Under Pressure - The Rust Stops Here: Keeping Stainless Steel Stainless

0:00you know, some places might use chlorine exposure during cleaning for like a bleach or disinfectant, and beyond just chlorine bleaches, harsh cleaning chemicals in general, because like we talked about stainless isn't impervious, it's just resistant. And so if you put it in an aggressive environment, it's still going to corrode. So like that's a lot of it. It's just thinking about like realizing the stainless can still corrode and take care of it like it could. You know, you don't want to leave 30 dishes in the sink for, you know, days. And it's the same thing with surgical instruments. You want to clean them as soon as you can. Rising above the buzz of ultrasonic cleaners and the clanking of stainless steel are the ideas and voices that are changing in industry. You're listening to the Beyond Clean podcast, the central nexus for the people, processes, and products that are improving our sterile processing

1:00world. Each week, we speak with frontline technicians, CEOs, engineers, and entrepreneurs with a common goal to help you fight dirty every instrument every time. Whether you're tuning in for education or inspiration, we're glad you did. Now turn on those washers and turn up the volume. It's time to go Beyond Clean. All right, Clean Freaks. Welcome back to another episode of the Beyond Clean podcast. This is season 31 under pressure. I'm your host, Bobby Parker, and joining me as guest co star for the season is Melissa Morgan. Melissa, welcome back to the studio. Thank you so much, Bobby. So glad to be here. Fun, fun. Well, Melissa, in episode one, we got to know you a little bit there in the intro. You gave us a thumbnail of your professional career and what you've been up to in the industry.

2:04You mentioned in there in a previous role or previous life, having some operational oversight, over eight sterile processing departments. I wanted to know if you could tell us a little bit about what that was like going from a non-SPD world and infection prevention to all of a sudden having all of this operational oversight of SPD. A word I like to use when I refer to that role change was fascinating. Really, I had been engaged with our sterile processing from an infection prevention side, but I've always kind of been fascinated with workflows, right? And how what we do affects people all the way from the beginning to the end, right? And so thinking about my infection prevention career and looking at how patient comes to the hospital to the time they leave. And so sterile processing is one of those departments, right? So this is where the instruments start and this is where they end as well.

3:08And so really getting in there and the elbow as an IP and understanding that work, I was like, wow, there's some opportunities operationally here to really help this team be successful and not work so hard. And so that was really my journey was to eliminate barriers and create efficiencies so that they felt successful because it's hard work. Yeah, you're telling me. Well, yeah, it's logistically challenging as well, not just physically with all the instruments to keep up with, all the processes to keep up with. I tell folks all the time, like who asked me, hey, you know, nice to meet you, what do you do for a living? And I tell them about this podcast and about what we do at Beyond Clean and they're like, wait a minute, there's a podcast about how to clean surgical instruments. How many ways can you talk about cleaning surgical instruments and like, listen, there's a lot going on. Like we will never run out of content to talk about. So yeah, you're right. 100% and I loved to bring executives down into sterile processing.

4:12I think in my role at the time as the system director of infection prevention and also over sterile processing departments across multiple facilities, I had the chance to be at a different level and at a different table sometimes to say, hey, chief medical officer, why don't you come round with me? You know, get to know this team, get to understand the barriers and the work that they do to keep these patients safe each and every day. And, you know, help eliminate some of those barriers for us. And I felt like that was a new approach. I know that that's more prevalent now than it was, you know, 10 years ago. And so I appreciate how the industry continues to push that envelope on the professionalism that lives in this space. And then, well, in the spirit of you, of you taking on some, some learning kind of stretching the categories a bit to get some operational oversight in sterile processing and really embracing that. We're going to do a little

5:17bit of stretching of our own on today's episode. How about that for a segue? We are, so we're talking through sterile sterilization this season. And one of the topics that always comes up around steam sterilization is stained surgical instruments. And, you know, kind of the quick finger pointed at staining. Well, we got connected with a metallurgical engineer from a, from a listener of the show, who is quite the whizz bang when it comes to stainless steel metal science. And so I think it will be fun for us to take a deep dive today on some, yeah, on some metal science, on what, what makes stainless steel stainless and, and how can we, how can we address the, the stains and resting that inevitably show up in department. So with that introduction, we will be right back after a short break to talk to Michaela Kuba in a metallurgical engineer.

