Thorough cleaning of medical devices after use to remove blood, mucus, body fluids and other organic substances attached to them is an important part of preventing and controlling nosocomial infections and ensuring medical safety. If the cleaning is not thorough, any organic matter remaining on the medical device will form a protective layer on the surface of the microorganisms, preventing the contact between the disinfection and sterilization factors and the microorganisms or delaying their action, thereby hindering the disinfection and sterilization effect. According to reports, there are 15 million nosocomial infections caused by improper cleaning and disinfection of endoscopes in the United States each year, mainly caused by Pseudomonas aeruginosa, Mycobacterium tuberculosis, and hepatitis B virus. Therefore, how to remove the organic, inorganic, and microorganism contamination on the instrument to a safe level by physical and chemical methods plays an important role in ensuring the success of sterilization and controlling cross-infection. In recent years, many scholars have discussed the cleaning methods of surgical instruments.
Whether manual cleaning or mechanical cleaning is used, pretreatment before cleaning is an indispensable process, which mainly includes moisturizing treatment of instruments, an inspection of cleanliness, classification of instruments, and disinfection of especially contaminated instruments. If a physical or chemical disinfection method is used before cleaning, the protein attached to the dirt on the instrument can be coagulated and denatured, which increases the difficulty of cleaning. In the relevant disinfection technical specifications, only the equipment with special pollution is required to be soaked in a disinfectant containing 2000mg/L effective chlorine, and the rest of the medical equipment after use is in principle. The method of first cleaning and then disinfection is adopted, and the principle of standard prevention is adopted. . General instruments are routinely rinsed under running water at a temperature below 40C to remove dirt adhering to the instrument surface. For some devices with complex structures, those that can be disassembled should be fully disassembled, and those with a lumen should be pulled out to avoid covering the washing surface. Instruments with dry dirt will increase the difficulty of cleaning. It is not suitable to clean them directly. It should be soaked in an enzyme solution to loosen or digest the dirt adhering to the instruments. Soaking with chlorine-containing disinfectant before cleaning can also facilitate cleaning and effectively control the washing effect.
Using the same cleaning method, the washing quality of the instruments that were cleaned immediately after use and those that were washed after being placed for 2 hours were tested for washing quality. The positive rates of occult blood after washing were 5% and 40%, respectively. The key to reducing the difficulty of cleaning and ensuring the quality of cleaning. In order to effectively remove the organic matter, it is best to use an enzyme-containing cleaning agent to enhance the cleaning effect. The observation results show that the effect of using the multi-enzyme cleaning solution immersion method is significantly better than the cleaning method without multi-enzyme cleaning agent immersion. The cleaning effects of unimmersed, chlorine-containing disinfectant and enzyme-containing cleaners were compared, and it was found that the cleaning effect of multi-enzyme cleaner soaked for 5 minutes was significantly better than that of chlorine-containing disinfectant soaked for 30 minutes and no soaking group. The cleaning effects of several different soaking methods on residual blood stains of surgical instruments were compared, and it was found that the cleaning effect of the multi-enzyme washing solution soaking method for 5 minutes and the cleaning and boiling method was better than other methods. It was observed that the cleaning time of the group soaked in the enzyme-containing cleaning solution for 3 hours was significantly improved than that of the group soaked in the chlorine-containing disinfectant for 3 hours.
Manually cleaned instruments mainly include fine, precise, and sharp instruments, instruments that cannot be immersed in water (such as electric knives), instruments that are not resistant to high temperature (93°C), and those that are seriously polluted and rusted or have residual blood and secretions, Instruments that cannot be cleaned by machine. Manual cleaning is to use general instrument cleaning brushes or cleaning cloths to remove the dirt adhering to the instruments in running water and detergents that match the contamination of the instruments by physical methods, so as to achieve the purpose of cleaning. The three methods of traditional cleaning, cleaning plus multi-enzyme soaking, and automatic cleaning machine cleaning were used to observe the comparison of the cleaning effect of instruments after surgery. The cleaning effect of the cleaning plus multi-enzyme group was better than that of the other groups. Washing medical equipment that can be cleaned thoroughly. Various cleaning methods were carried out to observe the cleaning effect of medical instruments, and it was found that manual cleaning can be used for instruments with smooth surfaces, which not only ensures the quality but also saves the cleaning cost and improves the work efficiency. Parts that can be disassembled for complex instruments must be disassembled and carefully brushed, while pipes, gaps, rough surfaces, joints, etc. Cleaners should choose different types and sizes of medical instrument cleaning brushes. Manual preliminary brushing first to remove large dirt. After cleaning, use the washing machine to clean to ensure the cleaning effect. After observing the cleaning methods of contaminated instruments, it is believed that in the process of manual cleaning of instruments, it is emphasized that the instruments should not be brushed with iron wire balls, so as to avoid brush marks on the surface of the instruments, so that dirt or water accumulates in the traces and causes corrosion and damage. At the same time, it will also brush away the protective film on the surface of the equipment, which will accelerate the rust of the equipment.
Cleaning is a necessary process for the reprocessing of medical supplies. There are regulations at home and abroad to instruct medical personnel to effectively clean repeatedly used instruments. Cleaning personnel must follow the regulations to clean medical instruments.
