Sterilization Of Instruments Research Articles

Prevalence of work-related skin symptoms and associated factors among tertiary hospital workers exposed to cleaning agents in Southern Africa.

Working with cleaning products is associated with occupational contact dermatitis in health workers (HWs), but information on predictors for these outcomes is limited. This study investigated the prevalence of work-related skin symptoms (WRSS) and associated factors in HWs exposed to cleaning agents in two Southern African tertiary hospitals. A cross-sectional study of 697 HWs used an interviewer-administered questionnaire and assessed for atopy using Phadiatop. HWs' median age was 42 years, 77.0% were female and 42.5% were atopic. The prevalence of WRSS in the last 12 months was 14.8%, 12.3% had probable contact dermatitis (PCD) and 3.2% had probable contact urticaria (PCU). Technicians (ORadj 3.91) and tasks involving cleaning and disinfection of skin wounds (ORadj 1.98) were associated with WRSS in the past year. Factors associated with PCD included sterilizing instruments, disinfecting skin before procedures and use of wound adhesives. Factors associated with PCU included specimen preparation using formalin, medical instrument sterilization tasks, and skin/wound cleaning and disinfection. Appropriate glove use when performing patients' skin/wound care was protective against WRSS. Tasks involving cleaning and disinfecting patients' skin and wounds were associated with WRSS in HWs, especially when performed without gloves.

Intraoperative airborne bacterial contamination and covered sterile instrument tables: Is the standard two-drape method better than the single-drape method? Experimental study

BackgroundWe purposed to assess and compare the effectiveness and safety of covering with the single-drape method versus the standard two-drape method recommended by the Association of Perioperative Registered Nurses (AORN) in reducing contamination of the prepared sterile instrument tables (PSITs) with airborne bacteria-carrying particles (ABCPs). MethodsSix agar plates (n = 810) were used to measure the load of ABCPs on each PSIT both at rest (static period) and during a simulated surgical operation (dynamic period). At every time point, this arrangement was repeated two times during data collecting (81 PSITs were established in total). Experimental groups contained PSITs covered with the single-drape and the standard two-drape methods or no cover. We collected the plates after 60, 120, 180, 240 min, and 24 h. ResultsAt all-time points, covering the PSITs during static and dynamic operating theater (OT) conditions led to a meaningfully reduced load of ABCPs on the PSITs (P < 0.05). Moreover, no differences were found between the recommended two-drape method by the AORN and the single-drape method (P > 0.05). ConclusionCovering the PSITs during nonuse and active surgeries helps prevent the PSITs from becoming contaminated and thus can help decrease the incidence of surgical wound infection (SWI). Covering the PSITs with a sterile drape helps protect them from ABCPs that may be shed from the hair and skin of OT nurses (OTNs). Our study showed no priority for using the standard two-drape method compared with the single-drape method.

Guidelines for improvement of the procedural aspects of devices and surgical instruments in the operating theatre.

Surgical site infections are a major complication for patients undergoing surgical treatment and a significant cause of mortality and morbidity. Many international guidelines suggest measures for the prevention of surgical site infections (SSI) in perioperative processes and the decontamination of surgical devices and instruments. This document proposes guidelines for improving the perioperative setting in view of the devices and instrumentation required for surgical procedures, aiming to reduce contamination rates and improve clinical performance and management for patients undergoing surgical treatment. This document is intended for doctors, nurses and other practitioners involved in operating theatre procedures, resource management and clinical risk assessment processes, and the procurement, organisation, sterilisation and reprocessing of surgical instruments.

Iodinene Nanosheet-to-Iodine Molecule Allotropic Transformation for Antibiosis.

