Accelerate the breakdown of bioburden on surgical instruments with enzymatic products

Improve patient safety, reduce HAIs and enhance effectiveness of cleaning

Central sterile and endoscopy reprocessing tools continue to evolve to help improve patient safety outcomes. However, even with improvements, surgical site infections (SSIs) are the third most reported healthcare acquired infection (HAI) and can threaten a patient’s life, increase hospital stays, and increase healthcare costs.1


Removing bioburden from medical devices and instruments is essential to the safety of the next patient who will be exposed to the sterilized instrument. Even though an instrument may be considered clean and sterile, dried on bioburden in instrument lumens and channels are a culprit in causing many SSIs.


Bioburden is the term used to describe the whole population of viable microorganisms that inhabit a non-sterile surface or device.2 When utilizing reusable surgical instruments and devices, blood, fats, tissues, and other forms of bioburden, can quickly coagulate on instrument joints, hinges, grooves, lumens and channels. As the coagulated soil dries, it cements itself to microscopic irregularities on the surface of instruments.3 This renders the instrument or device difficult to clean, requiring more time for brushing and scrubbing to achieve cleaning compliance.


Preventing the hardening and enhancing the breakdown of bioburden on instruments and devices and can easily be achieved with one simple step: enzymatic products.


Enzymatic cleaners are biodegradable, non-toxic cleaning agent used to break down soil on instruments. By applying an enzymatic cleaner on the instrument immediately after use, the cleaner helps keep the instrument moist while also working to loosen soils.


According to the Centers for Disease Control, enzymes attack proteins that make up a large portion of common soil. Enzymatic cleaning solutions also can contain lipases (enzymes active on fats), amylases (enzymes active on starches), and proteases (enzymes active of blood, mucous, feces, and albumin). Enzymatic cleaners are not disinfectants, and proteinaceous enzymes can be inactivated by germicides.4


Enzymatic cleaners are so effective, they serve as catalysts that can speed up chemical reactions up to 1,000,000 times. Even detergents with the same surfactants and ingredients without enzymes take at least 10 to 15 times more contact time to achieve an acceptable outcome.5


A comparison among three different, widely used healthcare brands provides hard evidence of the real effectiveness of these brands. To compare, film strips were bronze-brown before soaking in enzymatic solution. Temperature, water level, timing and detergent dilution rates were all kept constant and according to manufacturer specifications.

enzymatic breakdown comparison


Maintaining enzymatic contact time with an instrument surface can be achieved through a variety of options, such as spraying enzymatic foams on instruments at the point-of-use, through liquid or concentration methods by soaking and subsequently, flushing enzymatic solutions through lumens and channels with a flushing system. It is important to note that enzymes work best under certain environmental conditions such as specific temperature ranges, pH levels, and washer settings and in combination with other chemical ingredients.6 IAHCSMM recommends that temperatures should not exceed 140˚F (60˚C), unless otherwise stated by the enzyme manufacturer.

flushing robotics blog

Central sterile processing departments, endoscopy and GI labs, and surgical centers can enhance the effectiveness of cleaning by using enzymatic detergents to reduce manual cleaning times and facilitating the breakdown of different forms of bioburden. Most importantly, utilizing enzymatic products to breakdown and loosen soils on instruments, helps ensure safe outcomes for patients.


As always, refer to manufacturer instructions for use (IFU) to ensure that instruments are compatible with enzymatic products.


Learn more about PureChannel Flush Instrument Channel Cleaner and Foam triple-enzyme formula that is specifically designed to help remove the typical organic soils that stick to hard-to-clean internal channels and external surfaces after patient use.


Want to earn 0.5 CE? Learn more about precleaning methods from the program, A Royal Flush: Your Winning Hand for Pre-Cleaning Protocol.


  5. IAHCSMM. Central Service Technician Manual, 8th ed., Chicago, IL, 2016.


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