Professional instrument reprocessing in CSSD

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1 Professional instrument reprocessing in CSSD

2 The reprocessing cycle in CSSD Fig. 1 The objective of the surgical instrument reprocessing cycle Only proper, professional manual as well as automatic in central sterile supply departments (CSSD) is to prevent cleaning guarantees safe and effective disinfection/steri- nosocomial infections within the hospital and thus help to lisation. ensure the safety of patients and staff. The reprocessing cycle generally comprises five steps, beginning with use The cleaning and disinfection process of the instruments in the operating theatre and ending Professional cleaning and disinfection processes gene- with their sterilisation/storage (fig. 1). Borer Chemie AG s rally comprise five steps. The first of these is proper pre- product portfolio covers the most important decontamination (pre-cleaning) and the final step is instru- deconex aspect of this cycle, namely cleaning and disinfection. ment care (fig. 2).

3 The five steps of cleaning and disinfection deconex FOAM ACTIVE Prevents drying of surgical soil Protects against corrosion Good rinsibility already at room temperature Stable foam Good compatibility to different materials Fig. 2 Step 1: Pre-cleaning The aim of pre-cleaning, which is usually carried out manually, is to remove any contamination and coarse contaminants from the used instruments. In this step detergent deconex PROZYME ACTIVE or detergent-disinfectant deconex 53 INSTRUMENT or deconex 53 PLUS are recommended (free from aldehydes, no protein-fixing effect). PRE-CLEANING deconex 53 FOAM Aldehyde-free Ready-to-use foam spray Wide spectrum of activity Suitable for use as a personal protection measure Protects against corrosion deconex 53 INSTRUMENT Combined cleaning and disinfectant activity Wide spectrum of activity Effective against mycobacteria incl. tuberculocidal Suitable for use in ultrasonic baths Service life of up to 14 days Validable with test strips deconex 53 PLUS Combined cleaning and disinfectant activity Wide spectrum of activity (also tuberculocidal) Particularly gentle action Suitable for use in ultrasonic baths No chloride salts Service life of up to 14 days

4 Step 2: Cleaning The instruments are best cleaned in automated washerdisinfectors (WD). If there is no WD, the instruments are cleaned manually. Ultrasonic baths are often used as a mechanical compliment to the manual process. The deconex product portfolio offers appropriate solution to fit any process need: e.g. enzymatic and high alkaline cleaning, activity against prions or biofilm, cleaning of sensitive instrument (like flexible endoscopes). The optimum cleaning and disinfection process depends All deconex products for automated and manual application are free from NTA, EDTA, fragrances and are biodegradable. on various factors. The nature and level of contamination as well as the varying degree of sensitivity of the instruments/materials (e.g. flexible endoscopes) have to be taken into account when selecting the right process or product. The quality of the water available for cleaning in CSSDs also has a major influence on the cleaning result. According to the Sinner circle (fig. 3) there are four main factors: chemical action, mechanical action, time and temperature, which determine the efficiency of cleaning and disinfection processes. Those have to be carefully chosen to achieve the optimal result. Fig. 3 Chemical action Temperature Mechanical action Time

5 deconex range for AUTOMATED cleaning NEUTRAL ENZYMATIC CLEANING MILD ALKALINE - ENZYMATIC CLEANING deconex POWER ZYME For universal use Very broad material compatibility (ph-neutral) Low dosage Good rinsability Suitable for endoscopes deconex 23 NEUTRAZYM-x Very good cleaning performance Excellent material compatibility Active against biofilm Compatible with hard water Particularly suitable for endoscopes deconex TWIN PH10 / TWIN ZYME Highly effective cleaning Low dosage Very broad material compatibility Active against biofilm ph > 10, neutralisation is not required Versatile Prevents formation of silicate deposits Very good rinsability Suitable for cleaning da Vinci EndoWrist instruments deconex PROZYME ALKA Highly effective cleaning Compatible with hard water Prevents formation of silicate deposits Active against biofilm Broad material comatibility Neutralisation not required ALKALINE CLEANING NEUTRALISATION deconex 28 ALKA ONE-x Excellent cleaning performance Active against prions ph > 10 (RKI-compliant) Compatible with hard water Neutralisation not required Prevents formation of silicate deposits Residue-free rinsability Active against biofilms deconex 21 CLF Very good cleaning performance Material compatibility Good cost-benefit ratio Free of chlorine and surfactants deconex ORGANACID Based on organic acid (citric acid) Successfully removes alkali residues Suitable as a pre-cleaner Compatible with aluminium Free of phosphates and surfactants deconex MINERALACID Based on inorganic acid (phosphoric acid) Successfully removes alkali residues Suitable as a pre-cleaner Surfactant-free

