Borer FAQ's

The pH scale is a measurement scale used to express the acidity or alkalinity (basicity) of a solution. It ranges from 0 to 14, with 7 being considered neutral. The scale is logarithmic, meaning that each unit represents a tenfold difference in acidity or alkalinity.

On the pH scale, values below 7 indicate acidity, with lower values representing stronger acidity. For example, a solution with a pH of 1 is highly acidic. A pH of 0 is theoretically possible but rarely observed in practical situations. 

Values above 7 on the pH scale indicate alkalinity, with higher values representing stronger alkalinity. A solution with a pH of 14 is highly alkaline or basic. Again, a pH of 15 is theoretically possible but uncommon. 

A pH of 7 represents neutrality, meaning the solution is neither acidic nor alkaline. Water, for instance, has a pH of around 7, making it neutral. However, it's important to note that even slightly acidic or alkaline solutions can have a significant impact on certain substances or biological systems. 

The pH scale is commonly used in various fields, including chemistry, biology, environmental science, and agriculture. It helps scientists and researchers determine the acidity or alkalinity of substances, monitor chemical reactions, assess the quality of water bodies, understand biological processes, and more.

Acidic Chemistry: Acidic chemistry is characterized by a higher concentration of hydrogen ions (H+) in a solution. Acids are substances that can release hydrogen ions when dissolved in water. They have a pH value below 7 on the pH scale. Acidic solutions have a sour taste, can corrode certain materials, and turn blue litmus paper red. Examples of common acids include hydrochloric acid (HCl) and vinegar (acetic acid).

Neutral Chemistry: Neutral chemistry refers to a state where the concentration of hydrogen ions (H+) and hydroxide ions (OH-) is equal, resulting in a balanced pH of 7. Pure water is considered neutral, as it has an equal concentration of H+ and OH-. Neutral solutions neither have acidic nor alkaline properties. They do not show any distinctive taste and do not affect litmus paper.

Alkaline (Basic) Chemistry: Alkaline chemistry involves a higher concentration of hydroxide ions (OH-) in a solution. Bases (also called alkalies) are substances that can accept hydrogen ions or donate hydroxide ions when dissolved in water. They have a pH value above 7 on the pH scale. Alkaline solutions have a bitter taste, feel slippery, and turn red litmus paper blue. Examples of common bases include sodium hydroxide (NaOH) and ammonia (NH3).

In terms of chemical reactions, acidic and basic solutions can undergo neutralization reactions when combined. The hydrogen ions (H+) from the acid react with the hydroxide ions (OH-) from the base to form water (H2O), resulting in a neutral pH.

It's important to note that acidity and alkalinity are relative terms, and the pH scale provides a quantitative measure to compare the levels of acidity or alkalinity in different solutions. The pH scale ranges from 0 to 14, with 7 being neutral. Values below 7 indicate acidity, while values above 7 indicate alkalinity.

pH is a very useful tool and guide when we select the most appropriate chemistry to work with. Different types of soil react to different pH’s with organic soils, i.e. those which have come from a patient are best removed using chemistries with higher (alkaline) pH’s like deconex® 28 ALKA ONE-x, while inorganic soils, i.e. those which may have come from sub-optimal water quality such as lime scale or silicate deposits, are best removed using chemistries with lower (acidic) pH’s. In this instance we would recommend using deconex® 34 GR.

Within these classifications, there are considerations to make on matters such as materials compatibility, the type of acid we are using and the outcome it provides, i.e. simple rust removal or a more sophisticated and long-lasting passivation process.

pH is a very good guide as to materials compatibility, but isn’t the deciding factor. The formulation of the product is key to materials compatibility and the advice given by your chemistry manufacturer should include details of compatibilities and incompatibilities. Just as it is impossible for all chemistry manufacturers to test every device which comes onto the market, it is impossible for all device manufacturers to test every chemistry which comes onto the market.

