Disinfection Of Instruments Research Articles

Do the prevention procedures work in reducing infections?

Abstract Introduction Healthcare-associated infections (HCAIs) pose significant challenges in healthcare settings. Poor environmental hygiene contributes to HCAI. This study aims to evaluate and to assess the effectiveness of HCAI containment practices in nursing homes (NH). Methods The study examined infection prevention procedures in eight NHs supervised by the Multidisciplinary Commission of the Tuscany South-East Local Health Authority of Italy. Infection frequencies were obtained from NHs management and compliance with preventive procedures was assessed by inspection reports. Infection prevention protocols, including cleaning and disinfection procedures, were referenced from ministerial guidelines for hospital and territorial facilities. Comparisons was done whit Mann-Whitney test, using STATA. Results In 2023 more frequent infections were SARS-CoV-2 (19.5%), urinary tract infections (17%), pharyngitis (15.7%), influenza-like syndromes (ILI) (15%), and pneumonia (9%). Compared to 2022, significant improvements were observed in legionellosis surveillance, laundry, sanitary procedures, instrument disinfection, and hairdressing services. Non-compliance to specific procedures revealed differences in infectious onset like cleaning process verification with fungal infections (P = 0.01; M = 2,5), gastrointestinal infections (P = 0.04; M = 1.5); cleaning sanitary pans with Clostridium Difficile gastrointestinal infections (P = 0.04; M = 2); instrument disinfection with gastrointestinal infections (P = 0.04; M = 1.5) conjunctivitis (P = 0.01; M = 8); laundry procedures with pneumonia (P = 0.04; M = 18) and ILI (P = 0.04; M = 35). Conclusions These findings emphasize the importance of well-defined procedures in reducing HCAIs. While preventive measures demonstrate efficacy, continuous efforts are necessary for their consistent implementation. Continuous monitoring and stakeholder engagement are essential for developing sustainable strategies in preventing healthcare-associated infections. Key messages • Healthcare-associated infections are a significant complication in the healthcare sector and require effective practices in nursing homes. • Prevention measures are effective, but continuous and collaborative effort is needed to ensure their uniform implementation and develop more effective strategies in preventing HCAI.

Analysis on the application of FMEA in 'instrument and equipment surface cleaning and disinfection' in hospitals based on standardization and cleaning and disinfection information system management.

To analyze the application of 'instrument and equipment surface cleaning and disinfection' in hospitals based on standardization and the management of cleaning and disinfection information systems. Employees and all cleaning and disinfected instruments and equipment from 56 inpatient departments in our hospital were selected as the subjects of observation. The period before the intervention (January 2023) was designated as the control group, while the period after the intervention (July 2023) was designated as the study group. In the control group, the instruments and equipment under routine management were disinfected. The research team applied the Failure Mode and Effects Analysis (FMEA) method to clean and disinfect the surfaces of instruments and equipment on the basis of standardization and cleaning and disinfection information system management. Employees' theoretical knowledge points and operational skill scores before and after the intervention were compared and evaluated. The changes in the risk priority coefficient (RPN) values of high-risk factors were analyzed. Fifty-six clinical medical staff from 56 inpatient departments in the hospital were selected to evaluate the clinical satisfaction of the cleaning and disinfection management of instruments and equipment before and after the intervention, and the clinical satisfaction of the two groups was compared. The scores of theoretical knowledge and operational skills of the staff in the research group were significantly higher than those in the control group. The passing rates of theoretical knowledge and operational skills in the control group and the research group were 44.64 and 94.64% respectively, and 55.36 and 96.43%, respectively. The qualified rate of theoretical knowledge and operational skills of staff in the study group was significantly higher than that in the control group (p < 0.05). The RPN scores of medical personnel, environment, system and system guarantee factors in the control group were 80, 80, 80, and 100, respectively. The RPN scores of medical personnel factors, environmental factors, system factors and system guarantee factors in the research group were 6, 24, 24, and 36, respectively. Through standardization and cleaning and disinfection information system management, the theoretical knowledge and technical operation capabilities of cleaning can be effectively improved.

