Yébenes Juan Carlos, Delgado Maria, Sauca Goretti, Serra-Prat Mateu, Solsona Manel, Almirall Jordi, Capdevila Josep Antón, Balanzó Xavier
Intensive Care Department, Hospital de Mataró, Barcelona, Spain.
Crit Care Med. 2008 Sep;36(9):2558-61. doi: 10.1097/CCM.0b013e318183effb.
Disinfectable needle-free closed connectors were designed to avoid needle-stick injuries and to be easily disinfected before handling. Workloads or lack of knowledge, however, could impede the correct handling of these devices, allowing endoluminal catheter colonization. The aim of our study was to assess the barrier effect of different disinfectable needle-free closed connectors during correct and incorrect handling using an experimental model.
We used a model consisting of a blood culture bottle with a peripheral venous catheter inserted under sterile conditions. Three different disinfectable needle-free closed connectors with different valve designs (microClave, Bionector, and Smartsite plus) were used to close the catheters. The external surfaces of the disinfectable needle-free closed connectors were contaminated with different concentrations of a Staphylococcus epidermidis culture broth. After contamination, 10 units of each connector and each concentration were assigned to the correct handling group (cleaned with 70% ethylic alcohol before handling) and the same number to the incorrect handling group (handled without disinfection) with a total of 180 bottles.
Increases in concentrations of external contamination and incorrect handling of the connectors resulted in an increase in connectors' permeability to the pass of microorganisms to the endoluminal way. MicroClave proved the best barrier in the experimental conditions described.
The barrier effect of disinfectable needle-free closed connectors is adversely affected by incorrect handling, the quantity of external valve colonization, and the valve design.
可消毒的无针密闭式接头旨在避免针刺伤，并便于在操作前进行消毒。然而，工作量或知识欠缺可能会妨碍对这些装置的正确操作，从而导致腔内导管定植。我们研究的目的是使用实验模型评估不同可消毒无针密闭式接头在正确和不正确操作过程中的屏障作用。
我们使用了一个模型，该模型由一个在无菌条件下插入外周静脉导管的血培养瓶组成。使用三种具有不同瓣膜设计的可消毒无针密闭式接头（微型消毒器、生物接头和智能站点升级版）来封闭导管。可消毒无针密闭式接头的外表面被不同浓度的表皮葡萄球菌培养液污染。污染后，将每种接头和每种浓度的10个装置分配到正确操作组（操作前用70%乙醇清洁），相同数量的装置分配到不正确操作组（不消毒进行操作），总共180个瓶子。
外部污染浓度的增加和接头的不正确操作导致接头对微生物进入腔内途径的通透性增加。在所述实验条件下，微型消毒器被证明是最佳屏障。
可消毒无针密闭式接头的屏障作用会受到不正确操作、外部瓣膜定植数量和瓣膜设计的不利影响。
