Franz Alexander, Bristela Margit, Stauffer Fritz
Bernhard Gottlieb University Clinic of Dentistry, Central Research Unit, Medical University of Vienna, Vienna, Austria.
GMS Krankenhhyg Interdiszip. 2012;7(1):Doc13. doi: 10.3205/dgkh000197. Epub 2012 Apr 4.
Reprocessing of medical devices, being classified as semi-critical B is recommended to be performed in a washer-disinfector. In order to estimate, whether the expected contaminants of the various medical disciplines can be effectively removed by this washer-disinfector, different so called "test soils" have been proposed to be tested as a marker of cleaning efficacy of the disinfector. Todays described test soils are optimised for the testing of contaminations occurring in surgical procedures, but not for dental procedures.
In this study the test soils being proposed in the EN 15883-5 (e.g. KMNE soil, recipe by Koller and coagulated sheep's blood) were compared with 8 reference substances used in the conservative-prosthetic dental practice. The success of the cleaning efficacy in the washer-disinfector was checked visually and by determining the residual protein concentration on the contaminated instruments after the cleaning procedure.
It could be shown that in contrast to the proposed test soils of the EN 15883-5, the used reference substances of the dental practice could not be removed by the washer-disinfector. Removal of these reference substances was only possible after manual or ultrasonic cleaning.
Since blood plays a subordinate role as a contaminant of instruments during conservative-prosthetic dental treatments, testing of the cleaning efficacy of the washer-disinfector with test soils according to the proposals of the EN 15883-5 is not representative in this discipline of dentistry. Most of the materials used in dental practice can only be removed manually or with the help of the ultrasound bath.
被归类为半关键B类的医疗器械再处理建议在清洗消毒器中进行。为了评估该清洗消毒器能否有效去除各医学学科预期的污染物，已提出使用不同的所谓“测试污渍”作为消毒器清洁效果的标志物进行测试。目前描述的测试污渍是针对外科手术中出现的污染测试进行优化的，而非牙科手术。
在本研究中，将EN 15883-5中提出的测试污渍（如KMNE污渍、科勒配方和凝固的羊血）与保守修复牙科实践中使用的8种参考物质进行比较。通过目视检查以及测定清洗程序后受污染器械上的残留蛋白质浓度，来检查清洗消毒器的清洁效果是否成功。
结果表明，与EN 15883-5中提出的测试污渍不同，牙科实践中使用的参考物质无法被清洗消毒器去除。只有经过手动或超声清洗后，这些参考物质才能被去除。
由于在保守修复牙科治疗过程中，血液作为器械污染物的作用较小，因此按照EN 15883-5的建议用测试污渍来测试清洗消毒器的清洁效果，在该牙科领域并不具有代表性。牙科实践中使用的大多数材料只能通过手动或借助超声浴去除。
