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JULLSURG may, in its sole and absolute discretion, can cancel, reject or accept any offer made by you for any reason (or no reason), including an error in the displayed price, description of item, products listed on the website or any error in the order. JULLSURG displays the correct price of items, however, if there is a price discrepancy with the incorrect price displayed, then JULLSURG reserves the right to charge the correct price or cancel the order.
JULLSURG will not be liable for any delay in performing any of their obligations if such delay is caused by circumstances beyond their reasonable control, including but not limited to natural disasters, failure of services such as electricity supply, bank payment systems or deliveries
Our logistics company will deliver the order within 15 working days. JULLSURG will comply with this delivery date except in the case of a Force Majeure, which is out of JULLSURG’s control. JULLSURG will take reasonable measures to ensure that there is minimal delay or damages as a result of any Force Majeure including natural disasters, customs issues or Government amendments.
1) Cancellation and Variation
No cancellation, suspension or variation by the Customer of any order submitted to the Company shall be valid unless agreed by the Company in writing. The Company reserves the right to levy a cancellation or amendment charge as a condition of their agreement.
Once the return is complete, your account will be credited or your card will be refunded.
2) The Price and Payment
a. All prices shown in this catalogue exclude taxes or any customs charges etc.
b. The price to be paid by the Customer shall be the sum[s] shown by the Company’s invoices[s]. This shall be based on the sum quoted to the Customer, but in any event the Company reserves the right to amend the price of goods at any time without notice.
c. . If there is any customs charges or any king of taxes applied by any country custom authority that has to pay by customer only. As every country they have different rules and regulation, which can not interfered.
All items are guaranteed according to manufacturer’s warranty. All glass and microsurgery items are specifically excluded from this guarantee.
4) How do I return a product?
Firstly, we're really sorry that you want to return something to us! Our Customer Care team will be happy to help you organize your return. Please send e-mail- email@example.com and they will coordinate with you.
5) I can't find a product on the website!
We try and make the website as searchable as possible, but in some cases the words you're using may be ones you hadn't thought of!
The website is organized in such a manner so you can find the products easily.
If you still cannot find a product please email us @ firstname.lastname@example.org and we'll be happy to help, or use the Ask JULLSURG page to send your enquiry.
In order for any return to be accepted and / or credited, all returning items must be authorized by JULLSURG sales or customer service representative, who will advise you of the proper mode of transportation for the shipment. Email – email@example.com
Each return request must include the following information:
Purchaser’s name, telephone number and address
Invoice number & Date
Catalog number and quantity of items
Reason for the return
Limits on returns
All products sold and distributed by JULLSURG are guaranteed shipped without defect. Upon receipt of your product, the package contents should be checked in the unlikely event of damaged or missing merchandise. If you decide not to keep your merchandise for any reason, you can return it to us within 30 days of delivery.
Returned goods will be subject to a restocking fee
0-30 days: 15%
31-60 days: 20%
No returns will be accepted after 60 days
Once an instrument has been used, it is not returnable.
Special order or modified items are not returnable and no refund will be issued.
Please make sure to send the email at firstname.lastname@example.org in advance to process return .
The return authorization will be valid for 30 days from the date of issue.
All returns must be sent prepaid to JULLSURG .
Return shipping, insurance, and handling is the responsibility of the customer. Credits will not be issued until the product is received in acceptable condition. Ship via a secure, trackable method: DHL, UPS, FedEx, or certified mail. JULLSURG is not liable for any instruments that are lost in route to our facility.
Please ship products in their original packaging, including documentation with all tags attached. Failure to do so may result in a restocking fee to enable us to return the merchandise to a saleable condition.
JULLSURG cannot be responsible for return shipping losses. Please allow 4 to 5 weeks from the time we receive your returned merchandise for your refund to be issued.
cleaning and sterilization validation completed
Disclaimer: This article is provided to JULLSURG. The information in this
document should be used in conjunction with your hospital or institution’s cleaning and decontamination policies and procedures.
CLEANING OF INSTRUMENTS
The first step in preparing an instrument for reuse after it has been used on a patient is cleaning. The
importance of this step cannot be underestimated, as studies have shown that a soiled
instrument cannot be effectively sterilized. This is because the soil shields bacteria and viruses from the
sterilizing agent. As a result, bacteria and viruses may very well survive the sterilization process and
can cross infect the next patient.