6:21Are your SPD and OR departments struggling to keep up with demands? Learn how the STERIQ multi-trace sterilization system can improve patient safety and throughput by eliminating many steps in your workflow. Reduce costs, OR turnover time, IUSS and surgical delays, and increase confidence in sterility and staff satisfaction. The STERIQ is the only container FDA cleared for sterilizing lumens as narrow as 0.7 millimeters, and as long as 850 millimeters with no limitation on quantity. To find out how you can save significant time and cost by using the STERIQ go to www.thesterrycube.com. That's TH-E-S-T-E-R-I-C-U-B-E.com. In a world of AI, automation, robots, and advanced technologies, the future is now, and it's time

7:25for every sterile processing department around the country to start considering DSI's new high-density robotic storage system for those hard to handle DaVinci instruments. This new system is a game changer, designed specifically for peelback or blue-rapped robotic instruments in a manner that exceeds industry guidelines. Conor the days of using ChromeWire cards made for the food and beverage industry 50 years ago. These DaVinci tips are expensive and extremely valuable for every hospital. It's time to protect those instruments in a specialized system offered exclusively by DSI. The instruments lay on their back in individual compartments, running lengthwise in the tray, and could store up to 108 arms within one cart. DSI's new system will protect DaVinci tips like no other system in the marketplace today. In a world controlled by robots and change, coming at us in lightning speed, now is the time to take action and connect with

8:28DSI. Contact DSI at dsidirect.com to find out more. That's dsidirect.com From the studios of healthcare HQ, you're listening to Beyond Clean, the global voice of sterile processing. And joining us now in studio is Michaela Kuba, consulting engineer at Bremen Lombard Engineering. Michaela, we've been very eager to talk with you. Welcome to the show. Thank you. Yeah, I'm really excited to be here. Awesome, awesome. Well, it is a unique experience for us to get to talk with somebody who's

9:30kind of industry adjacent around surgical instruments and teased a little bit in the opener about getting to talk with the metal scientist, metallurgical engineer. I think is the title that that you gave me. And so excited to do that. But before we dive into the content, wanted to give you an opportunity to introduce yourself, tell the sterile processing world what a metallurgical engineer does and how you got connected with this. Yeah, so a metallurgical engineer is an engineer that specializes in materials and specifically metals. So I have a lot of education that kind of combines chemical engineering and mechanical engineering so that I understand like the process of mining metal, of purifying it, of making it into a part, and then the whole life cycle. My specialty within metallurgical engineering is what's called failure analysis. So somebody else's parts break or don't perform the way they wanted them to and they come to me to help them figure out why. Michaela, that is fascinating and so unique from what we do in

10:38healthcare, but yet connected, right? Because the instruments we use contain metals. And so as we think about how this work translates, you know, we use a lot of stainless steel. And so can you kind of expand on what makes surgical stainless steel stainless? Absolutely. Yeah, so when you're wanting to have metals that are in contact with the human body, it's really important that they're non-reactive with the human body. You don't want to have any ions or bits or pieces of metal that get left in the patient when you're working with them. And so the invention of stainless steel was a huge point of progress for surgery. What makes stainless stainless is it has at least ten and a half percent chromium in the alloy composition. What happens when you have that much chromium is that instead of forming an iron oxide layer on the surface, which is the rust that we're all

11:38familiar, it's red, it flakes off, and once it flakes off, there's more metal exposed, it'll rust again, it'll flake off again, and it crotes. The chromium oxide doesn't flake off. So that's the most important part is that it sticks on that metal, and it protects the rest of the metal from any exposure to bodily fluids or bioburden or anything like that. Stainless is we usually think of it because of the way the English language works, is that stainless meaning it can't stain, and that's not really accurate. Stainless steel can still corrode. The better way to think about it is that it stains less. I remember talking with Rich Schultz, the guy who helped write the instrument manual for the CIS certification for HSBA, advocated for it being called stain more steel, because good grief. We're always talking about these instruments getting stains on them, and you're right, they're certainly not impervious, and that lines up with our impervious