Microbiological evaluation of ultraviolet C light-emitting diodes for disinfection of medical instruments

BackgroundDespite the many guidelines for reprocessing of medical instruments, challenges persist such as microbial resistance to biocides, corrosive effects on materials, and time-consuming reprocessing procedures. Ultraviolet (UV) C light-emitting diode (LED) chambers might provide a solution but the integration in healthcare is still in its infancy. Here, we evaluated the efficacy of a novel ZAPARAY™ UVC LED chamber as a time and energy-efficient alternative for reprocessing of medical instruments for which current disinfection protocols exhibit limitations. MethodsWe verified the disinfection efficacy of the UVC LED chamber on a Petri dish and contaminated several medical devices with Staphylococcus aureus ATCC 25923. The bacterial reduction was assessed after 5 min of UVC LED exposure. Additionally, we investigated the impact of rinsing before UVC exposure. ResultsWe demonstrated a bacterial reduction of 9 log10 on a Petri dish. Non-rinsed dental tools exhibited varied reduction levels ranging from a 3.23 log10 to a 6.25 log10 reduction. Rinsing alone yielded an average reduction of 2.7 log10 and additional UVC exposure further reduced the bacterial load by an average of 3.65 log10. We showed an average 4.90 log10 reduction on thermistors, 2 log10 or less on orthodontic pliers, and no reduction on handpieces. ConclusionsThis study demonstrates that UVC LED chambers may be used as a standardized substitute for specific (manual) disinfection procedures of certain medical devices, offering a time-efficient and more sustainable alternative. However, its use should be preceded by efficacy testing for each specific type of instrument.

Analysis of the Effect of Quality Control Circle on the Central Sterile Supply Department

Objective: To analyze the effect of quality control circle on the central sterile supply department (CSSD). Methods: The control group and the observation group each consisted of 180 instruments received by the sterilization supply center from January to March 2023 and 11 CSSD staff. The control group underwent routine management while quality control circle was implemented in the observation group. The quality of work, disinfection and sterilization qualification rates, disinfection and sterilization of various instruments, cleaning indicators, and management satisfaction of both groups were compared. Results: The observation group scored higher in terms of work quality, the qualification rate of disinfection and sterilization in each link, the disinfection and sterilization of instruments, and cleaning indicators compared to the control group. Besides, the management satisfaction of the observation group was higher than that of the control group (P &lt; 0.05). Conclusion: A quality control circle ensures the quality of work, improves the cleaning, disinfection, and sterilization of instruments of the CSSD, and improves the management satisfaction of the CSSD staff.

The Application Value of Sanitary Wipes and Medical Alcohol + Gauze Disinfection Method in the Management and Use of Medical Equipment

Objective: To analyze the effect of sanitary wipes and medical alcohol + gauze disinfection methods on the management and use of medical equipment in hospitals. Methods: From February 2023 to August 2023, 80 anorectal surgery medical instruments and equipment were randomly sampled as observation samples, and they were grouped using the random number table method (40 instruments in each group). One group was managed with sanitary wipes and medical alcohol + gauze disinfection method (observation group), and the other group was managed with medical alcohol + gauze disinfection method (control group). The degree of contamination on the surface of instruments and equipment and the staff satisfaction of both groups was noted and compared. Results: After cleaning and disinfection, the relative luminescence luminosity (RLU) value of the surface contamination of the sample instruments and equipment decreased significantly (P &lt; 0.05); and after cleaning and disinfection, the relative luminescence luminosity (RLU) of the observation group’s instruments and equipment decreased significantly, and the value was lower than that of the control group, (P &lt; 0.05); the results of the nursing job satisfaction questionnaire showed that the scores of each survey item in the observation group were higher than those in the control group, (P &lt; 0.05). Conclusion: Integrating sanitary wipes and medical alcohol + gauze disinfection method into the management and use of medical equipment not only improves the disinfection of medical instruments but also improves the job satisfaction of nursing staff. Therefore, this method should be popularized.

Single-use digital flexible cystoscope for double J removal versus reusable instruments: a prospective, comparative study of functionality, risk of infection, and costs

