Academic Center

With the development of modern management of hospitals, centralized management mode has become an imperative working mode of disinfection supply center (CSSD). The recovery and treatment of surgical instruments is an important work of CSSD. To ensure the quality of cleaning, disinfection and sterilization of batches of medical instruments, cleaning is the foundation and the key.... The investigation shows that the surface of the instrument after clinical use is stained with a large number of blood, mucus and other organic substances, incomplete cleaning will form biofilm, prevent the penetration of sterilization agents or hinder the effective contact between microorganisms and high temperature gas, affect the sterilization effect, cause iatrogenic cross infection, and affect the medical quality and medical safety of patients. A hospital CSSD using multi-enzyme cleaning agent according to the formal process of surgical instruments for treatment, achieved good results, to ensure the quality of sterilization.

1 Methods 1.1 cleaning method to extract 1296 reusable surgical instruments with the same degree of contamination, randomly divided into 3 groups, each group of 432 pieces, respectively, multi-enzyme cleaning agent cleaning group, single enzyme cleaning agent cleaning group and chlorine disinfectant cleaning group, all instruments before cleaning are opened shaft section disassembly. The multi-enzyme cleaning group opened all the shaft segments of 432 contaminated instruments and soaked them in the configured 1:270 multi-enzyme cleaning agent. After 5min, they were rinsed with flowing water. The instruments with joints, gaps and tooth grooves were brushed with a brush, then rinsed with flowing water and finally rinsed with pure water. The single enzyme cleaning group opened all the shaft segments of 432 contaminated instruments and soaked in traditional cleaning agent 1:200 in detergent cleaning agent, rinse with flowing water after 30min, brush with brush for joints, gaps and tooth grooves, and then rinse with pure water at the end. The chlorine-containing disinfectant cleaning group opened all the shaft joints of 432 contaminated instruments and fully soaked them in chlorine-containing disinfectant with effective chlorine of 2000m#L. After 30min, rinse with flowing water and pure water. After all the cleaning steps are completed, take out the instruments, observe the cleaning effect. 1.2 sampling method The cleaned instruments shall be sampled, and the surface, tooth groove, shaft joint and other parts of the instrument shall be smeared with disinfection cotton swab neutralizer. Each instrument shall be submitted for inspection immediately for one sampling unit. 1.3 cleaning effect determination method: visual inspection, Jieli test paper detection method and light source magnifying glass shall be used to check the cleanliness of the equipment. After cleaning, the surface and joint teeth of the equipment to be packaged shall be clean, bright and free of blood stains, stains, scale and other residues and rust spots. White gauze shall be wiped without rust stains. Visual inspection shows that the surface of the washed equipment is dirty, and sporadic spots are visible.

2 Results The cleaning rate of instruments cleaned by multi-enzyme cleaning agent was 99.07%, and the qualified rate of Jeli test paper was 93.75%. The cleaning rate of instruments cleaned by single enzyme cleaning method was 75.23, the qualified rate of Jieli test paper was 70.83, the cleaning rate of instruments cleaned by chlorine disinfectant group cleaning method was 69.68, and the qualified rate of Jieli test paper was 53.47. the multi-enzyme cleaning method was significantly better than the conventional cleaning method, with significant difference (P<0.O1)(table 1).

3 Discussion Any residual organic matter such as blood, mucus and pus will hinder the effective contact between disinfection and sterilization factors and microorganisms, forming a protective film of bacteria or spores and affecting the sterilization effect]. Chlorine-containing disinfectants have strong pungent odor, corrosive to metals, bleaching effect on fabrics, large influence of organic matter, unstable disinfectant, etc..., It can not decompose human secretions, which is harmful to human body, and the concentration of chlorine-containing disinfectant should be monitored before each application to achieve the function of cleaning and disinfection. Enzymes have single enzyme and multi enzyme, the former can only remove the protein in the dirt, the latter can decompose the organic dirt J. The multi-enzyme cleaning agent can effectively decompose and remove the proteins, mucopolysaccharides, fats and carbohydrates that adhere to the instrument, so that the number of organic matter and microorganisms remaining on the instrument is minimized as much as possible], thereby quickly disposing of the contaminated blood on the instrument And body fluids. Multi-enzyme cleaning agent is a neutral detergent, non-toxic, non-corrosive, will not damage any metal, plastic, rubber products, suitable for manual, mechanical, ultrasonic and automatic cleaning machine cleaning, just soak 2 - 5min can decompose protein and other organic matter, if the equipment pollution is serious, need to extend the soaking time to achieve good cleaning effect J. The multi-enzyme cleaning agent should be ready-made, the soaked instrument shaft section should be fully opened, and all instruments should be disassembled to zero, so that they can fully contact with the multi-enzyme solution. When the multi-enzyme solution is configured, the water temperature is controlled between 30% and 4O, and the soaking time should be prolonged when the temperature is low. Too high temperature will cause the loss of enzyme activity and reduce the efficiency of the enzyme. In order to make all kinds of medical equipment and articles meet the standard requirements, we have used multi-enzyme cleaning agent to clean according to the pollution degree, type, structure and precision of all kinds of articles since 2010, which ensures the cleaning quality and greatly improves the work efficiency. From the results, it can be seen that the cleanliness and bacteriological monitoring pass rate of the instruments cleaned by conventional cleaning method are far lower than that of the use of multi-enzyme cleaning agents. Therefore, the thorough cleaning of medical devices must use multi-enzyme cleaning agents. Multi-enzyme cleaning agent is not only reliable cleaning effect, and has antibacterial and antirust performance, non-corrosive, non-toxic, tasteless, safe, hygienic and environmentally friendly, multi-enzyme cleaning agent is non-corrosive to surgical instruments, non-toxic to the human body after food testing, is a good way to protect surgical instruments and improve the sterilization effect.