Whitworth C L, Davies K, Palmer N O A, Martin M V
Hoghton Street Dental Practice, 22 Hoghton Street, Southport, UK.
Br Dent J. 2007 Feb 24;202(4):E12; discussion 220-1. doi: 10.1038/bdj.2007.142. Epub 2007 Feb 16.
This study investigated blood contamination of artificially and clinically contaminated Siqveland matrix bands and retainers. A modified version of the recognised Kastle-Meyer test for blood was used to compare the efficacy of enzymatic agents, a washer-disinfector and an instrument washer for pre-sterilisation cleaning of Siqveland matrix bands and retainers.
Assembled Siqveland matrix bands were contaminated either artificially with horse blood or clinically during dental treatment. Contaminated assembled matrix bands and retainers were subjected to immersion in an enzymatic agent, automated processing in a washer-disinfector or instrument washer, or a combination of pre-soaking and automatic cleaning. Residual blood contamination from each band and retainer was measured and compared to the volume of blood recovered from an unprocessed control group of contaminated assembled matrix bands or retainers.
Residual blood was recovered from every clinically contaminated assembled Siqveland matrix band and retainer. The volume of blood recovered from assembled Siqveland matrix bands ranged from 0.13-7.1 microl and from retainers, following removal of the matrix band, from 0.001-1.523 microl. The most effective method of pre-sterilisation cleaning for artificially contaminated assembled matrix bands was processing in the washer-disinfector. Conversely, the most effective method for cleaning clinically contaminated assembled matrix bands and retainers was pre-soaking in an enzymatic agent followed by a heavy-duty cycle in an instrument washer.
It is not possible to clean assembled Siqveland matrix bands using any method currently available to dental practitioners. Matrix bands should be discarded after use on one patient. Once the band is removed, all detectable blood can be removed from the retainer by pre-soaking in an enzymatic detergent followed by processing in an instrument washer.
本研究调查了人工污染和临床污染的西克维兰德(Siqveland)成形片带及固位器的血液污染情况。采用改良版公认的血液凯氏-迈耶(Kastle-Meyer)试验,比较酶制剂、清洗消毒器和器械清洗机对西克维兰德成形片带及固位器进行灭菌前清洁的效果。
将组装好的西克维兰德成形片带人工用马血污染或在牙科治疗过程中进行临床污染。将污染的组装成形片带及固位器浸泡在酶制剂中、在清洗消毒器或器械清洗机中进行自动化处理,或进行预浸泡和自动清洗相结合的处理。测量每个片带和固位器的残留血液污染情况,并与从未经处理的污染组装成形片带或固位器对照组回收的血液量进行比较。
从每个临床污染的组装西克维兰德成形片带及固位器中都回收了残留血液。从组装的西克维兰德成形片带中回收的血液量为0.13 - 7.1微升,从固位器中回收的血液量(在取下成形片带后)为0.001 - 1.523微升。对人工污染的组装成形片带进行灭菌前清洁的最有效方法是在清洗消毒器中处理。相反,对临床污染的组装成形片带及固位器进行清洁的最有效方法是先在酶制剂中预浸泡,然后在器械清洗机中进行强力循环清洗。
牙科从业者目前可用的任何方法都无法清洁组装好的西克维兰德成形片带。成形片带在用于一名患者后应丢弃。一旦取下片带,通过在酶洗涤剂中预浸泡,然后在器械清洗机中处理,可以从固位器中去除所有可检测到的血液。