Iodine, as a typical haloid element in group VIIA, has been extensively applied as antiseptics clinically, thanks to its effective and wide-spectrum antimicrobial activity against bacteria, fungi, and viruses. Nevertheless, current iodic sterilizing agents are still limited to topical applications such as instrument sterilization and treatments of skin or mucous membrane infection due to its unsatisfactory stability and biocompatibility. Here, we propose an emerging two-dimensional iodine nanomaterial (noted as iodinene) for the treatment of infection diseases in vivo. Iodinene nanosheets were fabricated by a facile and environmentally friendly approach via sonication-assisted liquid exfoliation, which present an intriguing layered structure and negligible toxicity. The as-synthesized iodinene would experience an in situ allotropic transformation spontaneously to release active HIO and I2 molecules by reacting with H2O2 in the infectious microenvironment. By the in situ production of active HIO and I2 molecules via allotropic transformation, iodinene presents enhanced antibacterial efficacy against Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. In vivo outcome demonstrates the desirable antibacterial efficacy of iodinene in treating bacterial wound infection and pneumonia. This study thus offers an alternative to conventional sterilizing agents against hard-to-treat bacterial infections.

Attitude and compliance of nurses to standard precautions to infection control in Ekiti State, Southwest Nigeria.

The attitude and compliance to standard precautions (SP) by nurses have been recognized as efficient and effective means to prevent and control infections among patients and healthcare workers. This study investigated nurses' attitude and compliance to standard precautions in tertiary hospitals in Ekiti State, Southwest Nigeria. A cross-sectional, descriptive research designs using purposive sampling techniques were used. Adapted and standardized instruments were used to elicit information from 137 nurses. Data were analyzed using descriptive and inferential statistics. Participants' age was between 21 and 62 years, with a mean age of 33.54± 9.41 years; 85.4% were females; while the majority had five to ten years working experience. Participants had poor attitude toward SP, but with good compliance (96.6%). All participants (100%) had good compliance with the use of personnel protective equipment, while most had good compliance with hand hygiene, respiratory hygiene, safety injection practice, clean environment, and sterilization of instruments. The ward/unit allocation of the nurses had a significant positive effect (R= 0.225, p= 0.008) on compliance with respiratory hygiene. Hence, sensitization programs should be intensified to ensure that health workers understand and comply with infection control through the use of SP.

UpToDate®

UpToDate| June 2023 UpToDate® ASA Monitor June 2023, Vol. 87, 31. https://doi.org/10.1097/01.ASM.0000938852.60627.fa Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Search Site Citation UpToDate®. ASA Monitor 2023; 87:31 doi: https://doi.org/10.1097/01.ASM.0000938852.60627.fa Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: perioperative care, surgery specialty, surgical procedures, operative, gloves, protective UpToDate® and ASA Monitor are collaborating to present select content abstracts on “What's New.” UpToDate is an evidence-based, clinical support resource used worldwide by health care practitioners to make decisions at the point of care. For complete, current “What's New” content, or to become a subscriber for full content access, go to www.uptodate.com. “What's New” abstract information is free for all medical professionals. Routine glove and instrument change prior to closure of abdominal incisions (December 2022) Whether changing gloves and using new instruments prior to wound closure affects surgical site infection (SSI) rates is uncertain. In an unblinded cluster randomized trial of over 13,000 patients undergoing intra-abdominal surgery in low- to middle-income (LMIC) countries, the risk of SSI was lower when routine glove and sterile instrument change was performed prior to closure compared with no glove or instrument change (16 versus 19%).1 The results from this... You do not currently have access to this content.

Effect of far-infrared radiation on inhibition of colonies on packaging during storage of sterilised surgical instruments

The sterilisation of surgical instruments is a major factor in infection control in the operating room (OR). All items used in the OR must be sterile for patient safety. Therefore, the present study evaluated the effect of far-infrared radiation (FIR) on the inhibition of colonies on packaging surface during the long-term storage of sterilised surgical instruments. From September 2021 to July 2022, 68.2% of 85 packages without FIR treatment showed microbial growth after incubation at 35 °C for 30 days and at room temperature for 5 days. A total of 34 bacterial species were identified, with the number of colonies increasing over time. In total, 130 colony-forming units were observed. The main microorganisms detected were Staphylococcus spp. (35%) and Bacillus spp. (21%) , Kocuria marina and Lactobacillus spp. (14%), and mould (5%). No colonies were found in 72 packages treated with FIR in the OR. Even after sterilisation, microbial growth can occur due to movement of the packages by staff, sweeping of floors, lack of high-efficiency particulate air filtration, high humidity, and inadequate hand hygiene. Thus, safe and simple far-infrared devices that allow continuous disinfection for storage spaces, as well as temperature and humidity control, help to reduce microorganisms in the OR.