12:38sustaining, and that lines up with our lived experience, because certainly stains on it. I'm curious before we dive deeper into that, you mentioned so resting happens as a result of fan and oxygen, and we're pretty familiar with that iron oxide, but adding this chromium to the mix makes this layer that stains a little bit less. I'm curious, why is that? Why does chromium help? Is there a particular chemical or scientific reason why chromium and not something else? So there are other elements that can do that, but chromium fits well with iron atoms. It is about the same size, so if you think about the atomic structure of metals, you can kind of approximate it as just a bunch of ping pong balls that are stacked together as close as they can be, and you know how like if you have a bucket of ping pong balls, they all kind of nestle in with each other, and so like if you put a tennis ball in there, then all of the ping pong balls around

13:41that tennis ball are kind of weird, or if you put marble in, then everything's weird in a different way. And so chromium is about the same size as iron, and so that helps. Whereas titanium and aluminum are two other metal elements that form adherent oxides is what we call them. And those atoms are a lot smaller. The other thing that happens is the chromium oxide happens to be really compatible with iron and chromium and nickel alloys, some other oxides. They have too much of a size change, or they don't line up well. The atoms just don't line up well, and so chromium works really well from that regard too. Yeah, I'm tracking with you. Before we make everybody's eyes roll in the back of their head, though, like, try trying to keep up with what just happened on the Beyond Clean podcast. I'm back in high school chemistry class. Yeah, it kind of is sometimes. That's right. So the connection of this topic to what we're talking about for the season with steam sterilization, of course,

14:44is instrument staining and rusting on surgical instruments in departments. Now, Michaela, we got connected with you through a listener of the podcast who had worked with your firm on trying to solve an instrument staining or instrument resting problem in their department. You want to give us a thumbnail of what that project was like and how you were able to help them? Sure. So later in the podcast, we'll talk about a lot of the different kinds of corrosion, and they were having corrosion in a very specific spot on an instrument where there was a guard over a tubing clamp, and that guard was to help keep the tube from, like, interacting with the end, but the way the instrument was built, that guard was attached with a method that's called brazing. So in terms of metal attachment, you have soldering, brazing, and welding. Welding, you actually melt the base metal, soldering, you don't. Brazing is best understood as

15:45just high temperature of soldering. And when you do that, you end up with two different kinds of metal that are in contact, which the word for that is galvanic corrosion. And so that was the issue that they were having was they had galvanic corrosion that they couldn't control, and they couldn't figure out on their own why that was happening. And so I started talking about the metallurgy of making these surgical instruments, and some different decisions that manufacturers might make, and like what things they could do to account for that or improve their process. That makes sense. And when we think about instruments that get rust on them, or start to corrode in some way, it often is around those weld points, or even by the manufacturer markings, like if they've got a laser etching or something on the instrument. And so it seems like anything that disrupts kind of the normal and smooth surface of that stainless steel instrument creates a risk. The topic that the term and topic that gets talked about a lot in SPD is

16:52passivation. Is it because those welds and those etchings and markings are disrupting that passivation process? That's why instruments rust. And if so, is there anything that we can do about it? So for most surgical tools, yes, that's the issue. It might be important to note that like surgical stainless doesn't have like a precise definition beyond is just stainless used during surgery. But most surgical alloys have that chromium addition. That's what it's doing. And so that passivation is the process that makes that chromium oxide layer that we were talking about earlier. And generally speaking, for alloys that have that chromium in it, something has to disrupt the passivation. Sometimes that is just the fluid that is in us too corrosive. Sometimes that's a contamination issue. Sometimes it's abrasion or like you said, the laser engraving is going to end