6 deconex range for AUTOMATED cleaning BEDPANS deconex 41 STS Final rinse aid and limescale inhibitor Thorough and clear rinsing Prevents the formation of deposits on reprocessed devices and the bedpan washer Speeds up drying process deconex 41 STS ALKA Detergent and limescale inhibitor Good cleaning performance Prevents the formation of deposits on reprocessed devices and bedpan washers Suitable for bedpan washers with acidsensitive components TROUBLE- SHOOTING deconex 34 GR Removes discolourations as well as inorganic and rust deposits Suitable for passivating of stainless steel instruments Ideal for deep cleaning of WD chambers

7 deconex range for MANUAL cleaning NEUTRAL CLEANING deconex PROZYME ACTIVE Conformity to EN ISO/TS :2005 Outstanding cleaning performance Effective biofilm removal Good compatibility with different materials Rapid cleaning at room temperature (cost saving) Safety and sustainability Particularly suitable for endoscopes deconex 36 INTENSIV-x Suitable for multiple applications Good cleaning performance Very broad material compatibility Excellent cost-benefit ratio NEUTRAL ENZYMATIC CLEANING deconex POWER ZYME For universal use Very broad material compatibility (ph-neutral) Low dosage Good rinsability Suitable for endoscopes

8 Step 3: Disinfection It is important that the products used to clean and disinfect such sensitive instruments are compatible with each other, like e.g. deconex 23 NEUTRAZYM-x and deconex ENDOMATIC. This prevents a reduction in efficacy, changes to the surfaces of endoscopes and excessive foam production in the machine. Disinfection is usually carried out thermally in a WD, ideally with demineralized water at a temperature of C. Chemo-thermal disinfection Chemo-thermal disinfection is primarily restricted to thermolabile instruments such as endoscopes, where purely thermal disinfection is not possible. Such instruments can only be cleaned automatically in special washer-disinfectors. AUTOMATED DISINFECTION deconex ENDOMATIC Rapid effect at low dosage Broad spectrum of activity Glutaraldehyde-based Exceptionally gentle action Suitable for endoscopes Listed for endoscope reprocessing by Karl Storz and Pentax deconex ANTISEPTIC Excellent cleaning properties Alkaline, contains surfactants Broad spectrum of activity when used for chemical-thermal disinfection Good material compatibility Neutralisation not required Prevents formation of silicate deposits

9 Manual instrument disinfection For manual disinfection, aldehyde-free, non-protein-fixing disinfectants such as deconex 53 INSTRUMENT or deconex 53 PLUS should be used. Endoscope disinfection If there is no special WD available for the chemo-thermal disinfection of endoscopes, manual chemical terminal disinfection must be performed using a high-level disinfectant. Material compatibility is highly important when it comes to selecting the right disinfectant. Influencing factors include the type of active ingredient, the composition, exposure time, concentration and the ph-value of the application solution. ALDEHYDE-FREE (PRE-) DISINFECTION deconex 53 INSTRUMENT Combined cleaning and disinfectant activity Wide spectrum of activity Effective against mycobacteria incl. tuberculocidal Suitable for use in ultrasonic baths Service life of up to 14 days Validable with test strips deconex 53 PLUS Excellent cleaning performance Extremely wide range of activity incl. tuberculocide effect Compatible with a wide range of materials incl. acrylic glass and PET VAH certified (German Association for Applied Hygiene) Suitable for use in ultrasonic baths No quaternary chloride salts Disinfectants based on aldehydes or peroxo compounds, in particular disinfectants containing peracetic acid, are best suited to terminal disinfection. MANUAL CHEMICAL TERMINAL DISINFECTION deconex HLD PA / PA20 Ready-to-use straight after activation Comprehensive spectrum of activity incl. against spores Rapid effect Very broad material compatibility Service life of up to 14 days Validable with test strips

