RESUMOEstudo de revisão integrati va da literatura com o objeti vo de buscar evidências que subsidiem a incorporação do ozônio como agente esterilizante de produtos para saú-de. A busca foi realizada nas bases MEDLI-NE, SCOPUS, COCHRANE, COMPENDEX, INSPEC E ENGINEERING RESEARCH DATA-BASE, uti lizando-se os descritores ozone e sterilizati on. Foram obti das cinco publicações, entre 1990 e 2008, que testaram o ozônio como esterilizante. Todas uti lizaram o mesmo ti po de investi gação (experimental laboratorial) e alcançaram esterilização pelo ozônio, porém com variados escopos e produtos testados, além de diversos procedimentos metodológicos. Tendo em vista a incessante tecnologia de novos produtos, com ampla variedade de conformações e matéria-prima, os achados denotam o ozônio um método promissor, porém ainda em fase inicial de investi gação. Mais estudos experimentais ainda são necessários, de maneira a subsidiar evidências mais amplas sobre suas possibilidades e limitações. DESCRITORES Ozônio Esterilização Enfermagem ABSTRACTThe objecti ve of this integrati ve literature review was to fi nd evidence to support using ozone as a sterilizing agent for health products. The search was performed on the following bases: MEDLINE, SCOPUS, COCHRANE, COMPENDEX, INSPEC and EN-GINEERING RESEARCH DATABASE; using ozone and sterilizati on as descriptors. Five arti cles were found between 1990 and 2008, which tested ozone as a sterilizer. All studies used the same type of investi gati on (experimental laboratory study) and achieved sterilizati on with ozone, but with diff erent scopes and products, besides using diff erent methodological procedures. Considering the ever-growing technology for new products, with the vast range of forms and materials, the fi ndings point at ozone sterilizati on as a promising method, but sti ll in an initi al phase of investi gati on. Further experimental studies are needed to provide broader evidence regarding the possibiliti es and limitati ons of ozone sterilizati on. DESCRIPTORS Ozone Sterilizati on Nursing RESUMENEstudio de revisión integradora de literatura objeti vando buscar evidencias que respalden la incorporación del ozono como agente esterilizante de productos para la salud. La búsqueda se realizó en las bases MEDLINE, SCOPUS, COCHRANE, COMPEN-DEX, INSPEC y ENGINEERING RESEARCH DA-TABASE, uti lizándose los descriptores ozone y sterilizati on. Se rescataron cinco publicaciones entre 1990 y 2008 que testearon al ozono como esterilizante. Todas uti lizaron el mismo ti po de investi gación (experimental laboratorial) y consiguieron la esterilización mediante el ozono; sin embargo, con variados objeti vos y productos probados, además de diversidad de procedimientos metodológicos. Teniendo en cuenta la alta tecnología de nuevos productos, con amplia diversidad de conformaciones y materias primas, los hallazgos determinan al ozono como método promisorio, no obstante que aún esté en fase inicial de investi gación. Se necesitan más estudios experimentales, para respaldar con evidencias ampli...
OBJECTIVE To compare the effectiveness of manual and automated methods for cleaning laparoscopic instruments. DESIGN Experimental laboratory study. METHODS We evaluated 4 methods of cleaning laparoscopic instruments: (1) manual-only cleaning and rinsing with potable tap water; (2) manual cleaning and rinsing with potable tap water, followed by ultrasonic cleaning without rinsing; (3) manual cleaning and rinsing with potable tap water followed by ultrasonic cleaning and rinsing with potable tap water; and (4) manual cleaning and rinsing with potable tap water, followed by ultrasonic cleaning and rinsing: first with potable tap water and then with sterile distilled water. Organic residues of protein, hemoglobin, and carbohydrates were evaluated using spectrophotometry. RESULTS The various cleaning methods tested did not result in statistically significant differences (P>.05) in the levels of investigated organic residues. CONCLUSIONS All cleaning and rinsing methods tested were found to be effective in reducing the levels of organic residues on laparoscopic instruments. Thus, there is no advantage gained by supplementing manual-only cleaning with automated ultrasonic cleaning, nor was there a difference between rinsing with potable tap versus sterile distilled water. Infect Control Hosp Epidemiol 2018;39:58-63.
