How should casters suitable for hospital operating room environments be cleaned and maintained?

Cleaning and Maintenance Specifications for Hospital Operating Room Casters

The cleaning and maintenance of operating room casters (such as medical-grade PU casters and chemically resistant modified nylon casters) must strictly adhere to the principles of "sterility first, contamination prevention, and performance maintenance." A process should be developed based on the specific characteristics of the operating room environment (frequent disinfection and high cleanliness requirements). The specific steps and key points are as follows:

 

1. Daily Cleaning: Clean immediately after each use to prevent residual contaminants.

Daily cleaning should be performed between surgeries or after equipment transfer. The key is to remove contaminants such as blood, medical solutions, and dust from the caster surface to prevent bacterial growth. The specific steps are as follows:

Pretreatment: Remove Visible Dirt

 

Use a disposable, dust-free cloth or medical gauze dampened with purified water to gently wipe the wheel, wheel frame, and brake assembly surfaces. First, remove any visible blood, tissue debris, and medical solution residue. (If there is dried dirt, soak the gauze in purified water for 5-10 seconds to soften it before wiping to avoid scratching the caster surface.) Disinfection and Cleaning: Kill pathogens.

 

Replace a clean gauze cloth and dip it in 75% medical alcohol or a 500mg/L chlorine-containing disinfectant (such as 84 disinfectant, which should be prepared freshly and used immediately). Wipe the caster thoroughly:
Wheel body: Focus on the wheel surface and the gap between the wheel axle (a cotton swab dipped in disinfectant can be used to clean deep into the gap to avoid trapping dirt and grime).

 

Wheel frame: This includes welds, mounting holes, and the connection between the brake lever and the wheel frame (these areas are prone to residual dirt and require repeated wiping 2-3 times).

 

Brake assembly: After applying the brake, wipe the contact area between the brake pad and the wheel body to ensure there is no disinfectant residue (to prevent brake pad degradation).

 

After disinfection, let the disinfectant evaporate naturally for 3-5 minutes. No need to rinse with water (to prevent secondary contamination). Drying: Prevent moisture from breeding mold.

 

Use sterile, dry gauze to dry the caster surface, especially areas prone to moisture accumulation, such as the axle and bearing gaps, to ensure no residual moisture remains. (In the constant temperature and high humidity environment of an operating room, moisture can easily cause the wheel frame to rust or the bearings to seize.)

 

2. Regular Maintenance: Weekly Deep Maintenance to Ensure Stable Performance
Operating room casters require weekly deep maintenance, focusing on structural integrity, lubrication, and sterility. Details are as follows:

 

Structural Inspection: Identify safety hazards
Wheel: Inspect for cracks, deformation, and surface wear (e.g., missing pieces on PU wheels, dents on nylon wheels). If wear exceeds 1mm or cracks appear, replace immediately to prevent the wheel from breaking and causing the equipment to tilt.

 

Wheel Frame and Brake: Inspect the wheel frame for rust, loose welds (stainless steel wheel frames must be rust-free), and ensure the brake assembly is flexible (the brake should firmly lock the wheel when pressed and not bind when released. If the brake pad is worn more than 1/3, replace the pad).

 

Bearings and Pins: Manually rotate the wheel to feel for any sticking or unusual noise (normal rotation should be smooth and noiseless). If sticking occurs, inspect the bearing for contaminants and disassemble and clean if necessary.

 

Bearing Lubrication: Preventing Seizure and Wear

For sealed ball bearings only (standard on operating room casters to prevent grease leakage and contamination), use a sterile cotton swab to apply medical-grade silicone grease (do not use standard industrial grease to prevent chemical release). Gently apply it to the outer gap of the bearing (apply no more than 0.5g at a time to avoid spillage and contamination of the sterile area). After lubrication, rotate the wheel 10-20 times to ensure even distribution of the grease.

 

Sterility Verification: Sampling and Microbiological Testing
Monthly, sample one or two casters. Wipe the wheel and brake surfaces with a sterile cotton swab and send them to the laboratory for microbiological testing (must meet operating room "sterility standards" (i.e., colony count ≤ 0 CFU/25 cm²). If the test fails, investigate any flaws in the cleaning process (e.g., whether the disinfectant concentration meets the required standards, whether any blind spots were missed during cleaning), and re-disinfect all casters.

 

3. Special Situation Handling: Emergency Cleaning After Contamination
If the caster comes into contact with high-risk contaminants such as blood or body fluids (e.g., accidental spillage during surgery), immediate emergency cleaning is required. The steps are as follows:

 

First, cover the contaminant with a disposable absorbent pad to prevent spread.
Wearing sterile gloves, spray the absorbent pad with 1000mg/L chlorine-based disinfectant and let it sit for 10 minutes (to ensure it kills pathogens such as hepatitis B virus and COVID-19).

 

Remove the absorbent pad and wipe the caster with disinfectant three times according to the "Daily Cleaning" procedure. Finally, wipe dry with sterile dry gauze.

 

After cleaning, change gloves and dispose of cleaning tools (such as gauze and cotton swabs) as medical waste. Do not reuse them.

 

4. Taboos: Avoid Damaging Casters and Environmental Pollution
Do not use strong acid or alkaline disinfectants (such as hydrochloric acid or sodium hydroxide with a concentration greater than 10%) to clean the casters, as this will corrode the wheel and frame.

 

Do not rinse or soak the casters in water (to prevent water from entering the bearings and rusting, or disinfectants from seeping into the wheel body and causing material degradation).

 

During maintenance, do not disassemble non-sealed components (such as bearing seals) to prevent contaminants from entering. If disassembly is necessary, perform it on a sterile operating table and replace the seals with new ones.

 

When replacing casters, select medical-grade casters of the same model (e.g., PU casters must be medical-grade certified, and nylon casters must contain antimicrobial agents). Do not substitute with standard industrial casters.

 

Following these procedures will ensure that operating room casters remain sterile, smooth, and stable over time, minimizing the risk of cross-infection, extending the caster's lifespan, and ensuring the safe transportation of surgical equipment.