Two common problems often encountered during the cleaning of surgical instruments are the appearance of white or black specks on instruments and inside The POD.

Understanding the root cause and implementing effective solutions can significantly improve the longevity and performance of your surgical instruments, as well as the equipment used to clean and sterilize them.

White Speck Causes and Resolutions

Cause: Detergent Residue

• Occurs due to improper rinsing of instruments and equipment in both the sink and washer cycle.
• May result from incorrect calibration of chemical dispensing equipment or hand-pouring unmeasured amounts into the sink.

Resolution: Detergent Residue

• Retrain Staff:
  • Ensure proper use of the three-sink method, which includes:
    • Cold water rinse.
    • Soaking and scrubbing in appropriately prepared enzymatic solutions.
    • Rinsing thoroughly as directed in the instrument’s IFU (Instructions for Use) using tap water, followed by a final rinse in treated water for hand-washed items.
• Verify Automated Washer Functionality:
  • Review test lots and cycle parameters to ensure correct operation.
  • Confirm appropriate rinse times for complex medical instruments.
  • Check detergent settings to ensure proper calibration. Over-dispensed chemicals and short rinse times are common culprits of specks and spots.

Black Speck Causes and Resolutions

Cause: Vendor Tray Coating

• Black specks often originate from defects in the coating of vendor loaner trays, such as peeling, cracking, or fractures in plastic trays.

Resolution: Vendor Tray Coating

• Inspect vendor loaner trays regularly for defects.
• Remove defective trays from service and consult the vendor representative for assistance with processing.

White and Black Speck Combined Causes and Resolutions

Cause: Steam Quality

• “Wet” or oversaturated steam, as well as steam with impurities, can leave residue on surgical instruments during sterilization.

Resolution: Steam Quality

• Review maintenance logs to identify potential steam quality issues.
• Maintain sterilizer filters and traps regularly, as clean components are essential for steam purity.
• Schedule professional cleaning of sterilizers every 12 months (or more often for facilities with hard water issues).
• Ensure regular preventive maintenance (PM) is performed on each sterilizer to optimize equipment efficiency.

Cause: Water Quality

• Per ANSI/AAMI ST79:2017 and ANSI/AAMI ST108:2023, critical water (treated via deionization [DI] or reverse osmosis [RO]) is recommended for final rinses, high-level disinfection, and steam production.

Resolution: Water Quality

• Assess the type of water used in your facility for the final rinse in automated washers and steam production.
• Consider installing DI or RO water treatment systems. Though the initial investment can be significant, it prevents irreparable damage to costly surgical instruments and equipment, saving money in the long term.

Summary

Maintaining the integrity and cleanliness of surgical instruments and cleaning equipment is critical for patient safety and surgical success.

By addressing common issues such as detergent residue, improper rinsing, steam quality, and equipment maintenance, you can significantly reduce the occurrence of spotting and damage to instruments.

At Turbett Surgical, we are dedicated to helping you provide safe, clean, and sterile surgical instruments—on time, every time.

For more information or assistance, contact us today. Together, we can ensure the best possible outcomes for every patient, every time!

Written by

CAROL MALONE, CSPDT, CRCST, CIS, CHL, CER | Director, Implementation & Clinical Services, Central

With over 20 years in healthcare, I bring deep expertise in Sterile Processing, patient safety, and operational improvement. As a proven leader, I’ve trained over 200 technicians across 17 hospitals, contributed to AAMI standards, and advanced the field through mentorship and industry leadership.