Objective:assess the safety of steam sterilization of assembled laparoscopic instruments with challenge contamination. Method:a laboratory experimental study, using as test samples trocars and laparoscopic graspers. Geobacillus stearothermophillus ATCC-7953 was used, with a microbial population of 106UFC/Filter paper substrate, removed from the biological indicator. Three of them were introduced into each instrument at the time of assembly, and sterilized at pressurized saturated steam, 134oC for 5 minutes. After sterilization, the instrument was disassembled and each filter paper substrate was inoculated in soybean casein culture and incubated at 56oC for 21 days. In case of absence of growth, they were subjected to heat shock of 80oC, for 20 minutes and re-incubated for 72 hours. Sample size: 185 graspers and 185 trocars, with 95% power. We paired the experiments with comparative negative control groups (5 graspers and 5 trocars with challenge contamination, sterilized disassembled) and positive control (30 filter paper supports, unsterilized), subject to the same incubation procedures. Results:there was no microbial growth in experimental and negative control. The results of the positive control were satisfactory. Conclusion:this study provided strong scientific evidence to support the safety of steam sterilizing of the assembled laparoscopic instrument.
Video-laparoscopy represents one of the greatest surgical advances in the recent past. Reprocessable laparoscopic instruments are complex devices that, if completely disassembled for sterilization, would cause problems for the surgical teams at the moment of their use in the surgery. The method of choice for the sterilization of this equipment is saturated steam under pressure. The goal of this review was to describe the state-of-the-art in the search for safe results in autoclaving the previously-assembled reprocessable laparoscopic instruments, since they are difficult to assemble at the moment of surgery. The PUBMED database was consulted, using controlled and free keywords, as well as their combinations, without time or language restrictions. The study investigating the exact issue of this research found contamination in both assembled (1/24) and disassembled (1/30) instruments, demonstrating equivalent risks. In view of the results and considering the lack of studies, a new experimental laboratory study is recommended, using a contamination challenge. Keywords: Sterilization; Heat transference; Surgical instruments; Laparoscopy; Operating room nursing. RESUMOA vídeo-laparoscopia representa um dos maiores avanços na área da cirurgia nos últimos tempos. Os instrumentos laparoscópicos reprocessáveis são artigos complexos, que se esterilizados totalmente desmontados trazem transtornos às equipes cirúrgicas no momento da sua utilização no campo operatório. O método de escolha para a esterilização desses instrumentos é o vapor saturado sob pressão. O objetivo dessa revisão foi descrever o estado da arte em busca dos resultados da segurança na autoclavação do instrumental laparoscópico reprocessável, previamente montado, tendo em vista as dificuldades de montagem deles no momento da cirurgia. Foi consultada a base de dados PUBMED, usando vocábulos controlados, livres e a combinação deles, sem restrição de tempo e idioma. Foram localizados apenas dois artigos que permitiram conclusões favoráveis para a prática de autoclavar os instrumentos laparoscópicos previamente montados. O estudo que investigou exatamente a questão da pesquisa encontrou contaminação após a esterilização, tanto em instrumentos montados (1/24) como nos desmontados (1/30), demonstrando equivalência do risco. Frente aos resultados, e considerando a escassez de trabalhos sobre o assunto, recomenda-se um novo estudo experimental laboratorial randomizado utilizando contaminação desafio. Descritores: Esterilização, Transferência de calor; Instrumentos Cirúrgicos, Laparoscopia; Enfermagem de Centro Cirúrgico RESUMENEl video-laparoscopía representa uno de los mayores avances en el área de la cirugía en los últimos tiempos. Los instrumentos laparoscópicos reprocesables son artículos complejos, que si son esterilizados totalmente desarmados ocasionan trastornos a los equipos quirúrgicos en el momento de su utilización en el campo operatorio. El método de elección para la esterilización de esos instrumentos es el vapor saturado bajo presión. El obj...
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