Decontamination of minimally invasive surgical endoscopes and accessories

摘要: (1) Infections following invasive endoscopy are rare and usually of endogenous origin. Nevertheless, infections do occur due to inadequate cleaning disinfection the use contaminated rinse water processing equipment. (2) Rigid flexible operative endoscopes accessories should be thoroughly cleaned preferably sterilized using properly validated processes. (3) Heat tolerant a vacuum assisted steam sterilizer. Use autoclavable instrument trays or containers protect equipment during transit processing. Small bench top sterilizers without air removal unsuitable for packaged lumened devices. (4) sensitive rigid ethylene oxide, low temperature formaldehyde (rigid only) gas plasma (if appropriate). (5) If there insufficient instruments time sterilize endoscopes, if no suitable method is available locally, they may disinfected by immersion in 2% glutaraldehyde alternative. An at least 10 min adopted glutaraldehyde. This sufficient inactivate most vegetative bacteria viruses including HIV hepatitis B virus (HBV). Longer contact times 20 more necessary mycobacterial infection known suspected. At 3 h required kill spores. (6) Glutaraldehyde irritant sensitizing skin, eyes respiratory tract. Measures must taken ensure used safe manner, i.e., total containment and/or extraction harmful vapour provision personal protective equipment, gloves, apron eye protection splashing could occur. Health surveillance staff recommended include pre-employment enquiry regarding asthma, skin mucosal sensitivity problems lung function testing spirometry. (7) Possible alternative disinfectants peracetic acid (0.2-0.35%), chlorine dioxide (700-1100 ppm) superoxidized water. These very effective, killing bacteria, mycobacteria, 5 bacterial spores min. endorsement compatibility with from both solution/device manufacturer endoscope manufacturer. Other important considerations stability, cost safety user environmental standpoints. (8) Cleaning sterilization undertaken trained dedicated area, e.g., SSD TSSU. A training programme described. (9) processed disinfectants, residues removed thorough rinsing. Sterile free essential rinsing all prevent recontamination. (10) an automated washer disinfector it non-damaging, reliable, easy its performance regularly monitored. (11) used, disinfectors other on regular basis, between patients start each session. will biofilm formation recontamination Disinfection treatment system, present. (12) To comply Medical Devices Directive, manufacturers obliged provide full details how decontaminate reusable devices supply. heat, pressure, moisture, chemicals ultrasonics. (13) The Infection Control Team always involved formulation implementation decontamination policies. Wherever possible, national good practice guidelines produced Agency professional societies shoul