10 Step 4: Drying and Step 5: Care The professional cleaning and disinfection process for surgical instruments ends with drying and subsequent care. The WD or an appropriate manual procedure is used to ensure that the instruments are sufficiently dry. A final rinse/thermal disinfection additive can be used if necessary. These reduce the surface tension of the water and thus considerably shorten the drying time. Subsequent care of the instruments is important as it helps to preserve their functioning and prolong their life. It involves manually applying the right care product to specific joints, threads and sliding surfaces on the instruments: such as based on paraffin oil, deconex LUBE SPRAY. AUTOMATED MANUAL deconex 41 CLEAR Neutralises alkaline residues Prevents the formation of limescale deposits in the device and water spots on the washed items Reduces drying time deconex 64 NEUTRADRY Significant reduction in drying time Biocompatible ph-neutral Has mild lubricating properties (joints) Clean and clear rinsing deconex 42 KONZ Based on medicinal white oil Long-lasting instrument care Protects against fretting corrosion deconex LUBE SPRAY Excellent lubrication properties Protects against fretting corrosion and other signs of wear Good material compatibility Vapour-permeable and suitable for steam sterilisation Biocompatible (Ph. Eur.) Surfactant/silicone/CFC-free

11 Surface disinfection As well as products for reprocessing of surgical instruments, Borer Chemie AG s deconex line also offers a range of surface disinfectants which are certified by the German Association for Applied Hygiene (VAH). These include deconex SURFACE AF, an aldehyde-free concentrate, deconex 50 FF, a formaldehyde-free product, and deconex SOLARSEPT, a fast-acting alcohol disinfectant suitable for direct use. Hand disinfection decosept and decosept HA hand disinfectants complete the Borer Chemie AG product range. SURFACE DISINFECTION deconex 50 FF Combined cleaning and disinfectant properties Versatile Low dosage Pleasant fragrance Highly effective, even under blood and protein load Service life of up to 7 days Rapid effect on enveloped viruses deconex SOLARSEPT Ready-to-use in a convenient spray format Broad spectrum of activity incl. tuberculocidal activity Rapid effect Short drying time VAH-listed HAND DISINFECTION decosept * Rapid efficacy Very good remanence effect Spore-filtered Dermatologically tested Alcohol-based product VAH-listed decosept HA * Rapid efficacy Very good remanence effect Spore-filtered Dermatologically tested Alcohol-based product VAH-listed Contains no fragrances or dyes deconex SURFACE AF Cleaning and disinfection in a single step Rapid effect Broad spectrum of activity incl. tuberculocidal activity No residues VAH-listed * only available in selected markets

12 training pre-treatment trouble shooting detergents derouging disinfectants analyses process optimisation rinsing and drying central delivery systems care How you benefit % Swiss quality: both in development and production 99 Uncompromising cleaning: our products have been successful for 50 years 99 Qualified process optimisation: our experience your benefit 99 On-site technical support: our specialists bring their expertise to your company 99 Competent advice: we find the best solution for you, for optimal results and efficiency Our added extra: we also know about conveyor systems. Ask us about a solution tailored to your needs. Put us to the test! We are here for you safe, competent, fast, direct, personal. Brief profile Borer Chemie AG is a technological leader in cleaning and disinfection. The company develops, produces and markets internationally known brand products and proven processes for professional applications in hospital hygiene, industry and life sciences. Typical product users include medical institutions, manufacturers of precision parts, analytical laboratories and manufacturers of medicinal products. The Research & Development team develops processes and formulations for customer cleaning issues in the inhouse technology department. The entire process from manufacturing through filling, labelling and packaging to on-time dispatch of the more than 160 highly specialised products is also carried out at our company headquarters in Zuchwil. Borer Chemie AG Gewerbestrasse 13, 4528 Zuchwil / Switzerland Tel , Fax office@borer.ch en