Cleaning Endoscopes, Disinfecting Endoscopes, and Sterilizing Endoscopes
Articles have been published worldwide regarding the complexity of manually reprocessing flexible endoscopes and the related concerns. Automated reprocessing and "combination" all-in-one enzymatic-detergent-complex cleaning concentrates can provide valuable alternatives and have demonstrated superior outcomes. These technologies can improve scope performance, protect flexible scopes from damage, while reducing the costs and risks associated with manual reprocessing.
These developments have shown an increase in safety and demonstrated a decreased risk of nosocomial infections. Endoscope manufacturers have focused on improving the functionality and clinically related performance of scopes while manufacturers of washer decontaminators and dental washer disinfectors have focused on automating the reprocessing (cleaning, disinfection, packaging, and sterilization) process. With all these trends in mind, ONE main issue still remains and ongoing concern... human error. The most common human errors occur when flexible endoscopes are connected to automated endoscope re-processors (AER) and during manual cleaning. These errors occur in endoscope departments worldwide and have not be correlated to specific scopes or re-processors. Validation of these reprocessing methods and operations may be written down in Standard Operation Procedures (SOP‘s) but in fact, the verification on how close these procedures are followed may be quite difficult.
Cleaning Surgical Instruments is the prerequisite for sterilization.
Automated Cleaning of Rigid Scopes
Washer Decontaminator Disinfector Endoscope Pressure Box
Some automated Automated washer decontaminators and dental washer disinfectors offer an "Endoscope Pressure Box". The Pressure Box securely holds a number of Rigid Scope Heads and when closed is able to deliver the high volume low pressure cleaning fluids injected from the automated washer. The automated washer delivers the "proper sequence of treatments" (times, temperatures, cleaning concentrates, purified rinses, and hot air drying) into the Pressure Box and thoroughly cleans the scopes... inside-and-out. The washer fluid enters the scope ports and flows from proximal to the distal end of the rigid scope. Pressure Boxes are able to accommodate a wide range of scope sizes and types. The Pressure Box generates a maximum differential pressure through the optimal combination of pressure and vacuum. The Pressure Box delivers consistent predictable cleaning that provides rapid turnaround and reduces the costs and risks associated with manual cleaning. The automated cleaning of rigid and flexible scopes has proven to lengthen the usable life and improve the performance of scopes. Combination "all-in-one" cleaning concentrates (high level multi-tiered enzyme formulations in combination with a high level chemical complex of surfactants, have been shown to be more effective in preventing corrosion, removing stains, preventing hard water deposits, and removing encrusted bioburden. These neutral pH cleaning concentrates are safe for all metals, plastics, and elastic compounds.
Endoscope Cleaning Safety
An additional advantage using the washer decontaminator - washer disinfector pressure box is the contact free cleaning. In principle, only freely accessible surfaces can be cleaned and disinfected. The BHT Washers washer decontaminators and dental washer disinfectors Pressure Box avoids frictional connections and contacts on the endoscope and therefore guarantees the full efficiency of washing on all outer surfaces as well. Before and during the washing process, the endoscope is checked for leakage by overpressure sensors. High level enzymatic formulations (Enzymatic Surgical Instrument Cleaners), in combination with a high level surfactant chemical complex, have been shown to be more effective in removing stains, hard water deposits, and encrusted bioburden, while being safe to use for rigid or flexible scopes.
A pressure drop caused by leakage leads to the immediate stopping of the wash program which protects the endoscope against internal water damages. The thermal disinfection of the water for the final rinse is the safest and most easily validated method to eliminate any germs which may be in the water system. This method is performed by heating the final rinse water to a temperature of at least 93°C. Since this high water temperature would damage the endoscope it must be cooled to below 60°C where then the disinfected final rinse water can be safely be applied to the endoscope for the final rinse.
Generic Temperature Parameters for Cleaning Rigid and Flexible Scopes
Always refer to manufacturers specifications prior to establishing your reprocessing protocol.
Temperature Parameters for Cleaning Rigid scopes should not be heated over 199,4°F (93°C).
Temperature Parameters for Cleaning Flexible scopes should not be heated over 149°F (65°C).
Scopes with the HAMOU head are not suitable for reprocessing via washer decontaminators or washer disinfectors.
Cleaning Surgical Instruments is the prerequisite for sterilization.