Reducing the carbon footprint in carpal tunnel surgery inside the operating room with a lean and green model: a comparative study.

The primary aim of our study was to assess the environmental impact of moving from a standard to a lean and green model for a carpal tunnel decompression. We objectively measured the clinical waste generated, the number of single use items and the number of sterile instruments required for a standard procedure, and then moved to smaller instrument trays, smaller drapes and fewer disposables. These two models were compared for waste generation, financial costs and carbon footprint. Information prospectively collected on seven patients in the standard model and 103 patients in the lean and green model in two hospitals over a 15-month period, demonstrated a reduction in CO2 emissions of 80%, clinical waste reduction of 65%, and an average aggregate cost saving of 66%. The lean and green model can deliver a safe, efficient, cost-effective and sustainable service for patients undergoing carpal tunnel decompression.Level of evidence: III.

A Data-Driven Decision-Making Model for Configuring Surgical Trays Based on the Likelihood of Instrument Usages

In order to perform a surgical procedure, substantial numbers of sterile instruments should be readily available to surgeons through the containers referred to as surgical trays and peel packs. After the procedure, all instruments in the opened containers, regardless of whether they have been used or not, must go through the labor-intensive re-sterilization process. Empirical studies have shown that the utilization rate of instruments within trays is very low due to not having optimized tray configurations. Additionally, surgical trays often include instruments that are not likely to be used but are included “just in case”, which imposes an additional cost on hospitals through unnecessary instrument re-sterilization. This study is the first analytical attempt to address the issue of configuring surgical trays based on the likelihood of instrument usage through formulating and solving a probabilistic tray optimization problem (PTOP). The PTOP model can serve as a decision support for surgeons by providing them with the tray’s probability of being used for optimally configured trays and its associated reprocessing costs. The PTOP is constructed upon an integer non-linear programming model. A decomposition-based heuristic and metaheuristic method coupled with two novel local search algorithms are developed to solve the PTOP. The application of this model can be illustrated through a case study. We discuss how hospitals could benefit from our model in reducing the costs associated with opening trays unnecessarily before a procedure. Additionally, we conducted a risk analysis to estimate the level of confidence for the recommended solution.

Best Practices and a Business Case for Surgical Site Infection Prevention.

Surgical site infections (SSIs) can be costly and result in prolonged hospital stays; readmissions; and additional diagnostic tests, therapeutic antibiotic treatments, and surgical procedures. Evidence-based practices for preventing SSIs include environmental cleaning; instrument cleaning, decontamination, and sterilization; preoperative bathing; preoperative Staphylococcus aureus decolonization; intraoperative antimicrobial prophylaxis; hand hygiene; and surgical hand antisepsis. Strong partnerships among infection prevention personnel, perioperative nurses, surgeons, and anesthesia professionals may enhance perioperative infection prevention. Facility and physician-specific SSI rates should be reported to physicians and frontline personnel in a timely, accessible manner. Together with costs associated with SSIs, these data help determine the success of an infection prevention program. Leaders can develop a comprehensive business case proposal for perioperative infection prevention programs. The proposal should describe the need for the program and anticipated return on investment; it also should focus on the goal of decreasing SSIs by establishing metrics for assessing outcomes and addressing barriers.

Correlation among Sterilization, Antibiotic Resistance and Malnutrition with Surgical Site Infection in a Teritary Level Hospital

