Reprocessing Applications and Methods

A distinction is made between manual and automated cleaning.

For manual cleaning, choosing the right cleaning brush is essential.

Automated cleaning should be followed by thermal disinfection, especially for medical devices that are steam-sterilized. Telescopes must be held securely in the washer-disinfector, which requires suitable equipment such as telescope reprocessing baskets.

The instructions for use are an important reference for safe reprocessing of medical devices and must always be followed.

After use, instruments should be cleaned as soon as possible with water and additives (detergents) for better cleaning results.

If instruments are

• left dry for a long time, coarse residues dry and harden on them and become difficult to remove.

• left in liquid for a long time, they can be damaged, and their seals may be damaged or fail.

The Richard Wolf RIWO BOX container system is a safe, complete system for the manual cleaning, disinfection and neutralization of contaminated instruments. Its practical design and simple, effective handling ensure safe, smooth reprocessing. The containers are available in several sizes

Manual disinfection is mainly chemical, using various agents. Factors to consider include exposure time, concentration and material compatibility with the medical device.

In automated reprocessing, cleaning is followed by disinfection, which can be chemical, chemo-thermal or thermal depending on the medical device and the process.

The instructions for use are an important reference for safe reprocessing of medical devices and must always be followed.

Manual disinfection

Observe the exposure time specified by the disinfectant manufacturer and never exceed it.

The Richard Wolf RIWO BOX container system is a safe, complete system for the manual cleaning, disinfection and neutralization of contaminated instruments. Its practical design and simple, effective handling ensure safe, smooth reprocessing. The containers are available in several sizes.

Automated reprocessing

In accordance with the international ISO 15883 series of standards, only washer-disinfectors expressly intended for cleaning and disinfecting endoscopic instruments may be used.

The following criteria must be observed:

• All instruments must be secured firmly to the machine's inserts or baskets.

• The reprocessing media must reach all inner and outer surfaces of all instruments.

• Telescopes should be placed in dedicated reprocessing baskets.

• For ideal rinsing, instruments with channels/lumens must be connected using the machine's dedicated inserts or directly via its Luer lock connectors.

• Remove stopcocks, or place non-removable stopcocks in the fluid flow.

• Open the jaws of hand instruments/forceps.

If disinfection is not followed by sterilization, the final rinse should be with sterile water. To improve drying, the channels of flexible endoscopes can first be flushed with 70% alcohol (which evaporates quickly and absorbs moisture) and then purged with air; the outer surfaces should be dried with a sterile cloth.

Disinfection only reduces the number of microorganisms, while sterilization kills all microorganisms capable of reproduction, including spores. In minimally invasive surgery, sterility must be achieved by moist heat sterilization (steam sterilization) or low-temperature sterilization with formaldehyde, ethylene oxide or hydrogen peroxide (with or without plasma).

Sterilization baskets with outer packaging

Richard Wolf offers a range of basket systems for steam, plasma, ethylene oxide and formaldehyde sterilization. Different baskets must be used depending on the specialty.

The standard-size baskets can be wrapped in sterile packaging or sterilized in containers such as Martin, Aesculap or Wagner.

Sterilization containers without outer packaging

The Sterisafe DURO A3 is a sterilization container for Richard Wolf flexible endoscopes that needs no outer packaging. This stackable container is also ideal for plasma, ethylene oxide and LTSF sterilization.

The Sterisafe DURO A3 Set Universal Steam provides another container for steam sterilization of rigid instruments.

The reprocessing and care of medical devices has a huge impact on their service life.

The following recommendations supplement the reprocessing information in the products' instructions for use.

Use of detergents and disinfectants

Richard Wolf recommends using only products whose material compatibility we have tested. If you want to use other detergents or disinfectants, their manufacturer should confirm material compatibility with our endoscopes.

Approved reprocessing chemicals

The material compatibility of the following chemicals has been approved by Richard Wolf for reprocessing rigid endoscopes, flexible endoscopes and instruments.

The material compatibility of Richard Wolf products applies only to the reprocessing chemicals listed below. Because of the huge variety of chemicals on the market, possible interactions with other products cannot be taken into account. Always follow the exposure time, concentration and method of use specified by the manufacturer, and make sure no residues remain on the instruments.

Solution concentration

Overly concentrated solutions can damage instrument surfaces (medical steel, stainless steel, plastics), greatly shortening instrument life. They can also increase the cost of detergents and disinfectants.

Specified exposure time

Observe the specified exposure times for detergents and disinfectants and never exceed them.

Switching between manual and automated cleaning

Frequently switching reprocessing methods puts more stress on materials and should be avoided. If you switch between manual and automated cleaning, make sure the reprocessing agents used are compatible.

Recommendations for instrument reprocessing in hospitals have been summarized by the AKI (Working Group Instrument Reprocessing) in the brochure "Instrument Reprocessing – Reprocessing of Instruments to Retain Value".

http://www.a-k-i.org