本帖最后由 胡杨 于 2014-11-4 18:08 编辑
为什么不行?
好像低温等离子不行,环氧乙烷低温,压力蒸汽灭菌都可以的。不管是不是台式灭菌器。
再问问其他人确认。
基于使用卡式灭菌器于植入物有医院感染事件报道。美国指南“不推荐常规使用卡式灭菌器灭菌植入物”。指南认为使用卡式灭菌器有发生感染的潜在风险,并且一旦发生就比较严重;另外快速灭菌不便于生物监测;卡式灭菌器还有裸消存放污染风险;应急使用灼伤问题。但同时也认为工作中需要使用快速灭菌器灭菌植入物也无法避免。因此强调,如果必须应急使用,做好相关记录以备追溯(植入物名称,患者姓名,医院标识码,生物监测结果),并做灭菌工艺可靠性评价(如:生物监测,维修记录,保养记录等)。 台式灭菌器和卡式灭菌器的灭菌,监测条件有何差异?进一步了解。
参考文献:
A few adverse events have been associated with flash sterilization. When evaluating an increased incidence of neurosurgical infections, the investigators noted that surgical instruments were flash sterilized between cases and 2 of 3 craniotomy infections involved plate implants that were flash sterilized849. Flash sterilization is considered acceptable for processing cleaned patient- care items that cannot be packaged, sterilized, and stored before use. It also is used when there is insufficient time to sterilize an item by the preferred package method. Flash sterilization should not be used for reasons of convenience, as an alternative to purchasing additional instrument sets, or to save time. Because of the potential for serious infections, flash sterilization is not recommended for implantable devices (i.e., devices placed into a surgically or naturally formed cavity of the human body); however, flash sterilization may be unavoidable for some devices (e.g., orthopedic screw, plates). If flash sterilization of an implantable device is unavoidable, recordkeeping (i.e., load identification, patient's name/hospital identifier, and biological indicator result) is essential for epidemiological tracking (e.g., of surgical site infection, tracing results of biological indicators to patients who received the item to document sterility), and for an assessment of the reliability of the sterilization process (e.g., evaluation of biological monitoring records and sterilization maintenance records noting preventive maintenance and repairs with dates). Source from: Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008
另外: 小型蒸汽灭菌器主要用于“小批量物品,应急使用物品,偶有需要灭菌物品”的灭菌工作需求。台式和卡式都有“快速”的特点,但卡式仅用于“应急”。法规要求植入物灭菌必须做生物监测,“应急需求快与监测结果慢”就成为矛盾。在保障生物监测结果的前提下尽可能快,使用台式还是有优势的。不过美国有1小时出生物监测结果的产品,配合应急使用可以减少手术等待。如何配置和充分利用好小型灭菌器,也是需要思考的问题。
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