BackgroundThe removal of ureteral stent can be performed with disposable or reusable flexible cystoscopes, but limited comparative data are available on functionality, risk of infections, and costs.MethodsWe performed a multicentric, prospective, observational study on patients undergoing in-office ureteral stent removal with Isiris-α® or a reusable Storz™ flexible cystoscope. Study endpoints were the functionality and effectiveness of the devices, the rate of postoperative bacteriuria and UTIs, and the costs of the procedure.ResultsA total of 135 patients were included, 80 (59.2%) treated with reusable cystoscopes and 55 (40.8%) with Isiris-α®. No significant baseline differences between groups were detected. Isiris-α® outperformed the reusable device in terms of quality of vision (p 0.001), manoeuvrability (p 0.001), grasper functionality (p < 0.001), and quality of the procedure (p 0.01). Mean procedure time was shorter with Isiris-α® (p < 0.001) due to a shorter instrument preparation time (p < 0.001). No differences were found in terms of perceived patient pain (p 0.34), nor postoperative bacteriuria or symptomatic UTIs. According to our cost analysis, the in-office procedure performed with Isiris-α® was more expensive (+ 137.8€) but was independent from instrument turnover or disinfection. Among limitations of study we acknowledge the lack of randomization, the use of antibiotic prophylaxis in several patients, and the high rate of missing preoperative urine cultures.ConclusionsIsiris-α® outperforms reusable cystoscopes for in-office ureteral stent removal in terms of total operative time and quality of the procedure, at the cost of being more expensive. No significant differences in postoperative bacteriuria or symptomatic UTIs were found.

Using the Manufacturer's Instructions for Use and Spaulding Classification System to Assess Disinfection Practices for Ultrasound Transducers in the Perioperative Setting.

Proper use and disinfection of medical devices and instruments is essential to preventing infection and providing safe patient care. Because of an increase in the complexity of medical devices and patient interventions, it has become more difficult for perioperative staff members to ensure that equipment is properly used and disinfected according to the manufacturer's instructions for use and the Spaulding classification system. One type of medical device that may have multiple clinical uses is the ultrasound transducer. In the perioperative setting, ultrasound transducers can be used for surface, percutaneous, and endocavitary procedures. They also may be used at multiple times before, during, and after a procedure, which may make it challenging for perioperative staff members to know the correct disinfection practice. They should use the device's instructions for use and the Spaulding classification system to guide their clinical practice.

Assessment of the legal regulation of forensic medical bureau activities in the field of anti-epidemic measures

Introduction. The staff of the Bureau of Forensic Medicine (BFM) experience a high microbial load in the performance of their professional duties, which poses a serious health hazard. Cases of infectious diseases continue to be recorded among the medical personnel of the BFM, which requires the prevention of infection during professional activities. The process of legal regulation of BFM activities in terms of compliance with sanitary and hygienic measures ensuring the safety of BFM employees from infectious contamination and improving the quality of expertise is becoming highly relevant.The purpose of the study is to propose measures to improve the regulation of relevant procedures based on the analysis of the legal regulation of BFM activities in matters of infectious safety.Materials and methods. We studied laws and bylaws at the federal and departmental levels. The regulatory framework was evaluated at the following conditional stages of forensic medical examination: processing of the sectional table; processing of instruments used for autopsy; personnel hand hygiene; current and general cleaning in the sectional rooms of the BFM.Results It was noted that there are no recommendations for disinfection after each dissection when processing the sectional table, the disagreements in the documents regulating the processing and disinfection of sectional instruments were revealed, the necessity of processing the instruments by mechanized method with the help of ultrasonic washers was shown. The points requiring attention with respect to the use of personal protective equipment, treatment of experts’ hands and other antiepidemic measures in the light of the new regulatory documents that have come into force are listed: Sanitary Rules and Regulations 3.3686-21 and Sanitary Rules 2.1.3678-20.Discussion The identified contradictions in the issues determining the actions of the expert at each of the stages indicate that the sanitary and hygienic measures are covered insufficiently and require more detailed elaboration.Conclusion Changes are required at the legislative, subordinate, and regulatory levels. Standard operating procedures must be implemented for BSMSE staff, which must be carried out in compliance with the requirements of the legislation regulating the activities of BFM, as well as precautions to ensure the infectious safety of employees.

Occupational risk factors and exposure–response relationships for airway disease among health workers exposed to cleaning agents in tertiary hospitals

ObjectivesThis study investigated occupational risk factors and exposure–response relationships for airway disease among health workers (HWs) exposed to cleaning agents in two tertiary hospitals in South Africa and Tanzania.MethodsIn this...

Investigation into the current status of cleaning, disinfection, and sterilization of da Vinci surgical instruments-a cross-sectional survey.