For the protection of scope surfaces we recommend the use of Purified Water (DI or RO de-mineralized water), at least for the final rinse treatment. A cleaning agent in neutral pH-range (less that 9) can augmented with an enzymatic cleaner. Combination all-in-one Surgical Instrument Cleaner Enzymatic Surgical Instrument Cleaner detergent complexes have been shown to be highly effective. Depending on the water quality, it may be necessary to use a cleaning concentrate that softens the source water for the treatments: cold water pre-wash, detergent wash, and purified water rinse/lubrication. When the treatment processes are finished, the scopes should be removed from the reprocessor avoid corrosion.
all-in-one Surgical Instrument Cleaner Enzymatic Surgical Instrument Cleaners that require a neutralizing agent (citric acid) should not be used as they can etch instrumentation. Aluminum is highly susceptible to etching. Dyed anodized aluminum parts are not easily identified as aluminum. High level enzymatic formulations (Enzymatic Surgical Instrument Cleaners, in combination with a high level surfactant chemical complex, have been shown to be more effective in removing stains, hard water deposits, and encrusted bioburden, while being safe to use for rigid or flexible scopes.
BHT Washers washer decontaminators and dental washer disinfectors connect the channels of optics with the insufflating channel to the rinsing connections of the washer rack. This will effectively clean the lumens and working channels while cleaning the surface of the instrumentation.
General Procedures for Manual Cleaning of Scopes
Endoscope cleaning consists of the mechanical cleaning of internal and external surfaces. This includes brushing and flushing of internal channels with sterile, filtered or drinking-quality water and detergent.
The next stage involves the dismantling of detachable parts of the endoscope whereby valves and water bottle inlets are removed and detachable tips taken off the insertion tube. Rubber biopsy valve caps are discarded if breached. Water bottles and suction/air-water valves should be autoclaved. All exposed internal and external surfaces should then be cleaned and rinsed: use a low-foaming enzyme-detergent specifically designated for medical instrument cleaning use the appropriate dilution according to the manufacturer's instructions flush and brush all accessible channels to remove all organic (e.g. blood, tissue) and other residues with a disposable brush-tipped wire designed for this purpose use brushes of the appropriate size for the endoscope channel, parts, connectors and openings; bristles should have contact with all surfaces repeatedly actuate the valves during cleaning to facilitate access to all surfaces clean the external surfaces and components of the endoscope with a soft cloth, sponge or brush subject reusable endoscopic accessories and endoscope components to automated washer and/or ultrasonic cleaning to remove material from hard-to-clean areas
dispose of all cleaning items
Endoscopes and Surgical Instruments
Prevent Corrosion of Surgical Instruments.
If some of the above steps are not feasible due to limited resources, consider the following alternatives:
cleaning with a enzymatic detergent - enzymes to remove bioburden and detergents to clean the surface
cleaning very carefully with soap and water of acceptable quality as the minimum standard
using sterile, filtered, drinking-quality or boiled water
John Temple
Product Development
Cleaning Surgical Instruments is the prerequisite for sterilization.
The high Level multi-tiered all-in-ONE Enzymatic Enzyme Detergent easy FOAM-it is designed to deliver high quality outcomes with rapid results. The all-in-ONE will lower reprocessing costs and reduce the inventory of other cleaning products. The all-in-ONE Enzymatic Enzyme Detergent surgical instrument cleaners replace multiple products used as enzymatic surgical instrument cleaners, lubricants, stain removers, enzymes, detergents, and endoscope cleaners.
Endoscopes and Surgical Instruments
Prevent Corrosion of Surgical Instruments.
The all-in-ONE Enzyme Detergent and easy FOAM-it Surgical Instrument Cleaners Enzymatic Spray deliver long lasting hydration and immediately begin to break down blood, fat, and protein from the surface of Surgical Instruments while maintaining and building the stain-corrosion passive layer protection of surgical stainless steel. The The all-in-ONE Enzyme Detergent and easy FOAM-it Surgical Instrument Cleaners Enzymatic Spray keeps surgical instruments moist, prevents bio-burden from drying/encrusting onto surgical instruments, inhibits bacterial growth, applies lubricates and speeds surgical instrument reprocessing. The The all-in-ONE Enzyme Detergent and easy FOAM-it Surgical Instrument Cleaners Enzymatic Spray are safe for flexible and rigid scopes, stainless steel, tungsten carbide, aluminum, brass, plastic materials, delicate surgery micro surgical instruments, ultrasonic cleaners, and washer equipment. Compare the The all-in-ONE Enzyme Detergent and easy FOAM-it Surgical Instrument Cleaners Enzymatic Spray to other enzymatic cleaners and cleaning chemicals. Only the all-in-ONE Enzyme Detergents and easy FOAM-it Surgical Instrument Cleaners deliver: cleaners, detergents, lubricants, with a high-level multi-tiered enzymatic foam spray for: cleaning and reprocessing surgical instruments, surgical instrument washer decontaminators, surgical instrument disinfectors, ultrasonic cleaners and scope cleaners.
Cleaning Surgical Instruments is the prerequisite for sterilization.
Cleaning Endoscopes and Surgical Instruments
Cleaning Surgical Instruments Cleaner
Cleaning Flexible Scopes, Cleaning Endoscopes
