Complete sanitation of robotic surgical instruments virtually impossible
NEW YORK (October 31, 2016) – It is virtually impossible to remove all contamination from robotic surgical instruments, even after multiple cleanings, according to a study published today in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America. The results show that complete removal of surface contaminants from these tools may be unattainable, even after following manufacturers' cleansing instructions, leaving patients at risk for surgical site infections.
"One of the top priorities for hospitals is to treat patients safely and with minimal risk of infection," said Yuhei Saito, RN, PHN, MS, lead author of the study and assistant professor at the University of Tokyo Hospital. "Our results show that surgical instruments could be placing patients at risk due to current cleaning procedures. One way to address this issue is to establish new standards for cleaning surgical instruments, including multipart robotic tools."
The study examined 132 robotic and ordinary instruments over a 21-month period. Instruments were collected immediately after use to determine their level of contamination. The researchers used in-house cleaning methods that included manual procedures with ultrasonication following the manufacturers' instructions. Measurements of protein concentration were collected from tools after three subsequent cleanings to determine changes in the total amount of residual protein.
Due to the complex structures of robotic instruments, these tools had a greater protein residue and lower cleaning efficacy compared to ordinary instruments. The cleanings were 97.6 percent effective for robotic instruments and 99.1 percent effective for ordinary instruments. As a result, researchers suggest that it might be necessary to establish new cleaning standards that use repeated measurements of residual protein, instead of only measuring contamination once after cleaning.
"These instruments are wonderful tools that allow surgeons to operate with care; but completely decontaminating them has been a challenge for hospitals," said Saito. "By implementing new cleaning procedures using repeated measurements of the level of contamination on an instrument more than once, we could potentially save many patients from future infections."
Yuhei Saito, Hiroshi Yasuhara, Satoshi Murakoshi, Takami Komatsu, Kazuhiko Fukatsu, Yushi Uetera. "Challenging Residual Contamination of Instruments for Robotic Surgery." Web (October 31, 2016).
Published through a partnership between the Society for Healthcare Epidemiology of America and Cambridge University Press, Infection Control & Hospital Epidemiology provides original, peer reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 13th out of 158 journals in its discipline in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.
SHEA is a professional society representing physicians and other healthcare professionals around the world with expertise and passion in healthcare epidemiology, infection prevention, and antimicrobial stewardship. SHEA's mission is to prevent and control healthcare-associated infections, improve the use of antibiotics in healthcare settings, and advance the field of healthcare epidemiology. SHEA improves patient care and healthcare worker safety in all healthcare settings through the critical contributions of healthcare epidemiology and improved antibiotic use. The society leads this specialty by promoting science and research, advocating for effective policies, providing high-quality education and training, and developing appropriate guidelines and guidance in practice. Visit SHEA online at http://www.shea-online.org, http://www.facebook.com/SHEApreventingHAIs and @SHEA_Epi
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