In recent years, the use of robotic-assisted surgery has developed rapidly in China and is now widely used in many clinical fields. However, da Vinci robotic surgical instruments are more precise, expensive, and complex than ordinary laparoscopes, have less instrument configuration, involve restrictions on the duration of use, and have cleanliness requirements for supporting instruments. The purpose of this study was to analyze and summarize the current status of cleaning, disinfection, and maintenance of da Vinci robotic surgical instruments in China to improve the management of these devices. A questionnaire survey on the use of da Vinci robotic-assisted surgery at medical institutions in China was designed, distributed, and analyzed. The survey included items regarding general information, management of instrument handling personnel, instrument handling techniques, guidelines, and references for instrument handling. The results and conclusions were formed from the data generated by the analysis system and the answers of respondents to the open-ended questions. (I) All surgical instruments used in domestic surgery practice were imported. There were 25 hospitals that conduct more than 500 da Vinci robotic-assisted surgeries every year. (II) In a relatively high proportion of medical institutions, nurses continued to be responsible for the processes of cleaning (46%), disinfection (66%), and low-temperature sterilization (50%). (III) A total of 62% of the surveyed institutions used fully manual methods for cleaning instruments, and 30% of the ultrasonic cleaning equipment in surveyed institutions did not comply with the standard. (IV) A total of 28% of surveyed institutions used only visual inspection to evaluate cleaning efficacy. Only 16-32% of surveyed institutions regularly used adenosine triphosphate (ATP), residual protein, and other methods to detect sterilization of cavities in instruments. (V) In 60% of the surveyed institutions, robotic surgical instruments have been damaged. Cleaning efficacy detection methods of robotic surgical instruments were not uniform and standardized. The management of device protection operations should be further regulated. In addition, further study of relevant guidelines and specifications as well as the training of operators is warranted.

SG-APSIC1112: The quality enhancement in sterilization processes at Naresuan University Hospital

Background: Disinfection and sterilization of medical devices, instruments, and medical supplies are a crucial part of hospital infection control. The significant problems include insufficient cleaning, incorrect registration in the request form, no basic cleaning at the point of use (POS), and incorrect labelling. These problems were analyzed according using the fishbone diagram process. Objectives: We sought to decrease insufficient cleanliness of items after washing, to increase data accuracy in transferring contaminated devices from wards (from end users), to increase the rate of decontamination at the point of use, and to decrease incorrect labelling on instrument packaging. Method: The Community of Practice in Sterilization (CoP Sterile) team revised the disinfection and sterilization system of the Naresuan University Hospital Central Sterile Supply Department (CSSD) using root-cause analysis of subprocess problems and implementing prioritized solutions. A regular monthly meeting was set up to ensure active response, and closed monitoring was performed to ensure the implementation of the revised protocol according to the plan–do–study–act (PDSA) process. Results: From 2019 to 2021, the percentages of annual insufficient cleanliness of items after washing decreased from 4.8% to 3.6% to 3.1% each year. The percentages of incorrect request forms decreased from 14.59% to 2.91% to 1.84% during these same years. The percentages of decontamination ignorance at the point of use decreased from 3.13% to 0.12% to 0.03% from 2019 to 2021. The percentages of incorrect labelling were 0.013%, 0.008%, and 0.013% each year. Conclusions: The CoP Sterile team used quality improvement tools and regular monitoring to achieve reductions in insufficient cleanliness and incorrect request forms and to increase knowledge of decontamination procedures.

SG-APSIC1127: Digital transformation of the central sterile supply department: Justify by tracking system

Background: Avoidable infections in healthcare (healthcare-associated infections or HAIs) occur globally. The causes of HAI are influenced by a complex combination of gaps in policies, infrastructure, organization, knowledge, healthcare worker behavior, and patient-related factors. Through knowledge, best practices, and infrastructure improvement, the infection prevention and control (IPC) team aims to prevent harm to patients and healthcare workers due to HAIs. The most common HAIs are surgical site infections (SSIs) caused by harmful device-reuse practices, inadequate sterilization, and/or inadequate decontamination procedures. Disinfection and sterilization of instruments and medical devices play very important roles in HAI and SSI prevention. World Health Organization (WHO) Collaborating Centre in Quality Improvement Program certification, the first pilot project in Thailand, included the Central Sterilizing Services Association of Thailand and 15 hospital central sterile supply departments (CSSDs). This quality improvement program for sterilization reprocessing aimed to prevent harm to patients and healthcare workers due to HAIs. Objectives: We sought to reduce damage to instruments caused by inadequate reprocessing sterilization to zero incidents. We sought to reduce inadequate packing to ≤3 events per month. We sought to reduce the need to resterilize instruments by &gt;80%. Methods: A root-cause analysis meeting was held by CSSD staff, and an IT vendor was consulted about developing an electronic alert system. The following changes were implemented: Staff packed instruments using a list of pictures for each set. Sticker labels were applied showing the proper number of pieces in the set. Identification O-rings were added to instruments with inventory dates, serial numbers, and instructions for use. Stickers were added to indicate the method of sterilization, such as ethylene oxide gas only or hydrogen peroxide only. Results: Reports of damage due to the sterilization process decreased to zero. No events related to the packing process were reported, and resterilization of instruments decreased by 98.94%. Conclusions: In this project, we implemented a quality improvement process and tracking system, reduced defects, and increased healthcare worker competency to improve patient safety.