17:54up with like a different structure right there than next to it. And so anytime there's those differences like you talked about, that gives corrosion a chance to take hold. I think that really kind of connects the dots for me around maybe some of the common reasons that instruments might rest are staying from a technical perspective. When you really partnered with the team to look at this more specifically, were there things that were common in the work they did or in the way they performed their cleaning processes that landed to that more readily than others? So in terms of just like a general education, the way to think about passivation is just that it takes time to form. And anything that you could imagine just a layer on the steel that would disrupt it can. So one of the big things is like if you're using a metal brush, if you're using an iron brush or a steel brush instead of a stainless steel brush,

18:56those brushes will leave little iron particles. Those iron particles sit on the surface and the chromium oxide can't form around them. And so it leaves a hole in that layer that corrosion can occur through. You know, another one of the big things that affects stainless steels in particular is chlorine. And so anytime you have chlorides present, if they are present too long or there's too much of them or it's too high of a temperature, then that will disrupt that passivation layer. And that's just because chlorine is a very reactive element. So things you might think about are like post surgery, like directly right after the surgery when the instruments are used and they're sitting with a lot of bio burden. The longer they sit like that, the more chlorine exposure they have because, you know, human fluids have our saline, which is sodium chloride. And the longer that sits, the more opportunity there is for corrosion to occur. You might think like we, our city water has chlorine in it to disinfect it. So if you're not treating that city water before it comes into your

20:00cleaning process, that can have chlorine. And that really comes into effect when you're using like a steam sterilizer because now you're at a really high temperature. And if you haven't properly treated that water before it comes in, that's an issue. You know, some places might use chlorine exposure during cleaning for like a bleach or disinfectant. And beyond just chlorine bleaches, harsh cleaning chemicals in general, because like we talked about stainless isn't impervious, it's just resistant. And so if you put it in an aggressive environment, it's still going to corrode. So like that's a lot of it. It's just thinking about like, realizing the stainless can still corrode and taking care of it like it could. You know, you don't want to leave dirty dishes in the sink for, you know, days. And it's the same thing with surgical instruments. You want to clean them as soon as you can. You know, I think I had all these light bulbs going off in my head with my infection prevention background and all the things that we talked to teams about around removing of bioburden, right? And and how we do that at point of use.

21:07Also, you know, as an infection preventionist part of my world was treating water. And that was around what that chlorine level was and how close it was to appropriate level at point of use, which all are sinks. Now have that level, right? And so as good as we are on pieces, we're also creating that atmosphere for challenges in sterile processing, right? I mean, is that what that kind of breaks down to? And so how do we even think about what we do in terms of prevention? I always recommend taking kind of like a holistic attitude. You really want to look at the entire life cycle of the instrument and change how you're thinking about it and how you're approaching it. You know, sit down and look at for your specific facility, for your specific process, what's the entire life cycle of the instrument? Like once you first buy it, what do you do with it? The first time you sterilize it, how are you doing that? The first time it's used in surgery or another event? How are you cleaning it? How long does it sit? How long does this whole process take?

22:10How does it get stored? You really, because corrosion can happen at any point during the process if the situation is right. So you kind of have to like really go through the entire thing. Okay, but one of the things that you mentioned about what might cause an instrument to rest was the iron bristle brush. Now there's a big debate out in the sterile processing industry about the stainless steel bristle brushes and whether or not they damage instruments and whether or not you can do damage to the passivation layer with a stainless steel bristle wire brush. And I don't think we're going to solve that question today. But one of the related questions to that or comments to that is whenever, like you mentioned, iron gets on stainless steel and you get some rust on stainless steel, it tends to create more resting almost as if this rust is like a disease in your tray that

23:12if you let one instrument go, like it's going to start spreading to the other instruments. Is that how that works and why is that? Yeah, for for stainless specifically, it really is how it works. If you get a little bit of what we call free iron that stuck on an instrument, you can't passivate where that free iron is and you end up with a galvanic cell as well. We didn't go super far into it earlier. A galvanic cell is just two to similar metals and sometimes it's the same alloy and they're just processed differently that are in electrical contact and they're in some kind of fluid. And you make a battery. That's that's how batteries work. Batteries are just controlled corrosion to produce electricity. But when we don't mean for it to happen, we call it galvanic corrosion because engineers like to have different terms for everything. Of course. But it's the same thing. And so whenever you have those bits of free iron, they like to react with the stainless if they get stuck on there, then it's going to allow corrosion. Once corrosion happens that because the

