This guideline has been prepared in consultation with guidelines from various manufacturers of debriding burs.
Cleaning of burs should be done within 2 hours of last usage. Removal of nail polish may require the use of solvents such as acetone, provided the burs are rinsed immediately.
Removal of organic matter by brushing and/or enzymatic cleaners is effective. Nylon brushes cause the least damage. Brass brushes can be used on stainless steel burs. Stainless steel brushes can be used on diamond and carbide burs. If ultrasonic cleaners are used the burs must not touch each other nor the basket or walls of the reservoir. This may cause premature dulling of the sharp edges. Burs can be placed in a bur stand. Carbide burs should not be placed in ultrasonic cleaners since the vibrations may cause the carbide to separate from the bur stem. Disinfecting solutions can be used at this stage but are not necessary. Liquids containing aldehydes are not recommended. Solutions should have a neutral pH (around 7 to 8) and not contain chlorine. After cleaning the burs should be rinsed and dried.
Sterilization of burs is essential since the burs are in contact with the patient. Handpieces of drills do not require sterilization, however, most of the drill handpieces can be cleaned with disinfecting liquids or soaps with a damp (not wet) cloth and must be followed by immediate drying. Some users cover the drill handpiece and cable with a sheath of plastic. Using drills with footswitch control also reduces hand contact with the drill controls.
Sterilization of burs with hot air sterilizers is not recommended since these expose the burs to temperatures exceeding 140°C (135°C for corundum burs).
Sterilization with liquid sterilants (however not those containing aldehyde) is effective, however, prolonged exposure to the chemicals may result in discoloration of the bur head and/or stem. Some claim to have noticed early dulling, even of carbide burs. We have no information on the use of peracetic acid.
Sterilization with steam is the preferred method. Burs can be placed in a bur stand to avoid contact with other items. Unwrapped sterilization is achieved in 20 to 30 minutes at 121° to 124°C. Wrapped burs are typically sterilized at 134°C for 5 minutes if a pre-vacuum sterilizer is used, or 5 to 10 minutes in a gravitation (no pre-vacuum) sterilizer.
European Footcare Supply supplies this information in good faith, however, cannot accept any liability for the use of the above guidelines. The user must also consult the manufacturer of the autoclave or chemical sterilants he/she will be using. European Footcare Supply distributes burs made by Busch. http://www.busch.eu/export/sites/busch/en/pdf/sicherheit_hygiene/SuH_E2012_internet.pdf is their Safety and hygiene recommendation for rotary instruments. We will ask them if they can provide recommendations that comply with Health Canada requirements specifically with respect to sterilize temperature and dwell time.