College of Medical, Veterinary & Life Sciences, Glasgow Dental Hospital & School, University of Glasgow, 378 Sauchiehall Street, Glasgow, G2 3JZ.
Br Dent J. 2018 Aug 24;225(4):315-319. doi: 10.1038/sj.bdj.2018.643.
Cleaning of re-usable medical devices is a critical control point in the decontamination cycle, although defined end-points of the process are controversial.
Investigate cleaning efficacy and cost of different detergent classes in an automated washer disinfector (AWD) designed for dental practice.
Loads comprised test soiled dental hand instruments in cassettes and extraction forceps. Residual protein assayed using the International standard method (ISO 15883-5:2005) 1% SDS elution with ortho-phthalaldehyde (OPA) or GBox technology (on instrument OPA analysis). Short (60 minutes) and long (97 minutes) AWD cycles were used with four different classes of detergents, tap water and reverse osmosis water.
SDS elution analysis (N = 612 instruments) demonstrated four detergents with both wash cycles achieved equivalent cleanliness levels and below a threshold of 200 μg protein/instrument. GBox methodology (N = 575) using UK Department of Health threshold of 5 μg/instrument side demonstrated that tap water performed with the greatest efficacy for all types of instruments and cycle types.
Using International standard methodology, different detergent classes had equivalence in cleaning efficacy. Cheaper detergents used in this study performed with similar efficacy to more expensive solutions. Findings emphasise the importance of validating the detergent (type and concentration) for each AWD.
可重复使用医疗器械的清洗是消毒循环中的一个关键控制点，尽管该过程的定义终点存在争议。
研究自动清洗消毒器（AWD）中不同洗涤剂类别的清洗效果和成本，该 AWD 专为牙科实践而设计。
将装有测试污染牙科手动器械和拔牙钳的盒式载物架装入负载。使用国际标准方法（ISO 15883-5：2005），用邻苯二甲醛（OPA）或 GBox 技术（器械 OPA 分析）洗脱 1% SDS 后测定残留蛋白。使用两种不同的 AWD 循环（60 分钟和 97 分钟）和四种不同类型的清洁剂、自来水和反渗透水。
SDS 洗脱分析（N = 612 个器械）显示，两种清洗循环中使用的四种清洁剂均达到了相同的清洁水平，且低于 200 μg 蛋白/器械的阈值。使用英国卫生部 5 μg/器械的阈值，使用 GBox 方法（N = 575），对所有类型器械和循环类型的测试结果表明，自来水在所有器械和循环类型中均具有最高的清洁效果。
使用国际标准方法，不同的清洁剂类别的清洁效果具有等效性。在本研究中使用的较便宜的清洁剂与更昂贵的解决方案具有相似的效果。研究结果强调了为每个 AWD 验证清洁剂（类型和浓度）的重要性。