Clinical effect of standardized nursing for lymphoma patients and the influencing factors of nosocomial infection.

To analyze the clinical effect of standardized nursing for lymphoma patients and the influencing factors of nosocomial infection, a total of 360 diffuse large B-cell lymphoma patients with disease recurrence or progression after first-line treatment were retrospectively selected from our hospital from January 2021 to July 2022. After standardized nursing, the overall infection rate of lymphoma patients was 2.50% (9/360), which was significantly lower than the overall infection rate of our hospital in 2021 (7.44%, 844/11342) (P < .05). The proportion of 3 kinds of pathogenic bacteria detected were G+ bacteria (33.5%), G- bacteria (53.3%), and fungi (13.2%). The pathogenic bacteria genus with the most G+ bacteria is Enterococcus, the pathogenic bacteria genus with the most G+ bacteria is Enterobacteriaceae, and the pathogenic bacteria with the most fungi is Candida albicans. Female infection rate was significantly higher than male (P < .05). There was no significant difference in nosocomial infection among different marital status/fertility status (P > .05). The nosocomial infection of patients with different hospitalization times was statistically significant (P < .05). The duration of hospitalization in the infected group was significantly higher than that in the non-infected group (P < .05). The clinical effect of standardized nursing for lymphoma patients is significant, and the influencing factors of nosocomial infection include patient gender, hospitalization frequency, and hospitalization duration.

Effectiveness of Instrument Pre-Cleaning and Disinfection Sprays Against the Microbial Burden and Blood Stains Remover on Medical Devices

Effectiveness of Instrument Pre-Cleaning and Disinfection Sprays Against the Microbial Burden and Blood Stains Remover on Medical Devices

Effectiveness of Common Disinfecting Agents against Isolates of Nannizziopsis guarroi

Nannizziopsis guarroi, a keratinophilic fungus, is an important cause of dermatomycosis in companion lizards. At this time effective disinfection protocols are unknown and additional information is needed to prevent contamination of surfaces and equipment used in the care of these animals. To this aim, the qualitative in vitro disinfecting capability of eight commonly used household and laboratory disinfectants (Novalsan®, 3% and 10% dilutions of commercial bleach, Virkon®-S, Lysol® household cleaner with hydrogen peroxide, 70% ethanol, 409® and household cleaning ammonia) were tested at two different contact times (two and ten minutes) with three different aqueous fungal concentrations of four molecularly confirmed N. guarroi isolates. A positive control after contact with saline was also grown. After contact with disinfectant or saline, the isolates were incubated, and photographic images were taken of plate growth on day 10. Images of each plate were scored using a semiquantitative scoring system. The only disinfectant that completely inhibited growth for all four isolates at both contact times and at all three isolate dilutions was 10% dilution of commercial bleach. All four isolates grew after contact with ammonia, regardless of contact time or isolate dilution and the other disinfectants showed variable inhibition of growth that was either isolate or concentration dependent or both. In conclusion, a minimum of two-minute exposure to 10% dilution of commercial bleach is recommended for disinfection of surfaces and instruments contaminated with N. guarroi.

Hybrid flexible ureteroscopy strategy in the management of renal stones - a narrative review.

The introduction of single-use flexible ureteroscopes (suFURSs) in daily practice tends to overcome the main limitations of reusable ureteroscopes (reFURSs), in terms of high acquisition costs, maintenance, breakages and repairing costs, reprocessing and sterilization, as retrograde intrarenal surgery (RIRS) is promoted as first-line treatment of renal stones in most cases. A hybrid strategy implies having both instruments in the armamentarium of endourology and choosing the best strategy for cost-efficiency and protecting expensive reusable instruments in selected high-risk for breakage cases such as large stones of the inferior calyx, a steep infundibulopelvic angle or narrow infundibulum, or abnormal anatomy as in horseshoe and ectopic kidney. In terms of safety and efficiency, data present suFURSs as a safe alternative considering operating time, stone-free, and complication rates. An important aspect is highlighted by several authors about reusable instrument disinfection as various pathogens are still detected after proper sterilization. This comprehensive narrative review aims to analyze available data comparing suFURSs and reFURSs, considering economic, technical, and operative aspects of the two types of instruments, as well as the strategy of adopting a hybrid approach to selecting the most appropriate flexible ureteroscope in each case.

