"complete removal of all pathogens"
"the efficacy of disinfection was 100%"
John Temple
John Prohonic
Product Development
Critical cleaners, usually referred to as Surgical Instrument Washer Decontaminators Washer Disinfectors, perform pre-wash, ultrasonic (optional), detergent washing, purified water elevated temperature rinsing, lubrication and high temperature drying in such a manner as to provide thoroughly clean, stain free and lubricated medical devices. Surgical Instruments cannot be sterilized (be sterile) unless all exposed surfaces are properly cleaned, prior to sterilization, to remove soil (debris, bioburden) and properly rinsed to prevent staining.1,2,3 Not all Washer Decontaminators Washer Disinfectors provide adequate pre-rinsing, pre-cleaning, purified water rinsing, and thereby render higher rejection rates of processed surgical instruments. 4,5.
The "Proper Sequence of Washer Treatments"
Design Secures Performance
The proper sequence of treatment and the correct choice of time, temperature and the components used are necessary to render surgical instruments that are critically clean, safe to handle, and have the prerequisite for sterilization. 6,7,8.
Washer Decontaminators Washer Disinfectors employ a cold water pre-wash to remove gross debris. This removes proteins and lipids, preventing them from being baked onto devices during the high temperature treatments to follow. 9, 10. Then, the ultrasonic process creates millions of micro implosions to loosen and free debris from lock boxes, hinge pins, serrations and other difficult-to-access surface areas.
The Washer Decontaminators Washer Disinfectors detergent wash then applies high flow low pressure water with a cleaning concentrate (at ~ 135 degrees F) in such a manner as to evenly reach all areas of the load and strip bioburden from the surgical instruments. The elevated temperature (at ~ 194 to 209 degrees F) purified water final rinse secures the biocidal process, removes mineral deposits from prior cycles and lubricates the instruments. The high temperature (at ~ 158 to 230 degrees F) dry cycle presents heated, forced air which dries each device. The critical cleaned medical devices are now clean, safe to handle, have the prerequisite for sterilization, and are properly prepared for further reprocessing.
The Washington University School of Medicine at Washington University Medical Center examined the performance of a properly designed Washer Decontaminator Washer Disinfector (CESCO washer Decontaminator Model 520) and found that it removed all organisms from the surgical instruments tested. 11
Pure cultures of the following organisms were grown on appropriate agar plates:
1. Staphylococcus aureus;
2. Pseudomonas aerations;
3. Escherichia coli;
4. Bacillus species
Kelly clamps, tweezers and scissors wee placed on these plates of organism, taking care to ensure that all serrated edges were packed with all the organisms. Each contaminated instrument was then dipped into the tube of Thiogycolate medium before being placed in all the washer baskets. The instruments were then processed through the complete Washer Decontaminator Washer Disinfector cycle. At the end of the drying cycle, the instruments were allowed to cool and then dipped into another tube of Thioglycolate medium.
Performance Results
All tubes of the Thioglycoate medium tested before the wash grew the appropriate organism within six to 18 ours after testing. All tubes tested at the end of the wash showed no growth after 14 days of incubation. This Washer Decontaminator Washer Disinfector removed all organisms from the instruments.
Efficacy of Disinfection 100%
Another evaluation of Washer Decontaminators Washer Disinfectors confirmed that the efficacy of disinfection was 100%. In this study, L.P. Jette and N.G. Lambert used two test methods.12 One method (N) was to test the effect of heat only within the disinfection process and the other test method (G) was to test the efficacy of both heat and washing. Each method gave reproducible results and confirmed the efficacy of the Washer Decontaminator Washer Disinfector.
Surgical Instrument Washer Decontaminator Washer Disinfector
Critical Cleaners Will Work for You
Washer Decontaminator Washer Disinfector Critical cleaners demonstrated the ability to completely remove pathological organisms with effective repeatability. There operation is automatic, reliable, labor saving and easy to use. Central Processing departments rarely find the need to manually treat devices and report an exceptionally low rate of rejected devices.
Conclusion
The Surgical Instrument Washer "Proper Sequence of Washer Treatments": cold water pre-wash, ultrasonic cleaning, detergent washing action, elevated disinfecting temperature final rinses, and elevated temperature disinfecting hot air drying delivered by a properly designed Surgical instrument Washer Decontaminator Washer Disinfector Critical Cleaner will provide critical cleaning, the prerequisite for safe handling, optimal disinfecting, and sterilizing of medical devices.
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References
1. Peggy Ryan, RN, “Concepts of Cleaning Technologies and Processes,” Journal of Healthcare Material Management, (Nov./Dec. ’87), pp. 20-27.
2. Marimargaret Reichert, RN, “processing Reusable Medical Devices, “Journal of Hospital Material Management, p. 40.
3. Training Manual for Central Service Technicians, American Society for Central Services Personnel of the American Hospital Association, (Chicago, IL, 1986), p. 69.
4. Ryan, op. cit.
5. Training Manual for Central Service Technicians, op. cit.
6. Ryan, op. cit.
7. Interview with Charles A. Reed, Washington University School of Medicine, Washington University Medical Center, Dec. 1985.
8. L.P. Jette’and N.G.Lambert, “Evaluation of Two Hot Water Washer Disinfectors for Medical Instruments, “ Infection Control Hospital Epidemiology, Vo.1 9, No. 5, (1988), pp. 194-199.
9. Training Manual for Central Service Technicians, op. cit.
10. Ryan, op. cit.
11. Ryan, op. cit.
12. L.P. Jette’and N.G.Lambert, op.cit.
NOTE:
The Surgical Instrument Washers (Tunnel Washers) used in this research study were manufactured by CESCO, Mercersburg PA. Although these Surgical Instrument Washers (Tunnel Washers) are not currently available, the studies demonstrate the propensity for a properly designed Washer Decontaminator Washer Disinfector that uses the Proper Sequence of Washer Treatments, to deliver optimal cleaning results.
The Cleaning Concentrates used in these studies are currently available in the form of the all-in-ONE combination enzymatic enzyme detergent cleaners and conditioners. A critical component for optimal cleaning is using the best possible cleaning concentrate. Recent European studies have illustrated and concluded that combination enzymatic enzyme detergent cleaners and conditioners are more effective than conventional cleaners. The research was initiated to deactivate prions deactivating prions within the objective to prevent CJD (Creutzfeldt-Jakob Disease).