24:16the iron oxide isn't adherent and it pops off and now you've got another bit of free iron floating around that can attach to another instrument and it kind of works like a viral infection. So in addition to like your instrument starting to rust like that, you also need to look at like what are the vessels that handle the instruments? You know, what did the sinks look like? What does your sterilizer look like? Anytime you can have free iron develop and then end up on your instrument, there's something that you want to think about. Yeah, I'm thinking specifically of the like single use floor grade instruments that aren't intended to be reprocessed and how after one washing through that high temperature washer disinfector, they start resting right away. And if you don't catch that and certainly if you sterilize it and leave it in the tray that not only is, you know, that potentially introducing rest into your surgical tray that's going to end up in the OR, but could also start a chain reaction with some of your some of your surgical grade

25:19stainless instruments as well. So important to think about. Bobby, that's funny because the only thing I could think about was iron being like that little blob on the mucinex commercial that they're right now having a party in your tray and spreading their free iron everywhere. All right, so I'm going to be a very engineer engineer in response to say it depends. Yeah, I'm sure. So any kind of like abrasive scratching process is going to disrupt that passivation layer. The reason we use stainless brushes, brushes that have stainless bristles instead of carly steel bristles is because they don't damage the underlying metal in a way that doesn't allow that passivation layer to reform. Even if you scrub it super vigorously with a stainless brush, if that stainless brush is clean and there's a close enough match between the alloys, that passivation layer will reform and the instrument will kind of quote heal itself. You just have to give it a chance to do that. Like we said earlier,

26:20passivation takes time. It's a chemical reaction and you have to give it a chance to happen. But as long as it gives a chance to happen before you immediately go like sticking it and bleach that you accidentally mixed too strong, it'll probably be okay. What about taking it immediately into a high-temperature steam sterilizer? I would not recommend that. Yeah, because that's the environment that we're doing. We're scrubbing it aggressively and then sticking it in this really hot wet environment. It reminds me of similar conversations that I've had with folks who will get an instrument on the clean side outside the washer and they'll notice some rest on it and feel compelled to scrub that rust off the instrument and then have it rewashed. Now, any kind of scrubbing and cleaning activities ought to be happening in decontamination. So let me pause and say that really quick. We shouldn't be using any brushes out on the clean side, folks, but right, right? But it's like, okay, yeah, you can make the thing look beautiful again by scrubbing that rest off. But as soon as you send it back through

27:23the washer or send it through the sterilizer, it comes up in just the same spot sometimes worse than when you originally started with it. So I guess my follow-up question to this brush conversation is when you do find rust on stainless steel, if scrubbing it off and rewashing it doesn't solve the problem, are there any corrective steps you can take to fix rust on an instrument that will give that pacifation layer a chance? Yeah. So the go-to process on the metallurgical engineering side is what we do in chemical processing all the time where you actually purposefully completely strip the pacifation layer and completely rebuild it. And we can do that chemically through a fairly quick turnaround just by immersion in different acids. It's real common to use nitric acid or citric acid as an acid that will result in that chromium oxide forming evenly and quickly. And that's something that you can contract with a lot of local corrosion experts in your city

28:29or whatever to work with them and be like, okay, so we've got this instrument. We think the pacifation layer is damaged. You know, what products do you have? What processes do you recommend? And they should be able to help you out. The other thing is it's just kind of that turnaround of cleaning it. So if you clean it even on the clean side, then you need to give that pacifation layer a chance to reform. And it needs to reform evenly. So once you scrub off that rust, we have to make sure the surrounding area is clean too. And then it needs, it really just, a lot of the time, just needs to sit for a second while it's clean before it's exposed to an environment where it can current. This kind of where my mind was going because this pacifation layer is oxygen reacting with chromium to make that chromium oxide layer. You say let it sit for a second. I'm curious how long would it take for a small patch of cleaned off rust on an instrument to heal and kind of repassify? Is that like a truly, you know, couple of minutes process or a

