手术污染器械保湿过程中的污染控制

Contamination control during wetting of contaminated surgical instruments

目的分析手术污染器械保湿以提高器械的清洗效果,确保手术安全。方法选择2014年3-6月污染的医疗器械1 200件,分为保湿组与未保湿组,每组各600件,通过对手术污染器械处理过程中技术规范的实践,分析器械保湿对于提高器械清洗效果的重要性。结果在器械回收、转运、预清洗、正式清洗等环节中,不同时间保湿组细菌菌落数低于未保湿组,使用专用保湿剂抑制了细菌生长;保湿组目测及5倍放大镜下监测器械清洁合格率分别为100.0%、99.5%,均高于未保湿组的98.7%、97.8%;保湿组污染器械清洗后隐血试验合格率100.0%,高于未保湿组的98.7%。结论适当的保湿处理能提高器械清洗合格率,确保清洗质量,对于手术污染器械的感染控制有重要作用,为杜绝由于器械清洗不彻底引起医源性感染提供保证。

OBJECTIVE To analyze the wetting process of contaminated surgical instruments and improve cleanlinessso as to ensure the safety of surgical operation.METHODS Totally 1 200 contaminated items of surgical instruments during Mar.2014 to Jun.2014 were divided into two groups,the wetted group and the non-wetted group with 600 items in each group.The technical standard was implemented during the wetting management of contaminated surgical instruments.The results were analyzed to illustrate the importance of a wet condition for the benefit of improving sterilization.RESULTS During the processes of instrument recollection,transfer,pre-cleaning and formal cleaning,the bacterial colony count was less in the wetted group than in the non-wetted group at each time point,indicating that the use of specific humectant inhibited bacterial growth.The cleaning qualified rate reached 100.0% by visual inspection and 99.5% by magnifying glass in the wetted group,higher than 98.7%and97.8%in the non-wetted group.The qualified rate for occult blood test was 100.0%for contaminated instruments after cleaning in the wetted group,higher than 98.7% in the non-wetted group.CONCLUSIONProper wetting can improve efficacy of cleaning and ensure cleaning quality and thus plays an important role in infection control of contaminated surgical instruments and prevents hospital-acquired infections resulted from not thoroughly cleaned instruments.