Central Service - Issue 4/2009
- What’s New in Standardisation: EN ISO 17665 Must be Applied
- 4th Colloquium "Medical Instruments - Reprocessing, Value Preservation, Reuse". International wfk Detergency Conference, May 2009, Düsseldorf
- IAHCSMM Annual Meeting Shines on Knowledge, Networking. 2 - 5 May 2009, Orlando, Florida
The "vCJD-Ophtha Commission" (vCJK-Ophtha) of the German Society of Ophthalmology (DOG) and Working Group Instrument Preparation (AKI) in cooperation with the firm Geuder AG:
Investigation of Alkaline Detergents for Automated Reprocessing of Ophthalmic Surgery Instruments in Terms of Material Compatibility and Alkaline Residues
(Zentr Steril 2009; 17 (4): 245-256)
Ophthalmologic instruments, in particular those used for surgery of the posterior segment of the eye should, as advocated by the Recommendation of the Robert Koch Institute (RKI) to prevent iatrogenic spread of transmissible spongiform encephalopathies, be reprocessed while also using an alkaline cleaning step. The present study investigated the effects of automated processes with and without steam sterilisation on the material compatibility and functionality of the instruments and also tested for absence of residual process chemicals. Inspection of the instruments after 100 decontamination cycles in each case did not show any sign of adverse effects on material compatibility or functionality. There was evidence of a risk of alkaline residues in narrow-lumened cannulas, especially if these became blocked during the decontamination process. Therefore a microfilter must be installed when purging these and routine spot checks must be carried out to check for any residual alkalinity.
FROM THE FIELD
I. Haas, H. Henn*, U. Junghannß, K. Kobel, D. Toth, H.C. Weiss and Working Group Instrument Preparation+:
Steam Sterilisation of Reusable Surgical Instruments
The aim of the present study was to investigate various process challenge devices (PCDs) already used in a previous study focusing on the sterilisability of reusable surgical instruments (Sterilisability Study) , but now using shorter sterilisation times. Sterilisation processes were conducted in a resistometer (134?°C) as well as in a test steriliser at temperatures of 132?°C (270?°F) and 134?°C (273?°F), using different hold times. The results obtained for the resistometer showed that in the "Thread" model no test organisms could be detected after a sterilisation time of 90 s. In the "Gap" and "Seal" models positive results were obtained after this sterilisation time because of the design features of these models. Complete inactivation of test organisms was achieved for the biological indicators used after 180 s. The other models used, i.e. the "Hose" model, both with and without a volume-reducing insert, and the two "Sliding surface" models, with metal as well as with plastic, continued to show microbial growth even after a 5-min exposure time.
The following results were obtained for the test steriliser: For the majority of tests conducted, with and without a load, in the test steriliser, there was no evidence of any test organism remaining after a hold time of either 90 s or 180 s and a temperature of 134?°C.
For the "Seal" and "Hose with insert" models, test organisms were detected in some cases, and this was confirmed by running a confirmatory test.
In the tests carried out at a temperature of 132?°C with hold times of 2 and 4 min, test organisms were recovered only in the "Hose with insert" model for the 2-min hold time, both with and without a ballast load.
RECOMMENDATIONS BY THE QUALITY TASK GROUP (AK »QUALITÄT«)
Requirements for Construction or Conversion of a Hospital Central Sterile Supply Department Part 4 - Room Ventilation Systems in the CSSD