29:34multi-day or multi-week process? Like how long would we want to let it sit before we reintroduce it to a washer or a sterilizer? So it does start immediately, but it takes time to grow. And so when we talk about it taking time to form, there's certain thickness you want for your instruments. I would start with overnight and see how that works with your process. And if that's not long enough, maybe give it two nights. If two nights isn't doing enough, that's too long of a turnaround for most people. And that's when I would start looking into those chemical processes to reform it. Yeah. Yeah. Really interesting stuff. You know, I'm sure Melissa, your gears and wheels are turning the same way mine are because if you're in the middle of cleaning something setting an instrument aside and decontam for two days is certainly not what we want. But at the same time, we don't want to want to take a freshly cleaned instrument straight into the steam sterilizer. Probably leaning on those instrument repair reps who specialize in repassivation processes

30:37is the right answer here. I'm just curious if there's any Mickey Mouse science that can be done in the department to do something about it. A lot of it also depends on your specific process. You know, there's going to be a lot of facilities out there that do to their specific sterilizers and their specific just pipes and their specific water quality and their water treat that just are going to struggle with this less than other facilities. And that's probably part of the inconsistency you see in the industry is just some facilities aren't going to have this problem to the degree that other facilities are. And if you're one of those lucky facilities, then you know, so much of this is just do what works for your facility. And if you're noticing that you can scrub these clean with stainless brushes and then throw them right back in the sterilizer without any problems, like go for it. But for the people that are struggling with it, they're there are ways to move forward. Yeah. Well, and the industry solution by and large to this problem has been to use nylon bristle brushes just to make sure that we're not damaging that pacifation

31:40layer or causing any harm to it with the exception of maybe some inserts or things that are harder, like tungsten carbide inserts to needle drivers and things like that. They can be a bit more durable. But nylon brushes are great. And that was going to be my other recommendation is like if you can get moved to a completely non abrasive cleaning method, that's ideal. Yeah. So I mean, if you can think about it like a nonstick cuckware, you know, how you want to use special sponges and everything, it's the same thing. I know. Here, there's a specific set of spatulas in my house that are that are strictly forbidden in the nonstick cookware. I've I've had to learn that the hard way. So yeah, I'll bring that up next time that conversation happens in our house as well, just to live with these completely. All right. Well, time is running short here. So McKayla, I want to give you the last word. Is there any one thing that you would want sterile processing departments to take away from this interview? Just, you know, what they could be doing in their department. So it would be best practice to help take care of their stainless. Like I talked about earlier,

32:44I think that corrosion prevention is like a holistic attitude. And it's really a team effort. So everybody needs to be thinking about corrosion in the back of their mind during the whole process. Like, you can't fix us just with sterile processing. Your surgeons and your nurses need to be aware of the issue too, so that they understand why it's important to clean those instruments as soon as they're done with it. You know, if you've got like a really long surgery and you have an instrument just sitting in Bioburton for the entire surgery because you need it at the very beginning, that's a lot of corrosive exposure that that instrument didn't need to have if you just had somebody toss it in a bucket of water real quick and then set it out. And I know bucket of water is probably not sterile for this, but that's the... No, but we do have basins of sterile water for purposes like that. You're totally right. I'm tracking. I wasn't picturing the lowest bucket on the floor. I hope not. Yeah. That's somebody that has to get surgery sometimes. Place I'll have a loose bucket in the surgical room. It's a whole life cycle attitude and it's really a team effort. And just remember that stainless steel stains less. It's not stained proof.

