Banks Kayla C, Stalla David E, Bunyak Filiz E, White Tommi A, Schultz Loren G, Giuliano Elizabeth A
Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri.
Electron Microscopy Core Facility, University of Missouri, Columbia, Missouri.
Vet Ophthalmol. 2019 Sep;22(5):614-622. doi: 10.1111/vop.12632. Epub 2019 Feb 4.
To serially evaluate morphologic and elemental composition changes to diamond burr tips (DBTs) comparing two sterilization protocols.
A total of 300 fresh cadaver porcine globes.
Six DBTs were randomly, equally assigned into Group 1 or 2, and then analyzed using Scanning Electron Microscopy (SEM) and Energy Dispersive Spectroscopy (EDS) at 0, 25, 50, and 100 cycles. Diamond burr debridement (DBD) was performed for 120 seconds on corneal stroma using the Algerbrush®. DBTs were cleaned, and then: Group 1 was sterilized by Germinator 500™; and Group 2 underwent ultrasonic cleaning and pre-vacuum autoclave. A cycle is defined as one DBD, cleaning and sterilization protocol. Data were quantified using custom MatLab program.
Energy Dispersive Spectroscopy revealed minor buildup of sulfur on both groups. Group 1 displayed major buildup of carbon and calcium. All DBTs were stippled with inorganic particulate at baseline. Particulates were no longer present on Group 2 by 25 cycles, but remained on Group 1 at all time points. There was significantly more buildup on Group 1 at all time points (P = 0.0000, 0.0009, and 0.0003 for 25, 50, and 100 cycles, respectively). More damage to Group 2 at all time points (P = 0.003, 0.002, and 0.003 for 25, 50, and 100 cycles, respectively) was observed.
No significant damage to Group 1 DBTs was noted after 100 cycles, however, particulate matter is not adequately removed using this sterilization technique. Ultrasonic cleaning is warranted between DBDs to achieve adequate particulate removal prior to sterilization; greater damage occurs with this technique which supports replacing DBTs regularly.
通过比较两种灭菌方案,对金刚石磨头(DBT)的形态和元素组成变化进行系列评估。
总共300个新鲜猪尸体眼球。
将6个DBT随机、平均分为第1组或第2组,然后在0、25、50和100个循环时使用扫描电子显微镜(SEM)和能量色散光谱(EDS)进行分析。使用Algerbrush®在角膜基质上进行120秒的金刚石磨头清创术(DBD)。清洁DBT后,第1组通过Germinator 500™进行灭菌;第2组进行超声清洗和预真空高压灭菌。一个循环定义为一次DBD、清洁和灭菌方案。使用定制的MatLab程序对数据进行量化。
能量色散光谱显示两组均有少量硫的堆积。第1组显示有大量碳和钙的堆积。所有DBT在基线时都有无机颗粒斑痕。到25个循环时,第2组的颗粒不再存在,但在所有时间点第1组仍有颗粒。在所有时间点,第1组的堆积明显更多(25、50和100个循环时,P分别为0.0000、0.0009和0.0003)。在所有时间点观察到第2组的损伤更多(25、50和100个循环时,P分别为0.003、0.002和0.003)。
100个循环后,未发现第1组DBT有明显损伤,然而,使用这种灭菌技术不能充分去除颗粒物。在DBD之间进行超声清洗以在灭菌前充分去除颗粒物是必要的;这种技术会造成更大的损伤,这支持定期更换DBT。