Beyond Endoscopes: Pilot Study of Surgical Instrument Lumen Inspection.

Q4 Medicine
Biomedical Instrumentation and Technology Pub Date : 2024-01-01 Epub Date: 2024-02-20 DOI:10.2345/0899-8205-58.1.25
Krystina M Hopkins, Steven J Adams, Larry A Lamb, Abigail G Smart, Cori L Ofstead
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引用次数: 0

Abstract

Objective: Borescope examinations of endoscope channels are commonly described in literature, but no studies on surgical instrument lumen inspection have been published recently. Inadequately processed surgical instruments have been implicated in patient infections. This study assessed the utility of borescopes for inspecting surgical instruments. Methods: The study team inspected and photographed sterilized, patient-ready arthroscopic shaver handpieces and suction tips using a tablet camera and borescopes to characterize internal anatomy, defects found in lumens, and the impact of recleaning on debris or residues. Results: Ten suctions and eight shavers were inspected. All suctions had internal ridges and suction holes that were perpendicular to the lumen. All shavers had visible ridges, elbows, and lever mechanisms inside lumens. Of the 18 instruments, 16 (88%) had internal features that appeared rough or jagged and 17 (94%) had visible debris or discoloration in the lumens. Recleaning efforts generally were effective for suctions, but multiple rounds of recleaning with enhanced steps were less effective for shavers, which were replaced. Researchers documented retained soil and brush bristles in several new shavers despite following manufacturer instructions for cleaning and found visible damage and discoloration within five uses. Discussion: This study demonstrated the value of borescope examinations for surgical instrument lumens. Visual inspections identified anatomical features that could influence cleaning effectiveness and detected residual soil, discoloration, and debris in most instruments. The findings suggested that manufacturer cleaning instructions were insufficient and additional cleaning was not always effective. In response, the site's multidisciplinary team strengthened risk assessment protocols and enhanced their cleaning practices.

超越内窥镜:手术器械内腔检查试点研究。
目的:内窥镜通道的内窥镜检查在文献中很常见,但最近还没有关于手术器械内腔检查的研究发表。处理不当的手术器械会导致患者感染。本研究评估了内窥镜检查手术器械的实用性。方法:研究小组使用平板照相机和内窥镜对已消毒、患者可使用的关节镜剃刀手机和吸头进行检查和拍照,以确定内部解剖结构、管腔中发现的缺陷以及重新清洁对碎屑或残留物的影响。结果:共检查了 10 个吸头和 8 个剃须刀。所有吸盘都有与管腔垂直的内脊和吸孔。所有的剃须刀都有明显的棱线、肘部和管腔内的杠杆装置。在 18 个器械中,16 个(88%)的内部特征看起来粗糙或参差不齐,17 个(94%)的管腔内有明显的碎屑或变色。吸尘器的重新清洁工作一般都很有效,但对剃须刀进行多轮加强步骤的重新清洁效果较差,因此对剃须刀进行了更换。研究人员记录了几款新剃须刀中残留的泥土和刷毛,尽管他们按照制造商的说明进行了清洁,但在使用五次后就发现了明显的损坏和变色。讨论:这项研究证明了内窥镜检查手术器械管腔的价值。目视检查确定了可能影响清洁效果的解剖特征,并在大多数器械中检测到残留的泥土、变色和碎屑。检查结果表明,制造商的清洁说明不够充分,额外的清洁并不总是有效的。为此,现场的多学科团队加强了风险评估规程,并改进了清洁方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Biomedical Instrumentation and Technology
Biomedical Instrumentation and Technology Computer Science-Computer Networks and Communications
CiteScore
1.10
自引率
0.00%
发文量
16
期刊介绍: AAMI publishes Biomedical Instrumentation & Technology (BI&T) a bi-monthly peer-reviewed journal dedicated to the developers, managers, and users of medical instrumentation and technology.
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