Roach S K, Kozarek R A, Raltz S L, Sumida S E
Department of Microbiology, Virginia Mason Medical Center, Seattle, Washington 98111, USA.
Am J Gastroenterol. 1999 Jan;94(1):139-43. doi: 10.1111/j.1572-0241.1999.00784.x.
Argon plasma coagulation probes (APC) are currently marketed in the United States as single-use items, and may constitute a significant per-procedure expense. It is unknown whether these probes can be sterilized after endoscopic use and if electrical integrity can be maintained after reprocessing.
Ten probes (2.3 mm diameter, 220 cm length) manufactured by ERBE Inc., (Marietta, GA) were studied using the ERBE APC 300 at 60 watts. Baseline coagulation depth was measured by coagulating a piece of beefsteak for 60 s. Probes were contaminated with 10(6) Bacillus subtilis spores, cultured, and manually cleaned. Culturing involved introducing 10 cc sterile water through the probes; water was filtered, plated onto blood agar, and incubated for 48 h. After ethylene oxide (ETO), the probes were cultured to determine sterilization. Finally, the per-procedure cost of each probe was assessed.
Ten of 10 probes completed 10 testing sessions. One probe split at the proximal end but remained functionally intact. Electrical integrity remained intact for all 10 sessions. All probes grew too numerous to count colonies of B. subtilis after inoculation and no B. subtilis was detected after ETO sterilization. Assuming 10 uses clinically, a total per-procedure equipment cost would approximate $24.00, whereas per-procedure probe cost would equal $42.66 if only five uses were obtained in vivo.
The combination of manual cleaning and ETO sterilization consistently sterilized APC probes. Ninety percent of the probes showed no sign of physical deterioration and 100% maintained their electrical activity after 10 uses. APC probes can potentially be safely and effectively reused up to 10 times, and a significant procedural savings is possible with reuse.
氩等离子体凝固探头（APC）目前在美国作为一次性用品销售，每次使用的费用可能较高。尚不清楚这些探头在内镜使用后能否进行消毒，以及再处理后能否保持电气完整性。
使用ERBE APC 300在60瓦功率下对ERBE公司（佐治亚州玛丽埃塔）生产的10个探头（直径2.3毫米，长度220厘米）进行研究。通过对一块牛排进行60秒的凝固来测量基线凝固深度。探头用10⁶枯草芽孢杆菌孢子污染，进行培养并人工清洗。培养过程包括通过探头注入10毫升无菌水；水经过过滤，接种到血琼脂平板上，培养48小时。环氧乙烷（ETO）处理后，对探头进行培养以确定消毒效果。最后，评估每个探头每次使用的成本。
10个探头全部完成了10次测试。一个探头近端裂开，但功能仍完好。所有10次测试中电气完整性均保持完好。接种后所有探头生长的枯草芽孢杆菌菌落数多得无法计数，ETO消毒后未检测到枯草芽孢杆菌。假设临床上使用10次，每次使用的设备总成本约为24.00美元，而如果在体内仅使用5次，每次使用的探头成本将为42.66美元。
人工清洗和ETO消毒相结合能持续对APC探头进行消毒。90%的探头在使用10次后没有物理损坏的迹象，100%保持了电气活性。APC探头有可能安全有效地重复使用多达10次，重复使用可显著节省操作成本。
