time, we recommend to use it. Corrosion, pitting or intermittent operation are usual signs of a moisture induced corrosion problem.
FLASH AUTOCLAVING (fast heating/cooling cycle)
Flash autoclaving will reduce the useful life of the instrument particularly when it is constructed of various materials, encompassing different expansion rates.
COLD SOAKING
There is nothing detrimental about the use of glutaraldehyde or other cold soaking solutions, as long as the accessories are dried completely prior to use.
STERILIZATION WITH THE STERIS PROCESS
Sterilization of surgical devices by the STERIS PROCESS requires that the liquid sterilant make contact with all exterior and interior surfaces of the device. After the sterilization process the devices are rinsed with sterile water, but no drying cycle is employed. Since electrosurgical accessories perform inconsistently when moisture is present, you should make absolutely sure, that the instruments are dry before you use them.
STERILIZATION WITH THE STERRAD PROCESS
The STERRAD system uses low temperature plasma to sterilize metal and non-metal instruments. Please adhere to the sterilization instructions provided by the manufacturer of the equipment.
CHEMICLAVING
This is the most destructive method to the insulating and silicone materials of electrosurgical accessories and can cause rapid deterioration and failure.
All accessories may be cleaned by conventional procedures, including ultrasonic cleaning. The only exception to ultrasonic cleaning are handswitching (BI-CO-MATIC) bipolar forceps, and handswitching unipolar handles, which must not be immersed in an ultrasonic cleaner, to protect their RF-switching devices. Also, it should be noted that ultrasonic cleaning over extended periods of time can deteriorate the delicate joints of micro forceps. Again, it is important that electrosurgical accessories be dry when put into use, otherwise intermittent performance will be obtained.
It is most important that all electrosurgical accessories be inspected prior to each surgical procedure, for signs of deterioration. Also, all accessories must be thoroughly inspected and tested by a qualified biomedical technician at least every six months, to insure proper performance. Having an extra set of accessories on hand is always recommended.
Electrosurgical cables particularly are considered wear and tear items, and during heavy usage, will likely not last between these six months intervals. Electrosurgical cables which have any cracks or breaks in their insulation should be repaired or replaced upon any observation of cracked or peeling insulation, intermittent performance, or when any corrosion is present. Any such instrument should be immediately forwarded for repair.
When unplugging cables from equipment or instruments, grab the jacket of the plug and do not pull on the wire. The latter will break the union between the plug and the cable.
*** WARNING ***
Many electrosurgical accidents have been caused by faulty accessories, and by failure to check for and identify these accessories prior to each procedure.