Background: Despite the advances made in asepsis, antimicrobial drugs, sterilization and operative techniques, surgical site infection (SSI) continues to be a major problem in all branches of surgery in the hospitals. However, there is no infection control policy that runs effectively in our country. Aim:This study was designed to see the correlation among sterilization, antibiotic resistance and malnutrition with surgical site infection in a tertiary level hospital. Methods: This cross-sectional observational study was conducted in the Department of Surgery, Shaheed Suhrawardy Medical College and Hospital. Informed written consent, detailed history, physical examination and necessary investigations were performed. Total 160 admitted patients undergoing different surgical procedure were included in this study, irrespective of their age, sex, race and ethnic group. Data were collected by using a semi-structured questionnaire. Collected data were analyzed by the SPSS 25. Results: Average age of all patient was 36.10±12.15 years (range: 13-65 years), wherein maximum patients were aged &lt;40 years, male gender (56.3%), had normal BMI (61.3%) and non-smoker (62.07%). About 1/4th patients had diabetes mellitus. Maximum patients had undergone abdominal surgery (34.4%) followed by orthopaedic and traumatology (20.6%),General surgery other than abdominal surgery (18.8%), Neurosurgery (13.8%), Vascular surgery (12.5%). Pre-operative waiting period for surgery was &lt;3 days in most of the cases (48.8%), followed by 3-7 days (31.3%) and &gt;7 days (20%). Mean operation duration was 1.49±0.73 hours. Twenty-nine patients (18%) developed SSI, of which 7% had deep incisional SSI, 6% had superficial incisional SSI and 5% had organ/space SSI. SSI culture reports showed that majority (93.1%) had positive culture growth, wherein 66.7% had single microorganism and rest 33.3% had multiple growth. Staphylococcus aureus (34.48%) was the most frequently found microorganism. surgical team sterility was properly maintained in maximum surgical procedures (71.9%). Besides, OT room and surgical instruments were also properly sterilized in most of the cases (65.6% and 70%, respectively). Older age, abnormal BMI, smoking history, DM, longer pre-operative waiting period and operation duration was significantly associated with development of SSI. Besides, surgical team sterility, OT room sterility and Instrument sterility were not properly maintained in most of the surgical procedures among SSI patients (65.52%, 68.97% and 58.62%, respectively). Conclusion: Abnormal BMI (underweight and overweight or obese) and poor sterilization had significant association with development of SSI. However, further studies are needed to establish and use the findings. J Shaheed Suhrawardy Med Coll 2021; 13(2): 143-149

INGUINAL ABSCESS FOLLOWING TRANS-ABDOMINAL PREPERITONEAL MESH REPAIR FOR INGUINAL HERNIA

Introduction – Introduction of synthetic mesh was a landmark breakthrough in management of hernia repair and has signicantly reduced recurrence rates. But in addition to benets, some more problems have come in picture major being 'mesh infection'. Prolene mesh has shown promise when used in abdominal and inguinal hernia repair, especially when used in planned surgeries. Being a foreign material, slightest breach in asepsis can lead to favourable environment for bacterial proliferation and form a 'biolm'. It appears that laparoscopic hernia repair is a promising method but having chances of mesh infection owing to difcult approach and lack of uniformity in sterilization of laparoscopic instruments. Improper sterilization or protocols might lead to such a large ventral wall sinus or abscess increasing morbidity and cost of treatment. Case Report A 39 year old male patient presented to OPD with abdominal pain since 15 days, low grade fever , anorexia and weight loss 1.5 months following TAPP repair of bilateral inguinal hernia 1.5 months ago. Work-up showed acute diverticulitis with diverticula perforation involving descending colon and adjacent sigmoid colon in left iliac fossa with collection in left iliac fossa. Lower Midline Exploratory laparotomy was performed. Around 100 cc pus was drained around mesh beneath parietal peritoneum, the infected mesh was removed. Post operatively patient recovered excellently. TAPP is a safe procedure for treat groin hernias, unless, mesh complications Conclusion like foreign body reaction, deep-seated infection, mesh migration and perforation into viscera can occur even 20 years later of the procedure with no dened incidence. The chance of recurrence of hernia following management of infected mesh should always be considered

Strategies to minimise and monitor biases and imbalances by arm in surgical cluster randomised trials: evidence from ChEETAh, a trial in seven low- and middle-income countries

