COMPANY PROFILE

ALTRESCO INSTRUMENTS  is a leading Manufacturer & exporter of following products.

TERMS & CONDITIONS 

These Terms and conditions apply to all contracts for the sale of our products. 

       .  All oral or written contracts shall be free of obligation, unless has been agreed in writing for the acceptance proposal.

       .  No employee or representative of the Company has any right to make any representation, warranty or promise in relation to the products other than as contained in these Terms and conditions.        

       .  No amendment, alteration or cancellation of these Terms and conditions is binding on the Company unless confirmed by the Company in writing. 

QUOTATIONS & PRICES 

       .  Our quotations are in US$ and initially based on FOB Sialkot Pakistan

       .  Our quotations are valid  for thirty days from date of offer and after this period all quotations are subject to change or withdraw without prior notice

       .  If raise prices of raw material, service as well fare charges or impose surcharges, we reserve the right to re calculate and increase prices with mutual dialogue

ORDERS 

       .  We accept orders from responsible executive of the buyer company per mutual agreed terms and conditions by TELEPHONE/WHATSAPP, FAX & E-MAILS

       .  Order by telephone will not be valid without written agreement.

       .  All verbally made agreements become valid when approved in writing by us

       .  Deviations in the orders placed by the buyer from our terms of delivery and payment shall not be binding for us if we have not expressed our agreement in writing

       .  If buyer has a wish or need to amendment in order, he shall notify us in writing, we will issue revised invoice for approval  

       .  No order cancelled, modified or deferred without prior to inform us once confirmed by the buyer

       .  We shall be permitted expressly and in all cases to correct eventual errors in offers and invoices at a later point in time 

PAYMENT TERMS AND CONDITIONS 

       .  We determine prices at the time of order and prior to payment proceeding

       .  Payments are to be made to the Company without any deduction or discount as per stated these terms in the relevant invoice or contract

       .  Payments can be arranged via Irrevocable Letter of Credit (L/C)

       .  We accept 100% advance Payment by Bank telegraphic transfer (T/T) ,Western Union or Money Gram

       .  We also settle payment terms and conditions by mutual correspondence

       .  If no mentioned specific conditions on the invoices, the buyer  make sure payment within 10 days from date of invoice

       .  If payment is not made in relevant period, we have rights to suspend its obligations pursuant to the contract and any other current contracts until payment has been made

       .  In case of any confusion/difference of an invoice, Customer shall inform us immediately or within 10days.

CUSTOMIZED PACKING 

       .  We offer a wide range of packaging options to suit virtually packaged and presentation

       .  We are promoting our products under brand name “ALTRESCO”

       .  We offer (OEM) service and welcome to choose our (ODM) products

       .  Usually each product individually packs in zipper/simple poly bag.

       .  Customized packaging (PVC POUCHES, SINGLE/DOUBLE BLISTER, SKIN, REAL/SYNTHATIC LEATHER POUCHES/KITS PACKAGING) with private label/printing (screen/Etching /Laser/engraving/sublimation/digital ) service available  per buyer specification on request 

DELIVERY OF ORDERS 

       .  We ship orders in single /partial shipments per buyer requirement and instructions

       .  We use our best endeavors to supply goods with in the agreed period per contract

       .  We use different courier service for quick delivery as per buyer requirement and instructions.

  

For bulk quantity orders we offer by air and sea cargo services as per demand of buyer:

 CARGO  BY AIR:                                                                                                            CARGO BY SEA:

 CargoServ Tracking:                                                                                                    Track & Trace Tracking: 

       .  We can also ship your orders by your cargo broker/agent or can book through your courier account #.

       .  Usually our shipment date is within 35-40 days from date of order confirmation however  we settle shipment delivery time by mutual correspondence per desire/requirement of purchaser

       .  In case of failure to meet delivery deadline we shall consult with customer  prior to end deadline and set new deadline for delivery  

       .  Any partial or full damage of contract shall pass to customer prior to departure shipment from factory

       .  The shipment shall always (regardless of route and transportation means) be shipped to the place of destination at the risk of the customer.

