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可重复使用医疗器械的再处理

Reprocessing of reusable medical devices.

作者信息

Malchesky P S, Chamberlain V C, Scott-Conner C, Salis B, Wallace C

机构信息

STERIS Corporation, Mentor, Ohio, USA.

出版信息

ASAIO J. 1995 Apr-Jun;41(2):146-51.

PMID:7640417
Abstract

Advances in medical science and, in particular, minimally invasive surgical and diagnostic procedures have stimulated the development of new and improved medical devices. This has been made possible because of developments in engineering and material sciences. The design of devices for reusability is particularly important in an effort to provide cost effective healthcare. Concerns and issues include the ability to safely and effectively reprocess the devices, infection prevention and control, safety of the patient and healthcare worker, environmental concerns, and effective use of resources. From an infection prevention point of view, present requirements are based upon the intended use of the devices. Critical devices require sterilization. Semi-critical devices require, as a minimum, high level disinfection. Sterilization is, however, preferred whenever possible. Before sterilization or disinfection, devices should be cleaned adequately. Device designs should be readily amenable to cleaning and sterilization. In the past, design requirements focused primarily on the clinical user and device functionality, with reuse considerations left to the user. In the current market, the customer is redefined and, for reusable medical devices, includes all those associated with the device through the reprocessing procedure. In addition, regulations require that manufacturers give detailed instructions for reprocessing medical devices. The device users have the obligation to follow reprocessing instructions. Many choices exist today in device designs, including disposable or reusable devices. The user needs to balance cost versus convenience and reprocessing requirements for reusables. Current trends are to reuse more devices, including many of which were meant to be disposable. Cost effective designs can best be achieved when the user and manufacturer work together on the design.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

医学科学的进步,尤其是微创手术和诊断程序的发展,推动了新型和改良型医疗设备的开发。由于工程学和材料科学的发展,这已成为可能。为实现可重复使用而设计设备,对于提供具有成本效益的医疗保健尤为重要。相关的关注和问题包括安全有效地对设备进行再处理的能力、感染预防与控制、患者和医护人员的安全、环境问题以及资源的有效利用。从感染预防的角度来看,当前的要求基于设备的预期用途。关键设备需要进行灭菌。半关键设备至少需要进行高水平消毒。不过,只要有可能,还是首选灭菌。在灭菌或消毒之前,设备应进行充分清洁。设备设计应便于清洁和灭菌。过去,设计要求主要侧重于临床用户和设备功能,将再利用的考虑留给了用户。在当前市场中,客户的定义有所不同,对于可重复使用的医疗设备而言,客户包括所有通过再处理程序与该设备相关的人员。此外,法规要求制造商提供医疗设备再处理的详细说明。设备用户有义务遵循再处理说明。如今,设备设计有多种选择,包括一次性或可重复使用的设备。用户需要在成本与便利性以及可重复使用设备的再处理要求之间进行权衡。当前的趋势是更多地重复使用设备,包括许多原本设计为一次性使用的设备。当用户和制造商共同参与设计时,最能实现具有成本效益的设计。(摘要截选至250字)

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