BackgroundCluster randomised controlled trials (cRCT) present challenges regarding risks of bias and chance imbalances by arm. This paper reports strategies to minimise and monitor biases and imbalances in the ChEETAh cRCT.MethodsChEETAh was an international cRCT (hospitals as clusters) evaluating whether changing sterile gloves and instruments prior to abdominal wound closure reduces surgical site infection at 30 days postoperative. ChEETAh planned to recruit 12,800 consecutive patients from 64 hospitals in seven low-middle income countries. Eight strategies to minimise and monitor bias were pre-specified: (1) minimum of 4 hospitals per country; (2) pre-randomisation identification of units of exposure (operating theatres, lists, teams or sessions) within clusters; (3) minimisation of randomisation by country and hospital type; (4) site training delivered after randomisation; (5) dedicated ‘warm-up week’ to train teams; (6) trial specific sticker and patient register to monitor consecutive patient identification; (7) monitoring characteristics of patients and units of exposure; and (8) low-burden outcome-assessment.ResultsThis analysis includes 10,686 patients from 70 clusters. The results aligned to the eight strategies were (1) 6 out of 7 countries included ≥ 4 hospitals; (2) 87.1% (61/70) of hospitals maintained their planned operating theatres (82% [27/33] and 92% [34/37] in the intervention and control arms); (3) minimisation maintained balance of key factors in both arms; (4) post-randomisation training was conducted for all hospitals; (5) the ‘warm-up week’ was conducted at all sites, and feedback used to refine processes; (6) the sticker and trial register were maintained, with an overall inclusion of 98.1% (10,686/10,894) of eligible patients; (7) monitoring allowed swift identification of problems in patient inclusion and key patient characteristics were reported: malignancy (20.3% intervention vs 12.6% control), midline incisions (68.4% vs 58.9%) and elective surgery (52.4% vs 42.6%); and (8) 0.4% (41/9187) of patients refused consent for outcome assessment.ConclusioncRCTs in surgery have several potential sources of bias that include varying units of exposure and the need for consecutive inclusion of all eligible patients across complex settings. We report a system that monitored and minimised the risks of bias and imbalances by arm, with important lessons for future cRCTs within hospitals.

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.

MP68-20 RELIABLE INSTRUMENT COUNTER (RIC) FOR UROLOGIC PROCEDURES

You have accessJournal of UrologyCME1 Apr 2023MP68-20 RELIABLE INSTRUMENT COUNTER (RIC) FOR UROLOGIC PROCEDURES Catherine Nguyen, Michael Fink, Cayman Myers, Kayla Dunch, Daniel Aguilar, Jack Gibbs, Shelby McCoy, Hannah Bachtel, Chester Koh, and Charles Peak Catherine NguyenCatherine Nguyen More articles by this author , Michael FinkMichael Fink More articles by this author , Cayman MyersCayman Myers More articles by this author , Kayla DunchKayla Dunch More articles by this author , Daniel AguilarDaniel Aguilar More articles by this author , Jack GibbsJack Gibbs More articles by this author , Shelby McCoyShelby McCoy More articles by this author , Hannah BachtelHannah Bachtel More articles by this author , Chester KohChester Koh More articles by this author , and Charles PeakCharles Peak More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003331.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Retained sponges and surgical instruments with urologic procedures can have significant consequences on patient outcomes such as increased morbidity, long term disabilities, as well as medicolegal ramifications. The traditional method of ensuring accurate counts for sponges and surgical instruments is manual counting by surgical assistants (i.e. nurses and surgical technicians). However, this method is time-consuming and prone to systemic and human errors which can lead to unidentified retention of instruments. Current technologies for sponge and instrument tracking are limited by cost and accuracy issues. In collaboration with the engineering teams at local engineering schools, we sought to develop an automated surgical instrument counter to increase the accuracy of surgical equipment counts. METHODS: We developed a prototype for the Reliable Instrument Counter (RIC) which performs continuous and automatic counting of surgical instruments using RFID technology. The device consists of a hard polymer tabletop for RFID transparency with three RFID antennas and one multichannel RFID reader. RFID tags were placed on each surgical instrument (7.8mm x 6.8mm x 2.7mm) that were compatible with all methods of instrument sterilization Figure 1). Java-based software was used to automate the count of surgical instruments with a user-friendly interface. Benchtop testing was performed to identify the number of tags needed per instrument and the accuracy of the RIC to count the instruments. RESULTS: The prototype table was developed with the surface divided into zones. The accuracy of detecting tagged instruments averaged 99.03% readability across all zones with only three small areas on the edges of the table that had less than 100% accuracy. Further modifications will involve adjust the mounted location of the RFID reader for improved accuracy. CONCLUSIONS: The RIC can accurately track surgical instruments in real time for urologic procedures, thereby reducing overall OR time and risk of miscounts which translates into reducing overall cost and increasing the safety of patients undergoing urologic surgeries. Source of Funding: FDA grant #1p50FD006428 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e961 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Catherine Nguyen More articles by this author Michael Fink More articles by this author Cayman Myers More articles by this author Kayla Dunch More articles by this author Daniel Aguilar More articles by this author Jack Gibbs More articles by this author Shelby McCoy More articles by this author Hannah Bachtel More articles by this author Chester Koh More articles by this author Charles Peak More articles by this author Expand All Advertisement PDF downloadLoading ...