SCCI (Sialkot Chamber of Commerce & Industry) Membership:

FBR (Federal Board Of Revenue) Tax NTN :

SIMAP (The Surgical Instruments Manufacturers Association of Pakistan) Membership :

TDAP(Trade Development Authority of Pakistan):

GMP (FDA):   

          CE Mark:

We are associated and member of following associations

.   FBR (Federal Board Of Revenue) Tax NTN #

.   FBR (Federal Board Of Revenue) Sale Tax #

.   SCCI (Sialkot Chamber of Commerce & Industry) Membership #

.   SIMAP (The Surgical Instruments Manufacturers Association of Pakistan) Membership #

MANUFACTURING PROCESS:

Our manufacturing procedure contain on following steps

.  Selection of Raw material like stainless steel

.  Stainless steel available in different grade, Pakistani local and imported from Germany, France, Japan.

MAGNETIC STAINLESS STEEL:

.  AISI 410/410X  use for production of gripping instruments like Forceps, Tweezers, Retractors

.  AISI 420A  for cutting instruments like Bone Rongeurs, Chisels, Gouges, Scissors ,needle holders

.  AISI420B   production for high grade cutting instruments like scissors, Bone Ronerurs

.  AISI440C   for cutting high quality instruments like cutely and measuring instruments

NONE MAGNETIC STAINLESS STEEL:

.  AISI 304  use for making Cannula, Clamps, Holders, Spreaders, Suction tubes

FORGING PROCESS:

.  By hand as well as hammer forging.

.  Selection of forging process,i.e Hot, Warm or Cold forging

.  Forging process apply on instruments/devices (Hot, Warm or Cold) for shaping metal parts.

.  Trimming of excess material and acid cleaning

MILLING AND TURNING:

.  Cutting away the unnecessary material by milling machines

.  Making Serrations, Ratchets, Male & Female box Joints and grooves.

FILING, GRINDING & SETTING:

.  Removing of irregularity by grinding wheels and files so instruments develop its final shape.

.  Initial setting of instruments by hand with different type of gauges

HEAT TREATMENT:

.  Heat treatment is significant process to improve performance and strength of instruments

.  Heat treatment process is done to change  physical and mechanical properties of instruments without modification of original shape of instruments

.  For soften the material /metal Annealing process done.

.  Hardening/Tempering process is done to produce durability in the instruments.

.  Rockwell hardness (HRC) of needle holder without tungsten carbide inserts around 40-48 while scissors among HRC 50-58

CHEMICAL TREATMENT:

.  Chemical treatment clean surface of steel and increase rust resistance

MAIN PROCESS AS BELOW:

.  Pickling is done after heat treatment process to use dilute sulfuric acid/Nitric Acid.

.  The passivation process is done when free iron, oxide scale, rust, iron particles, metal chips adversely affect the stability of the surface and this process contains of immersing stainless steel instruments in a solution nitric or citric and sodium dichromate, dissolving the imbedded iron particles and restoring the original corrosion-resistant surface by forming a thin, transparent oxide film.

.  Passivation also is accomplished by electro polishing

.  Electro polish is an excellent electro chemical process, passive surface of stainless steel instruments more than other methods because metal gives a bright surface due to this process.

.  Spare burr also removed by electro polish process

.  Usually phosphoric and sulphuric acid are used in conjunction with high current density to clean and smooth surface of metal

FIXING AND FITTING:

.  Setting is done to aligning, fixing and fitting the instruments with accurate function

.  All unnecessary sharp edges, burrs are removed by skillful craftsmen

POLISHING / BUFFING:

.  Metal finishing process done by using different abrasives (grinding, cutting, brushing, felting, buffing wheels) to create a homogeneous surface and finalize appearances of instruments like shine /mirror/bright or dull/satin/matte.