Application Effect of the 6S Care Model in Sterilization in the Department of Stomatology and Its Impact on the Incidence of Nosocomial Infection.

Objective The study aimed to explore the effectiveness of the 6S care model in sterilization in department of stomatology and its impact on the incidence of nosocomial infections. Methods The infection surveillance indicators of the department of stomatology implementing the routine sterilization care model in 2019 were selected as the general group (including 140 patients and 140 cases of oral instrument kits for unpacking), and the infection surveillance indicators of the department of stomatology implementing the 6S care model in 2020 were selected as the 6S group (including 140 patients and 140 cases of oral instrument kits for unpacking). Analysis of the air culture qualification rate of the consultation room + operating room, medical equipment sterilization qualification rate, medical equipment damage rate, incidence of nosocomial infections, satisfaction of medical and nursing staff with instrument sterilization, and patient satisfaction with medical and nursing staff care services under different care models was carried out. Result The air culture pass rate of the consultation room + operating room in the 6S group was 96.43% (135/140), which was higher than 90.00% (126/140) in the general group, and the difference between the two groups was statistically significant (P > 0.05). The sterilization pass rate of medical devices in the 6S group was 100% (140/140), which was higher than 95.71% (134/140) in the general group, and the difference between the two groups was statistically significant (P > 0.05). The medical device damage rate in the 6S group was 0.71% (1/140), which was lower than 7.14% (10/140) in the general group, and the difference between the two groups was statistically significant (P > 0.05). The incidence of nosocomial infection in the 6S group was 0.71% (1/140), lower than 5.71% (8/140) in the general group, and the difference between the two groups was statistically significant (P > 0.05). In the 6S care model, the satisfaction score of 38 healthcare workers with the disinfection of instruments was (96.55 ± 2.40), which was higher than that of the general group (87.79 ± 3.14), and the difference between the two groups was statistically significant (P > 0.05). The total nursing satisfaction of the 6S group was 97.86% (137/140), which was higher than 91.43% (128/140) of the general group, and the difference between the two groups was statistically significant (P > 0.05). Conclusion The application of the 6S care model in the sterilization of the department of stomatology can significantly improve the passing rate of infection monitoring indicators in the department of stomatology, reduce the occurrence of medical device damage and nosocomial infection, and have high satisfaction among doctors and patients, which has the value of promotion.

Evaluation of disinfectant “Enzidez” according to physical and chemical parameters

The dependence of the national economy on disinfectants is constantly growing through prevention strategies and the development of resistance in microorganisms. Therefore, new disinfectants with different mechanisms of biocidal activity for a wide range of pathogens are appearing on the market. The aim of work has been to determine the physical and chemical parameters of the created disinfectant “Enzidez” active on biofilm forms of bacteria and the possible organic load. The magnitude of the surface tension of disinfectant “Enzidez” at different concentrations of solutions has been determined using a device with a Traube stalagmometer. The wettability of solutions has been determined by the method of measuring the wetting angle with a catheter. Washing properties and stability of foam by the method of washing animal fats, followed by application of indicator liquid. Proteolytic activity has been determined using milk and the effect of Enzidez solutions of different concentrations on it, followed by measurement of the optical density of the solutions spectrophotometrically at a wavelength of 600 nm. It is established that the disinfectant with enzymes – “Enzidez” for disinfection in veterinary clinics for pre-sterilization disinfection and treatment of products and instruments of surgical purpose (plastic, rubber, glass, stainless steel) and objects of veterinary supervision (tables, utensils, walls, floors, doors, windows, etc.) with organic load is well soluble in water and has a pH of 0.25–1.0 % solutions in the range of 8.2–8.0 units. At a solution temperature of +20 ± 1 °С it has had a surface tension not higher than 37.63 ± 0.50 mN/m and a wetting angle of 69.5 ± 0.7 degree. The disinfectant has provided an excellent detergent effect only at solutions with a concentration of 1.0 % and above. When assessing the corrosive action of Enzidez in the concentration of solutions from 0.25 to 1.0 %, the amount of corrosion on stainless steel has been hundreds of times lower than the allowable regulatory limit. The impact on galvanized steel is slightly higher than that of stainless steel, but also several tens below the norm. A study to determine the proteolytic activity of the disinfectant “Enzidez” on milk proteins has revealed that the disinfectant broke down proteins at a concentration of solutions 0.5–1.0 % at a temperature of + 20 °C at 41.3–43.1 %, respectively, for 15 min of exposure. However, increasing the temperature of solutions to +60 °C and exposure for 30 min has provided an increase in proteolytic activity up to 70 %. Thus, disinfectant “Enzidez” is a highly active disinfectant for disinfecting surfaces even in the case of organic contamination.

