King Jonathan S, Pink Marilyn M, Jobe Christopher M
Department of Orthopaedic Surgery, Loma Linda University, Loma Linda, California 92354, USA.
Arthroscopy. 2006 Oct;22(10):1046-52. doi: 10.1016/j.arthro.2006.07.021.
The purpose of this study was to evaluate the level of contaminants on, as well as the quality of, reprocessed shaver blades.
We assessed 7 new shaver blades and 27 shaver blades that had been reprocessed with mechanical cleaning, functional testing, and sterilization with ethylene oxide. A spectrophotometer measured the amount of nucleic acid and protein. The blade quality was assessed by photographing the blades with magnification and determining the percentage of damage present on each blade. A subset of shaver blades were then used to cut meniscal tissue, and the cut surface was measured for smoothness by image processing and automated laser scanning cytometry. In evaluation of the meniscus, for the subset of shavers, an image processing value of 1 indicates a smooth, straight line, and values lower than 1 reflect deviations in the cut surface (the closer the value is to 1, the smoother the surface). Laser scanning cytometry values indicate the percentage of irregularities in the cut surface (the lower the value is, the smoother the surface).
Of the 27 reprocessed shaver blades, 13 (48%) had detectable levels of protein and 17 (63%) had detectable levels of nucleic acid. On the reprocessed shaver blades, protein levels ranged from 2.43 microg to 60 microg and nucleic acid levels ranged from 0.40 microg to 3.5 microg. No new shaver blade had contaminants. Twenty reprocessed shaver blades had been manufactured with teeth and could be evaluated for visible damage. Of these, 10 had 1% to 25% damage, 5 had 26% to 50% damage, 3 had 51% to 75% damage, and 2 had 76% to 100% damage. The new blades had no visible damage. Image processing revealed smoothness of the surface cut with new shaver blades, yielding values of 1 +/- 0.12, whereas the values for reprocessed shaver blades ranged from 0.62 +/- 0.02 to 1 +/- 0.07. Laser scanning cytometry values ranged from 3.3% to 7.1% for the new blades as compared with 5.8% to 20.0% for the reprocessed blades.
Of the reprocessed shaver blades, 48% had detectable levels of protein and 63% had detectable levels of nucleic acid. All of the reprocessed blades visually evaluated showed some level of damage or wear, whereas no new blade had such damage. In addition, menisci cut with reprocessed shavers showed rougher edges than did menisci cut with new shavers.
To make an informed decision regarding the use of reprocessed shaver blades, surgeons will want to know the level of contamination on, and the quality of, reprocessed shaver blades.
本研究的目的是评估再处理后的剃须刀刀片上的污染物水平及其质量。
我们评估了7片新的剃须刀刀片和27片经过机械清洗、功能测试及环氧乙烷灭菌处理的再处理剃须刀刀片。用分光光度计测量核酸和蛋白质的含量。通过放大拍摄刀片并确定每片刀片上的损伤百分比来评估刀片质量。然后用一部分剃须刀刀片切割半月板组织，并通过图像处理和自动激光扫描细胞术测量切割表面的光滑度。在半月板评估中，对于部分剃须刀，图像处理值为1表示表面光滑、呈直线，低于1的值反映切割表面存在偏差（值越接近1，表面越光滑）。激光扫描细胞术值表示切割表面不规则部分的百分比（值越低，表面越光滑）。
在27片再处理后的剃须刀刀片中，13片（48%）可检测到蛋白质水平，17片（63%）可检测到核酸水平。再处理后的剃须刀刀片上，蛋白质水平在2.43微克至60微克之间，核酸水平在0.40微克至3.5微克之间。新的剃须刀刀片没有污染物。20片再处理后的剃须刀刀片带有齿，可以评估可见损伤情况。其中，10片有1%至25%的损伤，5片有26%至50%的损伤，3片有51%至75%的损伤，2片有76%至100%的损伤。新刀片没有可见损伤。图像处理显示，用新剃须刀刀片切割的表面很光滑，值为1±0.12，而再处理后的剃须刀刀片的值在0.62±0.02至1±0.07之间。新刀片的激光扫描细胞术值在3.3%至7.1%之间，相比之下，再处理后的刀片的值在5.8%至20.0%之间。
在再处理后的剃须刀刀片中，48%可检测到蛋白质水平，63%可检测到核酸水平。所有经过视觉评估的再处理刀片都显示出一定程度的损伤或磨损，而新刀片没有这种损伤。此外，用再处理后的剃须刀切割的半月板边缘比用新剃须刀切割的半月板边缘更粗糙。
为了就是否使用再处理后的剃须刀刀片做出明智的决定，外科医生需要了解再处理后的剃须刀刀片上的污染水平及其质量。
