In vitro evaluation of integrity and sterilization of single-use argon beam plasma coagulation probes
In vitro evaluation of integrity and sterilization of single-use argon beam plasma coagulation probes
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一次性使用氩束等离子体凝固探头完整性和灭菌的体外评价
DOI：
10.1111/j.1572-0241.1999.00784.x
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发表时间：
1999
影响因子：
9.8
通讯作者：
S. E. Sumida
中科院分区：
文献类型：
--
作者：
S. K. Roach;R. Kozarek;S. Raltz;S. E. Sumida
目的：氩等离子体凝固探头（APC）目前在美国作为一次性使用产品销售，可能会构成每次手术的重大费用。目前尚不清楚这些探头在内窥镜使用后是否可以灭菌，以及在再处理后是否可以保持电气完整性。方法：由埃尔贝Inc.生产的10个探头（直径2.3 mm，长度220 cm），（Marietta，GA）进行研究。通过将一块牛排浸泡60 s测量基线凝固深度。用106枯草芽孢杆菌孢子污染探针，培养并手动清洁。培养包括通过探针引入10 cc无菌水;过滤水，铺在血琼脂上，并孵育48小时。环氧乙烷（ETO）灭菌后，培养探针以确定灭菌情况。最后，评估每个探针的每次手术成本。结果：10个穿刺针中有10个完成了10次测试。一根穿刺针在近端裂开，但功能保持完整。所有10次治疗的电气完整性均保持完好。所有探针生长过多，无法计数B菌落。枯草芽孢杆菌，无B. ETO灭菌后检测到枯草芽孢杆菌。假设在临床上使用10次，每次手术的总设备成本约为24.00美元，而如果在体内仅使用5次，每次手术的探针成本将等于42.66美元。结论：手动清洁和ETO灭菌相结合对APC探头进行了一致的灭菌。90%的探头没有显示出物理退化的迹象，100%的探头在使用10次后仍保持其电活动。APC探针可以安全有效地重复使用多达10次，并且通过重复使用可以节省大量的程序。
Objective: 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. Methods: 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 106Bacillus 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. Results: 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. Conclusions: 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.