.  Electro polishing done to eliminate foreign substances and make surface more corrosion resistant.

FINAL INSPECTION:

.  To make sure quality of instruments per desired specifications final checking /inspection done by qualified technician.

MARKING/LABELING/PACKAGING:

.  Marking/Printing process done by laser marking system

.  Marking/Printing process also done by etching or screen printing.

.  Packaging done per desired specification.

CONFIDENTIAL:

• We maintain strict confidence policy and do not disclose to third party information or material relating to the other’s business which comes into that party’s possession and not use such information and material without written permission by the other party
• Buyer is obligated to keep confidential all our business related or other information even after contractual relationship between both we have ended.
• This confidentiality obligation shall not include any information that is lawfully disclosed by our written permission.

RETERNTION OF TITLE:

• The delivered products shall remain our property until all its claims against the buyer have been satisfied
• The buyer shall oblige himself to handle the goods properly and with care for the duration of the retention of title.
• The purchaser shall, within the scope of his orderly and usual business activities, be entitled to sell and process the products.
• The claims made by the purchaser from resale of the reserved goods shall with all additional reights,at this point in time be transferred to us until the full payment of our claims from physical deliveries to the full amount.
• The transferred claims shall serve as our security but only to the value of these reserved goods sold in each case
• The reserved products be sold by the purchaser after processing in conjunction with other goods not belonging to us
• The transfer of the buyer money claim shall be valid only to the value  of the received goods
• The purchaser shall be entitled to resell the reserved goods only in accordance with the stipulations regarding transfer of the purchase money claim.

INSTRUMENTS CARE GUIDELINE

Note: Under given Instrument care tips are general explanation, local regulations or hospital protocols may differnt from these recommendations.

We recommend following guideline of cleaning, sterilizing and maintaining instruments.

PERSONAL SAFTEY:

Personal safety must be ensure during reprocessing of instruments.

Fully trained personal must be perform these processes.

At the time of this procedures safety cloth, gloves and eyewear should be worn.

Sharp instruments always place separate in container.

RINSING:

Remove organic material immediately by rinsing instruments under warm running water after using instruments.

Be sure to remove all blood, body fluids and tissue. To use a nylon toothbrush may be helpful to rinse the lock boxes and joints of the instruments.

Do not process different metal like stainless steel, Copper, silver, chrome /gold plated together.

Also not use a sponge basin as any residue from normal saline solution can cause corrosion to develop over a period of time.

CLEANING:

There are several methods available to cleaning instruments; here we recommend a few methods.

A) Ultrasonic Cleaning:

Ultrasonic cleaning procedure is an effective process of cleaning instruments, especially instruments with hinges, locks and other moving parts.

Take following steps during ultrasonic process.

.  Instruments must be fully submerged.

.  Clean maximum 5 to10 minutes.

.  Place instruments in open position in ultrasonic cleaner.

.  Keep separate, avoid over-crowding instruments.

.  Sharp instruments (scissors, knives, chisel etc) keep separately.

.  Use a lid to avoid splashing.

.  Keep joints open and ratchets unlocked.

.  Place heavier instruments at the bottom of the basket.

.  Cleaning of aluminum items by ultrasonic is not recommended.

.  Rinse instruments with water to remove cleaning solution.

B) Automatic Washer / Disinfector:

.  Use only distilled water.

.  Use only low foaming and non-ionizing cleaning detergents.

.  Keep joints open and ratchets unlocked.

.  Items with concave surface must be placed face down to prevent pooling of water.

.  If possible, flush clean all items with tubal structure.

.  Electro-medical instruments must not be processed in washer/disinfectors.

.  Make sure instruments are lubricated after last rinse cycle and before sterilization cycle.

D) Manual Cleaning:

If ultrasonic or automatic washer/disinfectors are not available, manual cleaning process should be done in a basin or sink but only for micro and delicate instruments.

Please observe the following steps:

.  Use stiff nylon autoclavable cleaning brushes.

