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目的观察手术器械在消毒供应中心(CSSD)清洗消毒灭菌过程中表面形成黑色污渍的原因,并找出降低黑污形成的相关控制方法,从而确保铜材质手术器械的使用时清洁质量合格。方法对360件铜材质器械按性能及工艺构造分为A、B、C 3组,分别采用不同的清洗消毒、灭菌方法,在每次完成操作程序后检查器械表面及管腔内面的清洁程度。结果铜材质器械在CSSD的常规再处理流程中器械表面常会有一定程度的黑污形成,有黑污器械率达53.33%;新器械直接进入清洗消毒灭菌流程后表面也会生成黑色污渍,柔性器械黑污率高于实体器械,二者产生器械的黑污率均>80.0%;处理过程中温度、湿度及操作方法的不同所引起器械表面黑污程度也有区别,高温高湿易引起铜材质表面氧化;在同样清洗消毒灭菌过程,铜材质器械中柔性器械的黑污程度比实体器械严重,差异有统计学意义(P<0.01);器械制造工艺影响其表面清洁度,管腔器械内面表面氧化程度比管腔外表面严重,差异有统计学意义(P<0.01)。结论铜材质手术器械的材质特点决定其易与空气中氧气发生反应生成氧化铜,在清洗消毒灭菌过程中,控制处理过程的温度、湿度可以降低该类器械的氧化反应,延长器械的使用寿命。
Objective To observe the causes of black stains on the surfaces during surgical disinfection and sterilization of surgical instruments and to find out the relevant control methods to reduce the formation of black contaminants so as to ensure the clean quality of copper surgical instruments. Methods A total of 360 pieces of copper-based instruments were divided into A, B and C groups according to their performance and technological construction. Different cleaning, disinfection and sterilization methods were used to check the cleanliness of the instrument surface and the inner surface of the lumen after each operation procedure was completed . Results In the conventional reworking process of copper materials, copper materials often formed a certain degree of black dirt on the surface of the instruments, with a rate of 53.33%. The new instruments directly produced black stains on the surface after the cleaning, disinfection and sterilization process. The flexibility Instrument black stain rate is higher than the physical equipment, the two devices have black stain rate> 80.0%; process temperature, humidity and operating methods caused by the different degrees of black stains on the surface of the instrument, high temperature and humidity can easily lead to copper material Surface oxidation; in the same process of cleaning and disinfection, the degree of black dirt of flexible instruments in copper material instruments was more serious than that of solid instruments, the difference was statistically significant (P <0.01); the instrument manufacturing process affected the surface cleanliness, The degree of surface oxidation was more serious than that of the lumen, with significant difference (P <0.01). Conclusion The material characteristics of copper surgical instruments determine that they easily react with oxygen in the air to form copper oxide. During the process of cleaning, disinfection and sterilization, the temperature and humidity in the treatment process can reduce the oxidation reaction of such instruments and prolong the service life of the instruments .