33:53Right. Well, really fascinating interview today, Michaela. And I do hope that in having this conversation at least it has created enough curiosity and folks from kind of a scientific level who are maybe trying to solve a staining and and rusting problem at their own facility to do a bit of a deeper dive on maybe what some of those root causes are. We can be awfully quick to just point the finger at, you know, our steam quality must be bad. But sometimes it has to do with our process as like you said or our instrument selection of we're buying something that has two different kinds of metal welded together and it's creating some corrosion points. So yeah, really interesting fascinating conversation. Hey, if somebody would like to continue this conversation with you, whether just, you know, in theory or at the at the facility level trying to solve a problem is is linked in a good way for them to get in touch with you. Yeah, there's LinkedIn and then we also have a company website that has like an inquiry form. And I'm sure I'll talk to you and we'll get those linked in the podcast description. Yep, I'll make sure that gets included in there. Well,

34:58thanks again for joining us for the interview. It's been a great having. Thanks so much for having me. It's a great time. And that was Michaela Kuba Consulting Engineer at Bremen Lombard Engineering. Taken us to school a little bit on stainless steel. I don't know about you, Melissa, but I learned a few things in the episode today. I learned a lot including. Yes. Compared to Michaela. Because I obviously did not pay attention well in school or they left that semester at the nursing school. That's funny. Yeah, I was reliving high school chemistry class. They're talking about chromium oxide and ions and this, that and the other. But there were some good practical takeaways as well, you know, as she was talking about the the the chlorides that are in, you know, blood and other bodily fluids. You know, that's a big part of why we always talk about

36:00point of use treatment. And I thought your comment about chlorine in the water was interesting as well, because there's a lot of reasons we wanted in there. But I guess apparently some reasons we don't want it in there too. I know, you know, valuable point that every action we take has a reaction, right? You know, to just kind of school our own sales that we may be solving one problem, but be creating challenges for another department. And so how do we really get together and solve for that as a United team? Because if we're going to be holistic about our instruments, it involves a lot of. Yeah, for sure. Yeah, that closing exhortation is spot on that that solving corrosion is not a sterile processing problem. It's a whole team problem. It involves your facilities team, like with the boilers, which we're going to get into later in the season and involves the OR, your SPD, everybody that has anything to do with the instruments has to do with

37:05them. Even the instrument manufacturers, you know, we didn't talk about this, but one of one of my favorite topics around passivation has to do with those instruments that have been around your department since 1967. And they're still like, they're still cooking. And there's something about that, like it's not just that, you know, they don't make them the way they used to. These 1960s instruments were great. That may be true, but it's also true that like it's had decades of building up a really thick and sturdy passivation layer. And those brand new baby instruments you pull out of the, out of the packaging and put through the washer, that very first wash they go through is when they're at their most vulnerable because they haven't had that much time to build up that thick chromium oxide layer on the instruments. And so before you go just saying it's these, you know, it's these darn instrument manufacturers fault. Like we've got to look at our own processes and give these instruments the best shot that we absolutely can. And recognition, I mean, I love that point, right, that new instruments haven't had the time. And we don't think about time. We think about

38:14that's right. You got to get it all done right now. Well, Melissa, that's been, it's been a fun fun conversation with you this week as we're working through this season on steam sterilization. I hope that the conversation around metallurgical science, although maybe not the first topic you think of with steam sterilization has been helpful for the audience. We've got a lot more to talk about steam this season. So it encourages you to tune in each week, hang with us as we continue through this season. But until we talk to you again next time, we'll leave you as we always do over here on behalf of Melissa, myself and the rest of the team over here at Beyond Clean. Keep fighting, dirty. Thank you for listening to this week's episode of Beyond Clean. As a reminder, you can help support us by subscribing to Beyond Clean on your favorite podcast app or by downloading the smartphone app on iPhone or Android. Simply search for Beyond Clean in the App Store or Google Play.

39:17The best thing about downloading the smartphone app is that you can access bonus content for certain episodes and view episodes in certain categories like articles on the go and vendor spotlights. Are you following us on LinkedIn or Facebook yet? If you are and do love an episode or post, then let your social network know about it. Like, comment, or share our posts along with your thoughts and keep the conversation going. If you have any topics or guests that you would like to recommend for a future episode, just send us an email to infoatvyondclean.net. We look forward to hearing from you.