Dear Laparoscopic Surgeons: Caution with the Use of Glutaraldehyde!!!

Q3 Medicine
Shivani Phugat, Prativa Choudhury, Vishesh Jain, Anjan Kumar Dhua, Devendra Kumar Yadav, Hemanga Kumar Bhattacharjee, Sachit Anand, Harpreet Singh, Sandeep Agarwala, Prabudh Goel
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引用次数: 0

Abstract

Background: The occupational hazards of glutaraldehyde are well known; the possibility of harm to the patients has been highlighted in the form of isolated reports only.

Objective: To synthesize evidence for contact mucosal injury or injury due to intraperitoneal instillation of glutaraldehyde following its use during laparoendoscopy.

Materials and methods: The current review is Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) compliant. PubMed, PubMed Central, and Google Scholar were interrogated for animal and human studies upon the harmful effects of glutaraldehyde during laparoscopy and proctosigmoido-colonoscopy.

Results: Thirty-five studies substratified into animal experiments (n = 2), glutaraldehyde-induced colitis (G-iC) postendoscopy (n = 30), and laparoscopy (n = 3) were included. Rats suffered mucosal injury following colonic injection of glutaraldehyde which was time- and concentration-dependent quantum and developed bloody diarrhoea. Omental and renal injury was observed due to glutaraldehyde instillation during simulation of intra-peritoneal insufflation in rats; the serum leucocytes, CRP and creatinine were also elevated. G-iC following colonoscopy was related to contact mucosal injury due to failure (human or machinery) to rinse the chemical off the instrument surface or as a case of mistaken identity (glutaraldehyde was mistaken for saline or another reagent). The incubation period was <24 h in 90% of patients; clinical presentation was related to the initiation of intense inflammation. Intraperitoneal instillation during laparoscopy also leads to intense inflammation. One patient was asymptomatic, the second required laparotomy and peritoneal irrigation for 48 h, while the third case underwent multiple laparotomies for enteric cutaneous and enteroenteric fistulae, adhesions, and multiple intra-abdominal abscesses. Hydronephrosis consequent to retroperitoneal fibrosis has been reported.

Conclusions: The use of glutaraldehyde in the patient care facilities should be discontinued; when unavoidable, the standard processes of disinfection and rinsing must be stringently followed.

亲爱的腹腔镜外科医生:谨慎使用戊二醛!!!..!
背景:戊二醛的职业危害众所周知,但对患者造成伤害的可能性仅以个别报告的形式被强调:综述腹腔镜检查中使用戊二醛后因腹腔内灌注而导致接触性粘膜损伤或伤害的证据:本综述符合系统综述和荟萃分析首选报告项目(PRISMA)。我们在 PubMed、PubMed Central 和 Google Scholar 上查询了有关戊二醛在腹腔镜和直肠结肠镜检查中的有害影响的动物和人类研究:结果:共纳入 35 项研究,这些研究分为动物实验(n = 2)、内窥镜检查后戊二醛诱发结肠炎(G-iC)(n = 30)和腹腔镜检查(n = 3)。大鼠结肠注射戊二醛后出现粘膜损伤,这种损伤具有时间和浓度依赖性,并出现血性腹泻。在模拟大鼠腹腔充气过程中,观察到戊二醛灌注导致大网膜和肾脏损伤;血清白细胞、CRP 和肌酐也升高。结肠镜检查后的 G-iC 与接触性粘膜损伤有关,原因是(人为或机器)未能冲洗掉仪器表面的化学物质,或者是认错了(戊二醛被误认为是生理盐水或其他试剂)。培养期结论:应停止在病人护理设施中使用戊二醛;在不可避免的情况下,必须严格遵守消毒和冲洗的标准流程。
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
Journal of Indian Association of Pediatric Surgeons
Journal of Indian Association of Pediatric Surgeons Medicine-Pediatrics, Perinatology and Child Health
CiteScore
0.80
自引率
0.00%
发文量
148
审稿时长
30 weeks
期刊介绍: Journal of Indian Association of Pediatric Surgeons is the official organ of Indian Association of Pediatric Surgeons. The journal started its journey in October 1995 under the Editor-in-Chief Prof. Subir K Chatterjee. An advisory board was formed with well-versed internationally reputed senior members of our society like Late Prof. R K Gandhi, Prof. I C Pathak, Prof. P Upadhyay, Prof. T Dorairajan and many more. since then the journal is published quarterly uninterrupted. The journal publishes original articles, case reports, review articles and technical innovations. Special issues on different subjects are published every year. There have been several contributions from overseas experts.
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