Central Service - Issue 5/06

EDITORIAL

NEWS UPDATE

What's New in Standardisation: Biological Indicators
The DGSV 10 Years On - Medical Device Decontamination Today and Tomorrow. DGSV Congress, 1 - 3 October 2006 in Potsdam, Germany
Congratulations on DGSV’s 10th Anniversary. Extracts from the Speech at the DGSV Congress in Potsdam, 1 October 2006
A Step to the Future at the First Mexican Conference
Opportunities in Instrument Traceability and Management Systems. Getinge T-DOC Symposium in Advance of the EFHSS Congress

MAIN ARTICLES

J.R. Cronmiller, C.H. Kim, S.A. Cuminale, K.M. Antloga, G.E. McDonnell*:
Efficacy of the Manual Cleaning of Endoscopes
(Zentr Steril 2006; 14 (3): 345-357)

Abstract
Cleaning is a critical stage in the safe and effective decontamination of medical devices. Flexible endoscopes pose a particular challenge to manual and automated cleaning processes due to their complexity of design and, in particular for lower intestinal interventions, relatively heavy levels of microbial and chemical soiling in comparison to other routinely used surgical/medical devices. This study investigated the level of soiling on three different types of flexible endoscopes (gastroscopes, duodenoscopes and colonoscopes) directly after typical clinical use and following a recommended manual cleaning method. Endoscope lumens and surface sites where investigated. The indicators of cleaning efficacy used were bioburden (aerobic, mesophilic bacteria), protein, bilirubin, and hemoglobin concentrations. Particularly high levels of bioburden and other soil indicators were found in all lumens of the endoscopes investigated. Manual cleaning was efficient at reducing these levels to below detectable levels (using the methods used), with the exception of bacterial loads. Bacterial loads were reduced within the endoscope channels by an average of 2.6 log10/cm2.

A. Steeves, R.M. Steeves:
Endotoxin and Reprocessing of Medical Devices
(Zentr Steril 2006; 14 (5): 358-368)

Abstract
Medical devices contaminated with endotoxin may cause adverse reactions in patients during surgery. It is therefore important to understand to what extent the different stages of reprocessing surgical instruments in the sterile service department can affect endotoxin contamination so that appropriate monitoring points can be established.
In this preliminary study surgical instruments that were either depyrogenated or spiked with endotoxin, from Escherichia coli serotype O113:H10, where subjected to washing, handling and steam sterilisation. Endotoxin concentrations were measured after each or a combination of these activities.
Steam sterilisation inactivated the endotoxin activity on surgical instruments that had been contaminated through handling by cleanroom staff. The results of this investigation suggest that it would be more appropriate to monitor endotoxin levels on surgical instruments after steam sterilisation rather than in final rinse water used in the washer-disinfector. The results also question the necessity of using final rinse water with an endotoxin concentration limit of 0.25 EU/ml.

P. Kober:
The Implications of Endotoxins for Sterilisation of Surgical Instruments. Supplementary remarks from the Sterilisation Section of the German Society for Hospital Hygiene DGKH e.V. on the publication by Flocard, V. et al.: Central Service 2006; 14(2): 93-102)
(Zentr Steril 2006; )

Abstract

EDUCATION INSTRUMENTS - NEW!

Quality Management in the CSSD - Standard Surgical Instruments (1): Legal Fundamentals

RECOMMENDATIONS BY THE QUALITY TASK GROUP (AK »QUALITÄT«)

Manufacturers’ Instructions for Decontamination