Abstract
Achieving sterilization by adopting proper practices is essential to ensure that surgical instruments do not transmit microorganisms to patients. As the effectiveness of sterilization mandates effective cleaning, it is necessary to verify the success of cleaning procedures. In this study, we used the adenosine triphosphate (ATP) bioluminescence method for assessing the efficacy of the manual cleaning procedure during the reprocessing of reusable surgical instruments. The ATP bioluminescence assay was performed on 140 surgical instruments of 12 different types, both before being cleaned (baseline) and after each of the cleaning procedures (i.e., decontamination, manual washing, drying, and visual inspection). For each instrument, two swabs were used as follows: one to sample the entire surface (test point 1) and the other to sample the most difficult part of the surface to clean (test point 2). Overall, for each type of instrument, there was a decrease in contamination ranging from 99.6 to >99.9% (log reduction from 2.40 to 3.76). Thus, in order to standardize the assessment of cleanliness, it may be useful to introduce the bioluminescence method into the daily routine or, at least, at regular time intervals as a complementary check combined with visual inspection. This would allow real-time verification of the achievement of an adequate level of cleanliness.
Highlights
Surgical procedures involve contact between a surgical instrument and a patient’s sterile tissue, mucous membranes, or vascular system
Some investigators have described the degree of cleanliness of surgical instruments after processing by visual inspection and microscopic examination using a photomicrographic system
The reaction cuvette was placed in the luminometer, which provided a digital readout of the amount of light, expressed as relative light units (RLUs)
Summary
Surgical procedures involve contact between a surgical instrument and a patient’s sterile tissue, mucous membranes, or vascular system. This instrument must be sterile when used as any microbial contamination could result in the introduction of microbes in the surgical site, leading to infection. The most commonly used verification method relies on visual inspection, often with the aid of a magnifying glass. This method has several limitations owing to the difficulty of detecting soil on the internal surfaces of the instruments with lumens and, obviously, the subjectivity of the outcome. 90.6% of the instruments appeared to be clean; microscopic examination revealed residual debris on 84.3% of these [2]
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