Statewide Program for Infection Control and Epidemiology, UNC School of Medicine, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC.
J.M. Boyce Consulting, Boyce Consulting, LLC, Middletown, CT.
Am J Infect Control. 2023 Nov;51(11S):A3-A12. doi: 10.1016/j.ajic.2023.01.001.
Each year in the United States there are approximately 100,000,000 outpatient/inpatient surgical procedures. Each of these procedures involves contact by a medical device or surgical instrument with a patient's sterile tissue and/or mucous membrane. A major risk of all such procedures is the introduction of infection.
We searched published literature for articles on the use and effectiveness of disinfectants, sterilization methods and antiseptics.
The level of disinfection is dependent on the intended use of the object: critical (items that contact sterile tissue such as surgical instruments), semicritical (items that contact mucous membrane such as endoscopes), and noncritical (devices that contact only intact skin such as stethoscopes) items require sterilization, high-level disinfection and low-level disinfection, respectively. Cleaning must always precede high-level disinfection and sterilization. Antiseptics are essential to infection prevention as part of a hand hygiene program as well as other uses such as surgical hand antisepsis and pre-operative patient skin preparation.
When properly used, disinfection and sterilization can ensure the safe use of invasive and non-invasive medical devices. Cleaning should always precede high-level disinfection and sterilization. Strict adherence to current disinfection and sterilization guidelines is essential to prevent patient infections and exposures to infectious agents.
每年在美国，有大约 1 亿次门诊/住院手术。这些手术中，每一例都涉及医疗器械或手术器械与患者无菌组织和/或粘膜的接触。所有这些手术的主要风险是引入感染。
我们搜索了已发表的文献，以获取关于消毒剂、灭菌方法和防腐剂使用和有效性的文章。
消毒水平取决于物品的预期用途：关键物品（接触无菌组织的物品，如手术器械）、半关键物品（接触粘膜的物品，如内窥镜）和非关键物品（仅接触完整皮肤的物品，如听诊器）需要分别进行灭菌、高水平消毒和低水平消毒。清洁必须始终在高水平消毒和灭菌之前进行。防腐剂是感染预防的重要组成部分，作为手部卫生方案的一部分，以及其他用途，如手术手部消毒和术前患者皮肤准备。
当正确使用时，消毒和灭菌可以确保侵入性和非侵入性医疗器械的安全使用。清洁应始终在高水平消毒和灭菌之前进行。严格遵守当前的消毒和灭菌指南对于防止患者感染和接触传染性病原体至关重要。
