Creutzfeld-Jakob disease vCJD
The primary purpose of cleaning surgical instruments and scopes is to remove all inorganic and organic bioburden material from the internal and external surfaces of flexible endoscopes. The secondary purpose of cleaning surgical instruments and scopes is to maintain and improve the “passive Layer” of stainless steel. The passive layer is provided by the manufacturer of surgical stainless steel to resist (prevent) corrosion. Proper cleaning of surgical instruments will maintain and improve this passive layer. (for more information go to: Prevent Corrosion – Importance of Cleaning) If the manual cleaning of surgical instruments, brushing and rinsing steps are not properly carried out, protein debris can harden and lead to formation of biofilm on the biopsy channel of the endoscope. The optimal cleaning surgical instrument protocol will break down bioburden and clean the surface. Inadequate cleaning surgical of instruments can thus result in material remaining on the endoscope surfaces which prevents disinfection and sterilization fluids or gases reaching all parts of potentially contaminated surfaces. Inadequate sterilization or disinfection may in turn result in transmission of infectious organisms when the endoscope is reused. The intricate design, delicate materials and susceptibility to damage of flexible endoscopes further complicates their decontamination. The reprocessing decontamination process, whether done manually or automatically in a surgical instrument washer can only be effective if cleaning is adequate.
ONEcleaner Surgical Instrument Enzyme Detergent Lubricant Cleaner
Multi Enzyme Surgical Instruments Cleaning Concentrates
Enzyme Surgical Instrument Cleaners function more effectively at temperatures above room temperature. The optimal range begins as > 22C - 72°F with performance reaching it's peak at 58.3C - 137F. This is often referred to as the optimal temperature for the performance or activity of enzymatic action. The activity of Surgical Instrument Cleaners enzymes does not stop at higher temperatures but the level of performance does begin to decrease. Enzyme cleaning concentrates enzyme-detergents and all-in-one Surgical Instrument Cleaners, which include enzymes, should be used in accordance with the manufacturer's recommendations and the recommendations of the medical devices being cleaned. The approach is the same if the presence of pathological prions (including the prions of vCJD Creutzfeld-Jakob disease) is suspected, however attention to detail is more important. It has been long known, that prions are unusually resistant to disinfection and sterilization by physical and chemical methods in common use for decontamination of infectious pathogens. It is a difficult task to gain a consensus opinion on what constitutes optimal and practical conditions for decontamination of prions. Numerous studies have been conducted, but they do not reflect the reprocessing procedures for surgery instruments in a clinical setting which are critical for iatrogenic transmission. The method of reprocessing prion contaminated surgery instruments and scopes includes (1) decontamination by NaOH or NaOCl for 30 or 60 minutes followed by GL-autoclaving at 121°C for 30 minutes, (2) cleaning and (3) routine PL-sterilizing at 134°C. It is known that some surgery instruments cannot be decontaminated by heat and moisture. Disinfectants have been widely used for this purpose although practically ineffective. The most common practice believes that the only completely safe way to prevent transmission of vCJD is to use single-use surgery instruments. Because of the pervasive distribution of these infectious proteins and the long incubation time of the disease, reprocessing of surgery instruments and scopes has been identified as a risk factor for nosocomial transmission of vCJD. Research has shown that the agent of the vCJD disease, an infectious prion protein, is extremely resistant to today’s sterilization methods; therefore, the argument, “It does not matter if instruments are 100 percent clean, as they will be sterilized,” is definitely no longer valid. Today, we understand the washing process is fully as important as the sterilization process. Today’s standard washing processes require increasingly sophisticated Surgical Instrument Cleaners. Detergents, which are used in these processes, can be mild, with a neutral pH, or they may be more aggressive, with values in the alkaline range of the pH scale. A number of hospitals and surgery centers are effectively using neutral pH “combination” enzymatic-detergent Surgical Instrument Cleaners for reprocessing surgery instruments and scopes. The “combination” enzyme-detergent cleaners provide optimal cleaning as well as the highest possible level of care for surgery instruments and scopes. The early prion inactivation approach, using a high concentrate of sodium hydroxide solution or sodium hypochlorite combined with long hold times, is generally lethal for medical surgical instruments and washer-decontaminators- disinfectors. Recently, researchers have been looking for less destructive methods to decontaminate surgery instruments potentially contaminated with prions. The use of “combination” enzymatic-detergent Surgical Instrument Cleaners has offered the highest level of cleaning outcomes.