.  Always brush away from the body and avoid splashing.

.  Do not use steel wool or wire brushes except special steel wire brushes for instruments.

.  Scrub thoroughly until dust has been removed.

.  Pay particular attention to serrations, knurling, hinges, ratchets and tubes.

.  Rinse thoroughly making sure surfaces is visibly free of stains or tissues.

.  A good peracetic acid based instrument cleaner can help remove stains.

.  Clean delicate instruments separately to avoid damage.

.  After cleaning, sort and dry instruments using hand dryer or drying cabinet.

CAUTION:

.  Low pH (acidic less than 6 pH) detergents break down stainless protective surface, resulting pitting and black staining.

.  High pH (alkaline more than 8 pH) detergents can cause brown stains (phosphate deposits) that can interfere with the function of instruments.

.  Most brown stains are not rust and are easily wiped with lightly oiled cloth.

.  Electro-medical instruments must be cleaning very carefully to avoid damage to the coating.

Note: Manual cleaning is not a disinfection process.

INSPECTION AND REPAIR:

Inspect each instrument carefully after cleaning. To use a magnifying glass or microscope will be helpful to detect faults which not visible to the naked eyes.

Inspect and make sure.

.  Scissors blades should glide smoothly all the way (they must not be loose when in closed position).Test by cutting thin gauze or surgical glove material three quarters of length of blade. Scissors should cut all the way to the tips, and not hang up.

.  Forceps have properly aligned teeth and ratchets.

.  Hemostats forceps and Needle Holders must not allow light through the jaws when closed in first ratchet position (hemostats may show a small opening half way in from the closed tip) lock and unlock easily and joints should not be too loose. Check Needle Holders for wear on jaw surfaces.

.  Suction tubes or instruments with tubal structure are clean inside.

.  Biopsy Punches, punch a clean hole into tissue paper.

.  Retractors must function properly.

.  Cutting instruments like knives have the sharp undamaged edges.

.  Joints are not loose or crack. Also they are not dry and stiff.

.  There is no sign of breakage on any part of the instruments.

Note: Damaged instruments must be taken out of service immediately for repair or disposal.

STERILIZARION:

Sterilization is done to preserve the substance for a long time without decay.

Sterilization kills all microorganisms and spores. Autoclaving (saturated steam under high pressure) is the most common method for sterilizing surgical instruments; however, dry heat and chemical sterility (ethylene gas, hydrogen peroxide gas plasma, etc.) can also be used.There are several methods however we recommend boiling and steam sterilization

A) Preparation for Sterilization:

Before of sterilization be Ensure that:

.  Ensure instruments are fully clean, dried and lubricated.

.  Instruments must not contain detergent residue.

.  Do not put rusted instruments in autoclave, it can transfer rust to other instruments.

.  Place instruments in sterilization trays or wrapped in paper before autoclaving.

.  Use only a non-silicon water-soluble lubricant, not industrial type.

.  Sterilize Instruments either individually or in sets.

.  Place all instruments in unlocked position to avoid breakage.

.  Avoid to overload chamber.

B) Boiling:

Boiling is done for metallic devices like surgical scissors, scalpels, needles etc like instruments. Here substances are boiled to sterilize them.

 C) Steam / Autoclaving Sterilization

Arrange the instruments, sterilization trays or packs in the autoclave without stacking them. The steam must circulate freely inside the autoclave. Follow the manufacturer’s directions for adjusting the time, temperature and pressure of the autoclave cycle. Process the instruments as under.

.  Unwrapped instruments at 121°C for 20 minutes at 15 PSI above atmospheric pressure or at 134°C for 3–4 minutes at 30 PSI above atmospheric pressure.

.  Wrapped instruments at 121°C for 30 minutes at 15 PSI above atmospheric pressure or at 134°C for 15 minutes at 30 PSI above atmospheric pressure.