As the removal of contamination from an item to the extent necessary for
further processing or for the intended use. NOTE—In health care facilities, cleaning consists of the
removal, usually with detergent and water, of adherent soil (e.g., blood, protein substances, and other
debris) from the surfaces, crevices, serrations, joints, and lumens of instruments, devices, and
equipment by a manual or mechanical process that prepares the items for safe handling and/or further
decontamination”. The appropriate cleaning method for a particular medical device depends on the
Before any specific methods of cleaning instruments can be discussed, the issue of how to protect the
staff from the possibility of infection must be considered. Healthcare workers who do the hands-on
work of cleaning soiled instruments should be protected from the possibility of infection from infectious
material on the instruments. This is not just a good idea; it is the law. OSHA (Occupational Safety and
Health Administration) of the U.S. Department of Labor has issued regulations (29 CFR 1910.1030 subpart
Z) concerning handling of blood-borne pathogens that spell out universal precautions that must be
taken to avoid, or at least minimize the chance that a healthcare worker will be exposed to infectious
material. The health care facility is responsible for providing PPE for all service personnel and ensuring
that used, contaminated PPE is decontaminated and/or disposed of properly. Such equipment must
comply with OSHA regulations, and can include protective gloves, liquid-resistant or liquid-proof
clothing, face shields, and surgical face masks. Some of the most important points discussed in the
· provide initial and annual training on the blood-borne pathogen regulations,
· provide personal protective equipment such as disposable gloves,
· dispose of soiled dressings and potentially contaminated waste according to bio-hazardous material regulations, but,
· the use of personal protective equipment is required only when there is reasonably anticipated exposure to blood or other potentially infectious materials.
The oldest method of cleaning instruments is manual cleaning and any device should be able to be cleaned manually. This method is still used frequently in areas ranging from the small medical or dental office to the largest hospitals. Manual cleaning has the advantage of flexibility, in that any type of instrument can be cleaned. It also has the weakness that the cleanliness of the instruments will be different from worker to worker, since each person will vary in technique to some degree. It; however, has the drawback that the healthcare workers are exposed to possible cross infection as they are in contact with soiled instruments.
Manual cleaning often is recommended for delicate or complex medical devices, such as microsurgical instruments, lensed instruments, and air-powered drills. Recommended procedures for manual cleaning are to first soak the instrument in a tepid or lukewarm water or detergent bath for at least 10 minutes, preferably until all soil on the instrument is softened.
This step softens and loosens much of the soil that may have dried on the instrument between the time it was used and the time cleaning is begun. The duration of the soak depends upon how much soil is on the instruments and how long the soil has been allowed to dry. Note: The use of enzyme detergents is preferred, as they help to break up organic soil more readily and rapidly than do conventional detergents. The instrument manufacturer should be consulted to determine the appropriate type of cleaning agent and the cleaning agent manufacturer’s instructions for use should be followed.
The next step is to completely brush the instrument with a medium-soft brush while it is in the soak
bath. In the case of tube devices like endoscopes and hand-pieces, the insides (tubes, lumens,
channels, etc.) should be brushed out as well. Care should be taken to use brushes recommended by
the manufacturer to avoid damaging the instrument. Note: Brushing must be done under the surface of
the water with brush strokes away from the body to avoid exposure to spray from the brush and to
minimize aero solation, removing the instrument from the soak bath only to inspect its cleanliness. The
instrument must then be rinsed with clean water, and if difficult-to-remove soil remains, another
enzyme soak followed by brushing and rinsing must be done. Clean detergent solutions must be used
for each session, so as to make sure that soil that was removed from one instrument does not deposit
on the next instrument, creating the chance for cross infection.
Unless specified by the instrument manufacturer not to, ultrasonic cleaning is the follow-up to manual cleaning. While manual cleaning removes most or all of the visible soil from an instrument, it may not remove small or microscopic particles that are protected by the texture of a surface or design features like hinges. Ultrasonic creates microscopic bubbles in the solution that collapse when they contact the instrument releasing energy. This energy “kicks” any soil that is in the area off the instrument. This process is called cavitation. The detergent in the ultrasonic bath suspends the soil particles and keeps them from attaching back to the instrument. Ultrasonic cleaning should be done for a duration as specified by the detergent or ultrasonic machine manufacturer, whichever is longer. The detergent solutions must be changed following the instructions of the manufacturer of the detergent or the ultrasonic, whichever states a shorter change interval? This procedure ensures that the potential for
cross contamination of instruments is minimized. Following ultrasonic cleaning, the instruments are rinsed with clean water and dried. Distilled water is preferred, to ensure removal of as much detergent as possible, but is only essential if the tap water has a high mineral content that could cause spotting. After drying, the instruments may be packaged for sterilization. Be sure to check with the instrument manufacturer to determine which sterilization process(s) have been validated.
