DesCôteaux J G, Poulin E C, Julien M, Guidoin R
Foothills Hospital, University of Calgary, Alberta.
AORN J. 1995 Jul;62(1):23-30. doi: 10.1016/s0001-2092(06)63680-6.
This preliminary study describes the degree of cleanliness of three categories of surgical instruments after processing (ie, decontamination, inspection, sterilization). The three categories were reusable laparoscopic, reused disposable laparoscopic, and conventional surgical instruments. The objective of the study was to identify from visual inspection and microscopic examination residual particles, stains, or liquid on processed instruments. The investigators studied 32 instruments selected at random from a hospital's supply of processed surgical instruments. On visual inspection, 90.6% (29/32) of the instruments appeared clean. Microscopic examination with a photomicrographic system, however, revealed residual debris on 84.3% (27/32) of the instruments. The quantity of residual debris on both types of laparoscopic instruments (ie, reusable, reused disposable) was equivalent. The conventional instruments contained less residual debris than the laparoscopic instruments. Sites that contained residual debris included junctions between insulating sheaths and activating mechanisms of laparoscopic instruments and articulations and grooves of forceps. More research is needed to determine the prevalence and clinical significance of these findings.
这项初步研究描述了三类手术器械在处理后(即去污、检查、灭菌)的清洁程度。这三类器械分别是可重复使用的腹腔镜器械、重复使用的一次性腹腔镜器械和传统手术器械。该研究的目的是通过目视检查和显微镜检查,识别处理过的器械上的残留颗粒、污渍或液体。研究人员从一家医院供应的已处理手术器械中随机选取了32件器械进行研究。目视检查显示,90.6%(29/32)的器械看起来是干净的。然而,使用显微摄影系统进行的显微镜检查发现,84.3%(27/32)的器械上有残留碎片。两种类型的腹腔镜器械(即可重复使用的、重复使用的一次性器械)上的残留碎片数量相当。传统器械上的残留碎片比腹腔镜器械少。含有残留碎片的部位包括腹腔镜器械的绝缘鞘与启动机制之间的连接处以及镊子的关节和凹槽。需要更多的研究来确定这些发现的普遍性和临床意义。