ISO 17664 allows for a set of generic terminology to be used when describing the chemistries which can be used to reprocess the instrument in question meaning that you can have a wider range of chemistries to choose from and you are not restricted to older, outdated products. Just like cars and mobile phones, the development of chemistry for surgical instrument reprocessing moves at pace and is improving products all the time.

The correct chemistry is the one which helps you to achieve your goals, i.e. a clean, disinfected and dry load with the least amount of effort, input and steps possible. A huge emphasis is placed on the WD and what it can do for instrument reprocessing, and rightly so. The WD creates massive efficiency in our departments and we couldn’t work without them. Where focus is sometimes lacking is in the process itself. We can genuinely create even greater efficiency in our processes, saving time, money and resources (i.e. energy as well as plastic waste) by ensuring we have fine-tuned our processes to be the best they can be.

There is no right/wrong answer as to whether you select a neutral pH, high alkaline or anything in-between; whether the product contains enzymes or not. The most important consideration is that it helps you to deliver the required cleaning outcomes in the most efficient manner. This can be a combination of considerations, such as:

1. Number of WD’s available
2. Age of WD’s
3. Cleaning capacity of WD’s
4. Water qualities available
5. Required throughput
6. Availability and allocation of staff
7. Type of instruments to be reprocessed
8. …and a lot more

It is essential to ensure is that your chemistry is a Medical Device – this ensures that the product you are using has to have an extensive amount of R&D behind it, as well as a technical file which supports any claims made in terms of product performance, such as materials compatibility, dosage rates, use temperatures etc.

You the user, have the freedom to choose the chemistry best suited to you. You are not bound by recommendations from WD or instrument manufacturers, as long as the chemistry meets the demands as laid down in the device manufacturers IFU’s.

Even in its most simple form, i.e. hand soap, chemistry reacts differently to different water qualities.

The rule of thumb we can use is: the better the water quality, the less chemistry we’ll need to use to achieve the same outcome.

Modern and advanced instrument cleaning chemistry is equipped to deal with the challenges of poor water quality; a good-quality chemistry will contain corrosion inhibitors, sequestering agents, complexing agents as well as other components to help manage poor water quality. These components are called into action when they encounter the appropriate challenge in the water, i.e. corrosion inhibitors working against aggressive additives in the water to prevent damage to the medical devices. 

In the case of RO water, where all undesirable contaminants have been removed from the water, the chemistry doesn’t need to focus on these and can get directly to work on removing the soil(s) from the devices.

The two principle reasons for using a product in the final rinse/thermal disinfection are:

1. To speed-up the drying process

Drying aids such as deconex® 64 NEUTRADRY are used to improve efficiency in our automated processes. They work by reducing surface tension of the water droplets which in-turn allows the dryers in the WD to remove them more easily from the load. This can be particularly advantageous for those looking to increase process efficiency as it can provide up to a 50% reduction in drying time, with the associated benefit of lower energy consumption leading to a double cost saving.

2. To help manage sub-optimal water quality in the final rinse

For some users, water quality may be variable, i.e. those who do not have an RO plant or softener and as such the load, WD chamber and carrier(s) may be subject to water spotting, lime scale build-up and other consequences of sub-optimal water quality. In using a rinse aid we can help mitigate these issues and leave chamber, carrier as well as the load free from spotting, lime scale and discolouration. In these instances deconex® 41 CLEAR would solve this issue for you.

A biofilm is a complex and organized community of microorganisms that adhere to surfaces and form a slimy, protective matrix called the extracellular polymeric substance (EPS). Biofilms can develop on various surfaces, such as rocks, medical devices, pipes, and living tissues, both in natural and man-made environments.

Biofilms consist of diverse microorganisms, including bacteria, archaea, fungi, algae, and protozoa. These microorganisms attach to the surface and multiply, forming a structured community. The EPS produced by the microorganisms provides a protective environment, shielding them from environmental factors like antibiotics, disinfectants, and the host immune system.