Effect of Nursing in Operating Room Combined with Intraoperative Heat Preservation Intervention on Prevention of Incision Infection and Improvement of Hemodynamics in Patients with Anterior Cruciate Ligament Injury and Reconstruction under Knee Arthroscopy.

Objective To explore the effect of nursing in operating room combined with intraoperative heat preservation intervention on preventing incision infection and improving hemodynamics in patients with anterior cruciate ligament (ACL) injury and reconstruction under knee arthroscopy. Methods About 200 patients with knee arthroscopic ACL reconstruction in our hospital from January 2019 to July 2021 were enrolled. The patients were randomly assigned into two groups: the control group and the study group. The former group received nursing care in the operating room operating room and the latter group received nursing care in operating room combined with intraoperative heat preservation intervention. Nursing satisfaction, incidence of incision infection, knee joint VAS score, knee joint range of motion, knee joint Lysholm score, and hemodynamic indexes were compared. Results First of all, we compared the nursing satisfaction, the study group was very satisfied in 78 cases, satisfactory in 20 cases, and general in 2 cases, and the satisfaction rate was 100.00%, while in the control group, 445 cases were very satisfied, 20 cases were satisfied, 15 cases were general, and 8 cases were dissatisfied. The satisfaction rate was 82.00%. The nursing satisfaction of the study group was higher compared to the control group (P < 0.05). Secondly, we compared the incidence of incision infection. The incidence of incision infection in the study group was lower compared to the control group (P < 0.05). With regard to the knee joint VAS score, the knee joint VAS score of the study group was lower compared to the control group at 2 weeks, 4 weeks, 8 weeks, and 12 weeks after operation (P < 0.05). In terms of the range of motion of the knee joint, the range of motion of the knee joint in the study group was higher compared to the control group at 2 weeks, 4 weeks, 8 weeks, and 12 weeks after operation (P < 0.05). Regarding the knee joint Lysholm score, the knee joint Lysholm score of the study group was higher compared to the control group at 2 weeks, 4 weeks, 8 weeks, and 12 weeks after operation (P < 0.05). Finally, we compared the hemodynamic indexes. Before nursing, there exhibited no significant difference (P > 0.05). During and after nursing, the indexes of HR and MAP in the study group fluctuated little (P < 0.05). Conclusion During the perioperative period of patients with ACL injury and reconstruction under knee arthroscopy, standardized and necessary operating room combined with intraoperative thermal insulation intervention measures should be given, attention should be paid to the management of operating room, and intraoperative thermal insulation intervention should be strengthened. It includes preoperative visit, psychological nursing of patients, strict application of antibiotics before operation, monitoring of air quality in operating room, disinfection and sterilization of surgical instruments, shortening operation time, maintaining body temperature during operation, and paying attention to hand hygiene of medical staff. It plays a supervisory role in promoting the attention of medical staff to the prevention of wound infection, which is beneficial to the healing of surgical wounds of patients. It plays a positive role in enhancing hemodynamic indexes. Comprehensive nursing intervention on the risk factors of each link can effectively prevent postoperative wound infection and strengthen the prognosis and quality of life of patients.

EFFICIENCY OF DISINFECTION OF DENTAL INSTRUMENTS AND PRODUCTS CONTAMINATED WITH VARIOUS MICROORGANISMS

"ABK-EXTRA" has a high disinfecting activity and can be recommended for the disinfection of dental instruments and products in order to prevent bacterial, fungal infections in concentrations of 1,0; 2,0; 3,0% with an exposure time of 15-30-60 minutes, depending on the causative agent of the infection and the type of instrument.