Specifics of Organizational and Design Solutions for Buildings of the Bureau of Forensic Medical Examination

Introduction: Nowadays, biosafety of medical personnel and visitors of the Bureau of Forensic Medical Examination (BFME) is of special importance. One of the most significant issues in terms of infection prevention and control is the design solution for premises of the BFME and departments of anatomic pathology. Up-to-date forensic medical examination institutions shall combine functionality, good technical equipment, and engineering design, all ensuring human comfort and safety. Objective: To evaluate sanitary and hygienic measures, especially organizational and design solutions for BFME buildings ensuring occupational safety and health of the personnel and proper infection control, based on the analysis of scientific publications and valid regulatory documents. Materials and methods: We have reviewed recent Russian and English-language scientific papers on current approaches to infection prevention and control in bureaus of forensic medical examination published in 2018–2022. They were selected using a logical search on such platforms as eLIBRARY.ru, PubMed, CyberLeninka, and Google Scholar. The criteria for inclusion of publications in the review were a non-zero Hirsch index (h-index) or the Russian Science Citation Index (RSCI) and the presence of the following phrases in the title, abstract, and/or keywords: autopsy biosafety, infection of medical staff, infection prevention and control, design of forensic medical examination premises, and occupational safety in forensic medical services. Of 143 sources selected, 47 articles contained a proven risk assessment of biosafety of medical personnel and description of preventive measures and were thus found eligible for inclusion in the review. Results: We established problems in the design of construction or reconstruction of BFME premises in terms of creating a safe working environment. We have noted that the workflow, functionality of the premises, and the level of sanitary measures aimed at prevention of infection in staff and visitors is often disregarded. The procedure of instrument sterilization is not regulated by documents of the Russian Federation. Organization of forensic activities in areas remote from large cities and in towns of 25,000 residents or less remains challenging. It is essential to revise and supplement current regulations to ensure biosafety of forensic medical services. Conclusion: The article describes the shortcomings of design solutions that must be taken into account in construction and/or reconstruction of BFME premises. The design of such buildings in terms of infection control shall be specified in regulatory documents.

Spotlight in Plastic Surgery: April 2023.

Spotlight in Plastic Surgery: April 2023.

Sterilization of New Endodontic Hand Files Stored in Dental Office Inventory: An In Vitro Study.

