The Soap Opera The Soap Opera Johns Hopkins University, Bloomberg

The Soap Opera

10 Jan

Selecting Cleaning Chemistries for Medical Device Reprocessing: A Conundrum

Daytime TV serials are often called “soap operas”...

Daytime TV serials are often called “soap operas”, because laundry and dish detergent manufacturers have long been sponsors. The “opera” part is full of drama, passion, a plot where pressure is applied to force a decision, one which the victim was sorry to have agreed to in the first place. Just as “soap operas” use persuasive words, exaggerated statements, and even threats, to cancel out sound judgment or scientific principles; how often have we been persuaded to buy when a threat or pressure was applied? As simple as “buy this now before the price goes up” is a kind of threat; so too are statements like “using “X” cleaner will break the warranty on your equipment” or “buy the other product and we will no longer service you”.

Cleaning surgical devices is more of an art than a science...

Cleaning surgical devices is more of an art than a science, even a bit of a soap opera. Which cleaner to choose, the one that is validated and sustainable or one the equipment manufacturer insists upon? What parameters to apply in terms of time, temperature, concentration, and mechanical action? Detergents with dyes or clear, perfumed or fragrance-free, gel or foam?

Alkaline Detergents Can Cause Corrosion

Sterile processing staff understand that pH neutral or near neutral cleaners are best for cleaning reusable medical devices.  Then, why are “aluminum friendly” detergents considered at all, when the pH range approaches 14 in the bottle and buffered to remain highly alkaline even when diluted. It is commonly known that when a cleaning agent reaches a pH >9 metals begin to degrade and corrode. See the time-lapse GIF of a pH 14 corrosion effect; this experiment only took half a day. We've seen it happen in less than 3 cycles.

Cleaning is considered the most important decontamination step before sterilization or disinfection can occur

Unlike sterilization where validated settings determine the cycles, there are no such requirements for cleaning. The degree of soil or whether pre-treatment occurred may not be factored into the decision to use “fast” cycles. Short wash cycles, without elevated temperatures and without thorough rinsing, may not lead to best outcomes. What cleaner to use, how much to use, and how thoroughly to rinse remains unclear. Unlike reusable devises, cleaners are consumable, a frequent expense that falls under the operations budget. Once used, cleaners wash down the drain, must be purchased, kept in stock, and replenished.

Case Medical is proud to display the U.S. EPA Safer Choice label on its instrument chemistries


Few detergent manufacturers independently validate their products for safety, sustainability, and effectiveness. It is not required. What is currently done is on a voluntary basis.  Cleaners are most effective when they are properly formulated and tested scientifically for their intended use.

Case Medical is proud to display the U.S. EPA Safer Choice label on its cleaning products, and instrument lubricant. Case Medical has partnered with the EPA, since 2011 in support of their sustainability initiatives and meets EPA's yearly product review requirements. The U.S. EPA Safer Choice label is your guarantee that only the safest, most effective, and least harmful ingredients are used to formulate Case Medical’s instrument cleaning solutions.

Since soap operas are serialized, tune in for the next episode

We promise to leave out the drama and only have happy endings. Follow our blogs for more on sustainability and the science of cleaning. Learn how instrument chemistries are formulated for safety, sustainability and effectiveness. Review the critical parameters for detergent selection. Gain greater understanding as to which cycles are best for automated cleaning.

Then, join us in February for a virtual event on sustainable instrument cleaning with industry and healthcare experts committed to best practices and safer chemical usage.

Visit us at to learn more about our products and how they can help your facility lighten its impact on the environment for the good of us all.

Kindest Regards,
Marcia Frieze and the Case Medical team

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