Larger facilities need to reprocess more instruments than can reasonably be done by hand, and so use automatic cleaning machines. These machines may resemble home dishwashers or be specialized for the specific needs of cleaning endoscopes or dental hand-pieces and have been validated to meet the special needs of cleaning these instruments. These needs may include specialized racks that allow cleaning of the interior of anesthesia tubing, for example, and a wide range of temperature settings that allow the items to be processed at the maximum safe temperature for their use. Higher temperatures both speed cleaning, which is important in a high-volume setting, and provide some disinfection.
In the USA, there are three categories of washers which are defined and regulated by the FDA. Only washers and washer-disinfectors intended to process "general purpose" articles, such as laboratory glassware, pipettes, bottles and containers, are exempt from FDA review, unless they are promoted for use in the reprocessing of reusable medical devices [FDA, 1998]. These categories are:
removes soil from instruments
removes soil from instruments and provides at least a 1,000-fold reduction in the number of viable organisms present by use of a hot-water (180-200°F) or chemical disinfectant cycle.
removes soil from instruments, and provides a sterility assurance level of one chance in one million that the items processed will have a viable organism after processing.
Washer-disinfectors’ performance meets certain criteria, which were described in the table above. Per FDA, there are three levels of disinfection that may be claimed. The least demanding is low-level disinfection, in which 6-log (one-million fold) reduction of a suspension of vegetative organisms such as Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli or representatives of the Klebsiella-Enterobacter group is accomplished. The next is intermediate-level disinfection in which 3- log (one-thousand fold) reduction of an appropriate mycobacterium species is accomplished. The most demanding is high-level disinfection, in which 6-log (one-million fold) reduction of an appropriate mycobacterium species is accomplished [FDA, 1998a]. In order to meet these criteria, washerdisinfectors must thoroughly clean the instruments as well as subsequently disinfect them. Again, some washer-disinfectors are better suited for certain cleaning tasks than others, so review of the manufacturer’s literature and published articles is an essential part of a purchase decision.
These units are used to clean and sterilize instruments and materials that do not require packaging before use, i.e. pans and trays that receive instruments in an Operatory. For those situations in which a sufficient number of these items are to be reprocessed, washer-sterilizers are a good investment. Remember that washer-sterilizers are steam sterilizers and cannot be used for reprocessing materials or devices that cannot tolerate the heat and pressure of a steam sterilization cycle. Note: Sealed glass ampoule biological indicators are commercially available for routine quality assurance testing of these processes and should be performed to verify the sterilization cycle.
Instrument Preparation for Cleaning in an Automatic Washer
Regardless of the washer type used, instruments must be prepared for processing before being placed into a washer, with the extent of preparation depending upon the capabilities of the washer. The actual preparation must be done in accord with the washer manufacturer’s instructions. For the simplest washers, manual presoaking and sonication remain as necessary reprocessing steps. More-sophisticated washers include a presoaking step in the automated process. In all cases, standard operating procedures must be developed that take the capabilities of the washer into account, as assumption of a capability that is not present can compromise worker and patient safety.
Use of Containers
In many practices, instrument cassettes are used to hold instruments both during washing and sterilization. These cassettes use rubber strips to hold the instruments in place and should have many perforations that allow free flow of wash water/detergent solution through the cassette and over the instruments. Their use is only recommended in conjunction with automatic washers, as manual methods will not provide sufficient penetration of the cassette and the instruments within. Following the cleaning procedure, the cassette is dried and wrapped for sterilization.
Care of the Washing Equipment
Automated washers and washer-disinfectors provide a consistent level of cleaning if maintained properly. However, the internal parts of the unit, which are normally in a warm, moist atmosphere, can provide sites for the growth of pathogenic organisms in the form of biofilm [Health InfoCom Network News, 1991]. These organisms can cross contaminate patients if the instrument is not sterilized after cleaning. The best approach is to use a program of preventative maintenance that includes disinfection of the areas of the unit that are exposed to moisture and not actively rinsed. The manufacturer of the unit should be consulted to determine where these areas are located. Since around 1992, the FDA has required manufacturer’s to document these potential problem areas to receive their approval to market the device.
Multi-Step Automatic Cleaning
The ultimate in automatic cleaning is the multi-step or “tunnel” washer. These units incorporate separate soaking, sonication, washing, rinsing and drying stations and automatically transfer racks of instruments between these stations. These are expensive machines whose cost can be justified only by the highest-volume instrument processing requirements. However, these machines also provide the most-complete automation of instrument processing possible, permitting soiled instruments to be placed in a rack at one end of the unit and to be removed clean and dry and ready to be wrapped for terminal sterilization at the other end of the unit.