The formation of a biofilm typically occurs in several stages. Initially, microorganisms reversibly attach to the surface. As they multiply and produce EPS, they undergo irreversible attachment, forming a mature biofilm. Within the biofilm, microorganisms communicate and cooperate through a process known as quorum sensing, enabling them to coordinate their behavior and adapt to changing conditions.

Biofilms can have both beneficial and detrimental effects. In nature, biofilms play important roles in ecosystems, such as nutrient cycling, bioremediation, and symbiotic relationships. However, biofilms can also cause problems in various industries and medical settings. For example, biofilms can form on medical implants, causing infections that are difficult to treat. In industrial settings, they can lead to clogging of pipes and equipment, reducing efficiency.

Managing and controlling biofilms can be challenging due to their resistant nature. Strategies to prevent or control biofilms include regular cleaning and disinfection, surface modifications to discourage attachment, and the development of antimicrobial agents specifically targeting biofilm formation.

Understanding biofilms and their interactions is an active area of research, with scientists studying their formation, structure, communication mechanisms, and potential therapeutic interventions.

We won’t address the causes of these issues here; as this would extend to several thousand words. For the purposes of this discussion, we’ll assume there is one or more of the above issues above at your facility. Firstly, this is not unique to you, your institution, your city or even your country. It is something we see all over the world. As we have talked about above, these kind of deposits come from inorganic sources. This means we have to use an acid in order to remove them from the devices. 

A very important point to raise is that treatment of devices with acid is limited to those made from stainless steel, only. Devices made from other materials such a chrome plated or aluminium will likely be damaged through exposure to the kind of acids we use for this treatment. 

Having selected the right product, such as deconex® 34 GR, we have a choice on how we use it. It can be used in soaking baths/sinks and ultrasonic baths as well as in WD’s giving all kinds of facilities the opportunity to treat and restore their instruments, and extend their life.

Passivation is a process whereby we can (re)generate a passive layer on the surface of a stainless steel device in order to protect against corrosion and degradation. It shouldn’t be confused with rust removal etc as, even though both processes use deconex® 34 GR, the application is different. It is this difference in application which is key to the outcome and whether we are simply removing inorganic soil or if we are protecting the instruments. 

We can only use deconex® 34 GR to passivate stainless steel devices, but this can include WD chambers, carriers, baskets as well as surgical instruments. Studies have shown that deconex® 34 GR generates a passive layer 5x thicker than traditional methods. 

Instruments treated with deconex® 34 GR and subsequently reprocessed with chemistry from the deconex® range will enjoy long term protection and a longer use-life, saving your hospital thousands of dollars a year in repair and replacement costs.

We are all familiar with ensuring gross soil being removed at the point of use. The issue however arises when surgical sets sit for extended periods with blood, saline and other soils drying and attacking the surface of the instruments. It may not always be possible to collect instruments immediately; they may be used out of hours, there may be peak demand meaning extended collection times. Pre-treatment at the point of use, such as using a foam spray, will ensure not only protection for the devices against corrosion, but also that when they arrive at CSSD they are much easier to clean. 

Dried blood represents a particularly difficult cleaning challenge. It is corrosive as well as, once dry, very difficult to remove without fairly robust cleaning methods which require extended soaking times, or manually cleaning. We want to avoid manual cleaning where possible. It uses large amounts of chemistry, water, time, single use plastic as well as exposing the member of staff having to clean the devices to unnecessary risk. We can reduce the amount of chemistry, water, time and single use plastic as well as the risk to staff by treating the devices as soon as possible after use and this is where products such as deconex® FOAM ACTIVE can be advantageous. It protects the instruments from corrosion as well as making them easier to clean for up to 72 hours after treatment, even once dry.

A simple application of the spray to the set can save huge amounts of time and resources further down the reprocessing line and may mean that all manual steps can be bypassed in CSSD and devices can be loaded directly into the WD for further reprocessing, disinfection and drying.