3.1 Instrument Inspection & Functionality Testing
Key Takeaways
- Every instrument must be inspected for cleanliness, function, and damage after cleaning and before packaging
- Visual inspection should be performed using adequate lighting and magnification when available
- Scissors are tested by cutting through manufacturer-specified test material (typically latex or specific fabric)
- Hemostats and clamps are tested by closing on material — they should hold without slipping or "springing"
- Needle holders are tested for jaw alignment and the ability to securely grip a suture needle
- Insulated instruments must be tested with an insulation tester to detect breaches that could cause burns
- Damaged, stained, or malfunctioning instruments must be removed from service and sent for repair or replacement
- Instruments with pitting, corrosion, cracks, or burrs must be removed — they harbor organisms and can injure patients
Last updated: March 2026
Instrument Inspection & Functionality Testing
Inspection is the quality checkpoint between cleaning and packaging. Every instrument must be verified for cleanliness, proper function, and absence of damage before it can be packaged for sterilization. This step protects patients and ensures surgeons receive instruments that work correctly.
Visual Inspection for Cleanliness
What to Look For:
- Remaining soil — blood, tissue, mineral deposits, stains
- Biofilm — slimy residue in lumens, channels, or crevices
- Detergent residue — white powder or film from incomplete rinsing
- Water spots — mineral deposits from poor water quality
Inspection Best Practices:
- Use bright, focused lighting (lighted magnification highly recommended)
- Inspect all surfaces — including box locks, serrations, ratchets, lumens, and internal channels
- Use a lumen scope or borescope to inspect internal channels of lumened instruments
- Any instrument with visible soil must be returned to decontamination for re-cleaning
- Protein residual testing can supplement visual inspection for quality assurance
Functionality Testing by Instrument Type
Scissors
| Test | Method | Pass Criteria |
|---|---|---|
| Sharpness | Cut through manufacturer-specified test material (latex glove, cotton fabric) to the tip | Clean cut without shredding or catching |
| Blade alignment | Hold up to light in closed position | No light visible between blades; blades align evenly |
| Tension | Open and close repeatedly | Smooth action without excessive looseness or tightness |
Hemostats / Clamps
| Test | Method | Pass Criteria |
|---|---|---|
| Jaw alignment | Close fully and examine tips | Tips meet perfectly; no overlap or gap |
| Ratchet function | Close on each ratchet position | Ratchet holds firmly; does not slip or "spring" open |
| Spring tension | Open and close repeatedly | Returns to open position without sticking |
Needle Holders
| Test | Method | Pass Criteria |
|---|---|---|
| Jaw insert | Examine carbide insert (gold handles indicate carbide) | No wear, chipping, or loose inserts |
| Grip test | Place suture needle in jaws and close first ratchet | Needle holds securely without rotation |
| Alignment | Close and examine jaw tips | Tips meet evenly with no offset |
Forceps (Thumb/Tissue)
| Test | Method | Pass Criteria |
|---|---|---|
| Tip alignment | Hold up to light; close tips | Tips meet evenly; teeth interlock properly |
| Tension | Squeeze and release | Returns to rest position with appropriate spring |
| Teeth condition | Examine under magnification | Teeth intact, not bent or broken |
Retractors
| Test | Method | Pass Criteria |
|---|---|---|
| Surface condition | Visual examination | No bending, cracks, or sharp edges |
| Ratchet function (self-retaining) | Engage and disengage ratchet | Holds securely; releases cleanly |
| Finish | Check for pitting or corrosion | Smooth finish without defects |
Insulated Instruments (Electrosurgical)
| Test | Method | Pass Criteria |
|---|---|---|
| Insulation integrity | Use an insulation tester device | No breaches detected; no current leakage |
| Functionality | Test mechanical function as above | Proper operation of all moving parts |
Insulation testing is critical — tiny insulation breaches invisible to the naked eye can cause patient burns during electrosurgery. Always test with a dedicated insulation tester, not just visual inspection.
Instrument Defects — Remove From Service
| Defect | Risk | Action |
|---|---|---|
| Pitting/corrosion | Harbors organisms; weakens instrument | Remove; repair or replace |
| Cracked or broken jaws | Patient injury; instrument failure | Remove; discard or repair |
| Bent tips | Cannot perform intended function | Remove; send for repair |
| Burrs on edges | Can tear tissue; difficult to clean | Remove; send for repair |
| Loose box locks | Instrument will not hold properly | Remove; send for repair |
| Missing parts | Instrument incomplete; cannot function | Remove; order replacement parts |
| Staining | May indicate improper cleaning or corrosion | Evaluate cause; treat or replace |
| Dull scissors | Cannot cut properly; surgeon frustration | Send for sharpening |
Instrument Lubrication
- Water-soluble, steam-penetrable lubricant (instrument milk) may be applied after cleaning
- Lubricant keeps box locks, hinges, and moving parts functioning smoothly
- Never use silicone-based or WD-40 type lubricants — they are NOT steam-penetrable and will prevent sterilization
- Apply lubricant per manufacturer IFU
- Some facilities apply lubricant through automated lubrication baths
Test Your Knowledge
When inspecting scissors, light visible between the closed blades indicates:
A
B
C
D
Test Your Knowledge
Insulated electrosurgical instruments should be tested with:
A
B
C
D
Test Your Knowledge
Which type of lubricant should be used on surgical instruments?
A
B
C
D