Background and objective Endodontic files, as supplied by the manufacturers to the endodontists, are not pre-sterile routinely. For both new and used equipment, rotary as well as manual,autoclaving is the standard sterilization protocol used in clinical and academic practice. In dentistry, instrument sterilization aims to safeguard patients from cross-contamination through instruments. Hence, every device should be thoroughly cleaned and sterilized. In this study, we aimed to evaluate the presence of various microorganisms in sealed and unsealedstored packsin dental offices and the probable impact of pre-sterilization procedures on the survival of these microorganisms. Materials and methods Two groups of root canal files varying in their packing method, boxes (Mani stainless steel K-files, ISO25, length 25 mm)and blister packs (UGD, ISO 25, length 25 mm), pre-sterile, opened/unopened were chosen and stored for about two weeks in the dental office and were classifiedinto three groups based on theirstorage and further classified into subgroups depending on their packing modes as follows: Group-1 (unopened and stored in shelf for two weeks), Subgroup-1A (boxes), Subgroup-1B (blister packs); Group-2 (unopened and stored on the countertop for two weeks), Subgroup-2A (boxes), Subgroup-2B (blister packs); Group-3 (opened and stored on the countertop for two weeks). After two weeks of storage, a set of three new files from each pack, both boxes and blisters, were placed in the nutrient broth to assess the turbidity and later cultured to assess the presence/absence and type of any bacterial growth. All the instruments in the three groups and subgroups were placed separately in the nutrient broth and carried to the microbiology lab for bacterial cultures. The entire procedure was carried out under the laminar flow. All these files in the nutrient broth were incubated for about 72 hours and the turbidity was assessed, and then the turbid bacteria were cultured on blood agar and MacConkeyagar plates for the presence/absence and the type of bacteria in each group and subgroups. Results All specimens, both opened/unopened boxes and blister packs, afterabout two weeks of storage, were cultured and observed for contamination. All the tested files groups showed bacterial culture growth both on blood agar and MacConkey agar plates. Group-1 (Subgroups 1A, 1B) boxes and blister packs unopened and stored on the shelf for two weeks demonstrated aerobic spore bacilli; Group-2 (Subgroups 2A, 2B) boxes and blister packs unopened and stored on the countertop for two weeks demonstratedGram-positive bacilli; Group-3 opened boxes and blisters stored on the countertop for two weeks demonstrated Micrococci and Gram-negative bacilli. Conclusion In the present study, all the packs, blisters and boxes, demonstrated the presence of bacterial growth irrespective of their storage in the dental office. Hence, in order to prevent any new infections from the operating field, sterilization of not only the old files but also the pre-sterilization of new files should be made mandatory.

Current SARS-CoV-2 Protective Strategies for Healthcare Professionals.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the Coronavirus disease 2019 (COVID-19). COVID-19 was first reported in China in December 2019. SARS-CoV-2 is highly contagious and spread primarily via an airborne route. Hand hygiene, surgical masks, vaccinations and boosters, air filtration, environmental sanitization, instrument sterilization, mouth rinses, and social distancing are essential infection control measures against the transmission of SARS-CoV-2. This paper aims to provide healthcare professionals with evidence-based protective strategies.

Effects of Autoclave Sterilization on Cyclic Fatigue Resistance in 5 Types of Rotary Endodontic Instruments: An In Vitro Study.

BACKGROUND Rotary endodontic instruments are increasingly used in root canal treatment and have replaced stainless steel manual files. Cyclic fatigue is the cyclic loading of stress to produce deformation or fracture. This study aimed to evaluate and compare the effects of autoclave sterilization on cyclic fatigue in 5 types of rotary endodontic instruments. MATERIAL AND METHODS ProTaper Universal, BioRace, ProTaper Next, Twisted File, and HyFlex CM instruments were included in this study. Each type included 96 instruments, divided into 4 groups according to the number of sterilization cycles (0, 1, 3, 5). After sterilization, each group of instruments was divided into 2 subgroups and tested for cyclic fatigue in 2 simulated canals (45 degrees both and 2 radii, 2 mm and 5 mm). The number of cycles to failure (NCF) was calculated, and statistical analyses were carried out using the t test, Mann-Whitney U test, and ANOVA, followed by the Tukey post hoc test (p<0.05). Fracture surfaces were analyzed using scanning electron microscopy (SEM). RESULTS Within the group of non-sterilized instruments, ProTaper Universal showed significantly lower resistance to cyclic fatigue compared to the other types of instruments (p<0.001). After repeated sterilization, a significantly higher mean of NCF was observed for BioRace (p<0.001), ProTaper Next (p<0.001), Twisted File (p<0.001), and HyFlex CM (p<0.001) compared to ProTaper Universal. The resistance of HyFlex CM was significantly higher compared to the other types of instruments (p<0.001). CONCLUSIONS The findings from this study showed that autoclave sterilization of newer rotary endodontic instruments could increase resistance to cyclic fatigue.