The importance of detergent selection

Insuring that medical and surgical equipment is free from soil is essential for the safety of both hospital staff and patients. Understanding the chemical characteristics of the different types of detergents used in the hospital environment is necessary to implement a successful decontamination strategy. Selecting the right detergent for the task to be performed ensures that surgical instruments and other medical devices are not damaged and that cleaning is effective. 

Surgical instruments and endoscopes require cleaning prior to reprocessing or sterilisation. Both inorganic and soil residues (such as blood and protein) should be removed before the final disinfection or sterilisation process takes place, as poorly cleaned equipment has been associated with the transfer of healthcare-associated infection (HCAI). This risk arises because the presence of protein, or other soils, can provide a protective barrier to microorganisms from the disinfection or sterilisation treatment. An additional factor is that the presence of inorganic materials can interfere with effective decontamination. 

Pre-cleaning which may be undertaken manually, is achieved through the use of detergents to break up and remove grease and grime.1 Although there are a range of different chemicals which can be classed as detergents, the choice within the clinical setting is invariably between enzymatic and neutral (or ‘non-enzymatic’) detergents. Both classes have advantages and disadvantages, which are considered in this article.