Abstract
SummaryRe-usable air/water and suction valves used in endoscopes often demonstrate risk of infection. To the authors' knowledge, the safety and efficacy of re-usable and single-use valves have not been compared to date. As such, a laboratory investigation was undertaken to compare the safety and efficacy of re-usable and single-use valves at 11 Italian endoscopy sites. Safety was evaluated by analysing the rinse liquid of reprocessed re-usable valves ready for use, and efficacy was assessed based on the completion of endoscopic procedures without valve malfunction. This study found significantly lower contamination of single-use valves compared with re-usable valves (0 vs 29.1%, respectively; P=0.007) and similar efficacy (97.6 vs 98.8%, respectively; P=ns). Microbiological analysis of the rinse liquid of reprocessed re-usable valves identified various surviving micro-organisms and highlighted their potential pathogenicity. Such data suggest that sterile single-use valves may be safer than re-usable valves, and have comparable performance.
Highlights
Re-usable valves used in endoscopes are multi-component, structurally complex devices; as such, cleaning and disinfection are extremely difficult [1e3]
Reusable valves are supplied in a non-sterile state, and need to be cleaned and disinfected after each use in accordance with specific procedures recommended by the manufacturers
This prospective, multi-centre survey was conducted at 11 Italian public endoscopy units that adhered to the proposals of the Italian Society of Digestive Endoscopy and the Italian Society for Surgical Endoscopy
Summary
Re-usable valves (air/water and suction) used in endoscopes are multi-component, structurally complex devices; as such, cleaning and disinfection are extremely difficult [1e3]. Reusable valves are supplied in a non-sterile state, and need to be cleaned and disinfected after each use in accordance with specific procedures recommended by the manufacturers. Cleaning and disinfection are among the most critical elements when reprocessing an endoscope and its accessories. More than 30 steps can be required for correct manual cleaning and disinfection of valves [4]. The risk of infection related to these accessories should not be underestimated, and this study aimed to quantify and qualify these risks. Re-usable valves are subject to risk of clogging and/or leakage due to re-use and deterioration over time
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