Care and Repair of Forceps
By Barbara Greathouse, CPE December 9, 2009
An instrument used daily by electrologists is forceps, also known as tweezers. This delicate instrument is used to grasp and extract the hair from the follicle. Electrologists must be able to trust that forceps are going to do what they are supposed to do, but if forceps are damaged they won’t extract hairs from the hair follicle. This could result in possible overtreatment of multiple hair follicles before forceps damage is discovered.
History of Forceps
Tweezer-like tools have been in existence since the stone-age. The first precision tweezers were made for the watch industry in Switzerland in the 1870’s. These tweezers contained a high carbon content, which made them magnetic and porous. The advancement of medicine in the 20th century brought the need to manufacture instruments that would not oxidize and could be sterilized. Stainless steel sheet, the material medical instruments are made from, was developed in 1908. According to the Metals Industry Resource Guide the first patent for stainless steel was issued in 1919 for cutlery. Swiss made instruments are considered to be of the highest quality available.
There are over 150 grades of stainless steel, with the crystalline structure determining the classification. The combinations of steel and alloys will depend on the purpose of their use. Stainless steel instruments will be stamped with numbers and names that identify the grade or content. Some forceps used in electrolysis will be labeled with INOX, which is the alloy composed of the elements of Carbon and the minerals Manganese, Chromium, Molybdenum, and Vanadium. The chemical Carbon is a “non-metal” element that allows steel to have increased strength, wear and impact resistance.
Care of Forceps
Forceps are made of stainless steel, but the term “stainless” is misleading. If not handled properly, forceps can and do stain. While stains can be removed from stainless steel, stains can cause the damage that leads to rust. To discover if stains are turning into rust, use an eraser to rub hard over the discolored spots, and then examine forceps for pitting; which means corrosion has occurred.
When blood and debris are allowed to dry on forceps staining can occur, which leads to corrosion, rusting and pitting. Removing organic material during a treatment will keep forceps free of blood and debris that can be more difficult to remove once it dries out. Once a treatment has been completed, forceps should be placed in a soaking container with a neutral pH cleanser. Dish soap, salt, abrasives and chlorines should never be used to clean forceps, as they damage stainless steel, leading to spotting, corrosion and pitting. Enzyme detergents should be used as they are designed for the crucial steps of soaking and cleaning instruments such as forceps. Prolonged soaking of forceps can result in surface damage and decrease forceps life, so they should not be allowed to soak overnight.
When extracting an ingrown hair, forceps can invade the skin barrier so proper cleaning and sterilization of forceps is essential. Studies have shown that ultrasonic devices clean 16 times better than manual washing. Ultrasonic cleaning is considered the standard for caring for fine instruments such as forceps, since forceps have sharp points and a deep crevice which need the blasting energy of an ultrasonic cleaning device. Dissimilar metals should not be combined in ultrasonic cleaners, as ion transfer can result in etching and pitting. When placing forceps in containers to soak and clean, make sure that the points are all at the same end of the container. This allows the tips to be free from bumping up against other forceps which protects the points from damage and helps prevent puncture injuries when removing the forceps from the container. After 10 to 20 minutes of ultrasonic cleaning, forceps should be rinsed and dried. Rinsing removes the particles suspended on the surface of the forceps, but if tap water is used, the high concentration of minerals can contain chlorine which leaves water spots on the surface. Air-drying can cause spotting and rusting, so forceps should be placed on a clean towel and then gently blotted as soon as they are rinsed. Electrologists should not use chrome-plated instruments as ultrasonic cleaning can cause flaking of the surface material. Forceps must be clean before sterilization as dried-on debris becomes baked-on stains.
Forceps are packaged and then processed by dry heat or autoclave sterilization. Cold “sterilization” products should not be used because immersing instruments in solutions for long periods can damage forceps surfaces and liquid “sterilants” cannot be monitored for efficacy. When using the autoclave, forceps must be thoroughly dried before storage to prevent rust formation. Proper storage, away from moisture and exposure to soil and traffic will protect forceps from damage.
Electrolysis forceps have very sharp points that could cause a serious puncture wound to the client or the electrologist. Client eye protection during a treatment will help prevent an accidental eye injury if forceps are dropped. When forceps accumulate debris, the electrologist should wipe them from crevice to point (one direction only) with wet cotton. This is the safest way to remove gross soil from forceps during a treatment. Care in manipulating forceps must also be taken when handling them between treatments and when preparing them for decontamination.
As stainless steel instruments age they can soften with use and sterilization, so older instruments might feel different from new ones. Even well-cared-for forceps will eventually need repairs. Like any mechanical device that is used frequently, forceps need a regular visual inspection and may need a yearly refurbishing. An inspection of forceps includes checking for cleanliness, proper alignment of points and evidence of barbs or chips at the point. Repairs can be done by a professional instrument repair service, which would use the right tools and should provide a quick turnaround of instruments. A busy practice should have several dozen forceps which helps limit overuse and should help delay the need for routine repairs.
After investing hundreds of dollars in the number of forceps an electrologist must have, it makes good sense to take care of them so they will last. Good stainless steel instruments should last for 20 years. Knowledge of the selection, care and repair of forceps will result in a long lasting investment and developing good habits for proper daily care of forceps only takes a few minutes.