When the autoclaving cycle is complete and the pressure reaches zero, open the door a centimeter or two to allow the steam to escape. Run the drying cycle as recommended by the autoclave manufacturer until all the instruments are dry. It should take about 30 minutes. Using sterile tongs, remove all the instruments, trays and packages. Allow them to cool to room temperature before storing.

Unwrapped items must be used immediately or may be stored in covered, dry, sterile trays for up to a week. Store wrapped packages in a warm, dry, closed cabinet. Instruments remain sterile as long as the wrap is dry and intact.

CAUTION: 

With most portable table top Autoclaves, at the end of the autoclave cycle before the drying cycle unlock the door and open it about 6-7mm. Then run the dry cycle for the period recommended by the autoclave manufacturer. If the autoclave door is fully opened before the drying cycle, cold room air will rush into the chamber causing condensation on the instruments that may result in water stains or cause wet packs. Make sure autoclave filters and chambers are cleaned afterwards as recommended by the manufacturer.

DRY HEAT STERILIZATION:

Dry heat may also be used to sterilize surgical instruments. Instruments can be wrapped in aluminum foil or placed in sterilization trays before putting them in the oven. Refer to the manufacturer’s directions to heat the oven. Instruments can be heated to any of the following to be considered sterilized:

.  180°C for 30 minutes

.  170°C for 1 hour

.  160°C for 2 hours

.  149°C for 2.5 hours

.  141°C for 3 hours

Allow the instruments to cool to room temperature inside the oven and store them as described above.

Susceptible to a small number of bacterial spores, so a high level disinfection is suitable for semi-critical items. These items include anesthesia equipment, some scopes (endoscope) and temperature probes.

Non-critical items do not come into contact with mucous membranes but touch intact skin. Equipment like blood pressure cuffs, surgical beds and stereotaxic frames are considered non-critical. They must be thoroughly cleaned, but will not require sterilization. A low level disinfection may also be used.

THERMAL FISINFECTION:

Follow instructions of equipment manufacturer.

.  Do not use alkaline corrosive detergents.

.  COLD STERILIZATION:

.  Use only CE Marked products.

.  Do not use bleach (sodium hypochlorite.

.  Do not cold disinfect aluminum instruments, electro-medical instruments and instruments with tungsten carbide inserts.

.  Use only cold sterilization of highest standard that take a short time. Most cold sterilizations take up to 10 hours which is detrimental to the instruments.

.  Do not use a multi-day use disinfectant because organic residue collected in the solution after every immersion will not render instruments truly disinfected.

.  Multi-day use disinfectant can also damage or stain instruments surface.Not only this,it can also cause corrosion to instruments that are processed in the same solution afterwards. Finally, So remember what the following terms mean:

.  STERILE is an absolute term (no living organism survives).

.  DISINFECTED basically clean. Some organisms may survive. Always choose a proper method of sterilization to get instruments in the required condition for use.

STORAGE:

Instruments must be completely dry at the time of storage. Likewise, storage area must be absolutely dry. Wet climate and damp conditions can lead to corrosion. Even innocuous liquids like seawater have a devastating effect on stainless steel.we offers a high quality and affordable container system for sterilization and storage of instruments. All sizes are Included. Boxes are anodized aluminum and wire baskets are stainless steel. All necessary accessories are also available.

TERMINOLOGY:

AISI:

ASTM:

Austenitic:

Martensitic:

INTERNATIONAL STANDARDS: 

STAINLESS STEELS: 

STAINLESS STEEL TYPE AISI 304:

STAINLESS STEEL TYPE AISI 316L:

STAINLESS STEEL TYPE AISI 410:

STAINLESS STEEL TYPE AISI 420 & 440:

TITANIUM:  

TUNGSTEN CARBIDE: 

OTHER MATELS: 

STERLING SILVER:

GERMAN SILVER:

BRASS AND COPPER:

ALUMINUM:

NON-METAL MATERIALS:  

PLATING:

SILVER PLATING:

NICKLE PLATING:

CHROME PLATING:

BLACK CHROME PLATING: