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PubMed1984

Preparation and sterilization by filtration of Renacidin irrigation.

A method for the sterilizing filtration of Renacidin, a urologic irrigating solution, was evaluated. Renacidin irrigation was prepared and sterilized by microporous membrane filtration. A sterilizing membrane filtration apparatus was challenged by inoculating a batch of irrigation solution with Escherichia coli. The sterility of both intentionally contaminated and routinely prepared batches was evaluated. The stability of the solution was monitored by pH measurement, visual examination, maintenance of a vacuum, and absorbance spectrum of a 1:100 dilution in deionized water over a wavelength range from 400 to 200 nm. The time required to prepare three one-liter units was about two hours. No microbial growth was detected in any of the samples. The predicted minimum shelf-life at 10 degrees C was six months. Because the prepared solution contains some unreacted citric acid and bicarbonates, storage at room temperature could produce excessive pressure inside the container from carbon dioxide gas evolution. Refrigerated storage is recommended. This method for the preparation and sterilization of Renacidin irrigation is reasonably expedient, economical, and reliable.

Chemical Phenomena↗
PubMed1981

The declining length of hospitalization for tubal sterilization.

We analyzed factors affecting the length of hospital stay for tubal sterilization in 1970 and 1975, using data from the National Center for Health Statistic's Hospital Discharge Survey. The average hospital stay for tubal sterilization declined from 6.5 nights in 1970 to 4.0 nights in 1975. Pregnancy status, region of residence, and race were important determinants of the length of hospital stay. One technological innovation, the use of the laparoscope for tubal sterilization, accounted for 39% of the total length-of-stay reduction from 1970 to 1975. General changes in medical care from 1970 to 1975, combined with the introduction of laparoscopy, averted 1,363,000 nights of hospitalization for tubal sterilization in 1975. Conservatively, this resulted in a savings of more than $200 million. About $80 million of this savings was directly attributable to laparoscopy. Even greater savings could have been achieved if sterilization techniques requiring shorter hospital stays had been more widely used.

Black People↗
PubMed1984

The effect of steam sterilization on plaster casting material.

Plaster-impregnated gauze was autoclaved as a preventative measure against infection. The mechanical properties and the hardening time of casts made with autoclaved plaster were investigated by measuring flexural yield stress and flexural modulus of elasticity. A cantilever bending test was used to determine the time required to harden. The average yield stress in bending was reduced by an average of 8% and the modulus of elasticity was unchanged by the steam sterilization. The time required for the plaster splint to harden was increased by a factor of 5.6 after steam sterilization. Although the reduction in the yield strength was not prohibitive, the increase in hardening time was unacceptable. The use of gas sterilization is recommended when a sterile cast is necessary because gas sterilization does not increase hardening time.

Casts, Surgical↗
PubMed1984

[What should be the length and inner diameter of the testing device for microbiological efficacy testing of formaldehyde gas sterilization methods?].

The series of tests described in a preceding publication (Spicher and Borchers, 1983) has been continued in a modified way. This time, the dependency of the microbiological test results of a formaldehyde gas sterilization procedure on length and inner diameter of the tubes serving as test pieces was examined. The tubes were 1 or 2 m in length with an inner diameter of 1 or 2 mm. The tests were performed with four different preparations of bioindicators. Spores of Bac. stearothermophilus served as test germs. The preparations differed in the type of suspension used for the preparation of the bioindicators: distilled water, diluted blood (10%), undiluted blood, 10% albumin solution. The spore suspensions had been dried on linen thread. During the test procedure, the bioindicators were located near the sealed end of the tube. After completion of the sterilization procedure, the bioindicators were examined for viable germs. In tubes of identical length, the frequency of indicators carrying viable germs was always higher in those of 1 mm than in those of 2 mm inner diameter. In tubes of identical inner diameter, the frequency of indicators carrying viable germs in those of 2 m length was always higher than in those of 1 m length. This regularity was independent of the type of bioindicators used. The bioindicators for the preparation of which a 10% albumin solution had been employed showed the highest resistance. A somewhat lower resistance was found for the bioindicators prepared with undiluted blood. The bioindicators for which the spores had been suspended in diluted blood proved to have the lowest resistance. If the spores had been suspended in distilled water, the resistance of the bioindicators was a little lower than that of those suspended in undiluted blood, but was higher than that of the dried spores with diluted blood. The test results confirm the effectiveness of the method proposed earlier, i.e. to deposit the bioindicators in special test pieces (e.g. tubes or sounds) for the microbiological testing of formaldehyde gas sterilization procedures. These test pieces must be at least as long and as narrow as the longest and narrowest cavity of the object to be sterilized (tubes, catheters). In order to standardize the microbiological testing of formaldehyde gas sterilization procedures and to guarantee a certain minimum efficiency, the bioindicator as well as the test piece and its size (length and inner diameter) should be standardized.(ABSTRACT TRUNCATED AT 400 WORDS)

Culture Media↗
PubMed1983

Menstrual changes after tubal sterilization.

The authors used data from a multicenter prospective study of female sterilization surgery to study changes in menstrual function following tubal sterilization. Duration of menstrual bleeding, menstrual cycle length, cycle regularity, amount of menstrual bleeding, menstrual pain, and intermenstrual bleeding were examined. The authors followed 2456 women for two years after tubal sterilization surgery. Each woman served as her own control; her menstrual function at the two-year follow-up interview was compared with her menstrual function at the preoperative interview. Except for menstrual pain among women who underwent unipolar electrocoagulation procedures, there was no increase in the prevalence of adverse menstrual function after tubal sterilization. For all menstrual variables, 50% or more of women with adverse function preoperatively had an improvement by two years after tubal sterilization.

Adolescent↗
PubMed1984

Issues in fertility control for mentally retarded female adolescents: II. Parental attitudes toward sterilization.

Knowledge of the issues involving sterilization for mentally retarded adolescents is limited. Data were obtained from 69 interviewed parents whose mentally retarded daughters were attending the Cincinnati Adolescent Clinic. (A companion paper focuses on the experience of these girls with sexual activity, sexual abuse, and contraceptive use.) Forty-six percent of the parents had considered sterilization for their daughters. Twenty-six percent were still seeking the operation. Interest in sterilization especially correlated with increased severity of retardation (P less than .005) and with difficulty teaching menstrual hygiene (P less than .005). Parents of mildly retarded females sought tubal ligation, and those with severely retarded daughters chose hysterectomy and stressed their concern about menstrual management. Eighty-five percent of the parents favored a state statute that would enable sterilization under certain conditions and limitations. In general, few parents supported either an extremely restrictive or permissive position about sterilization.

Adolescent↗
PubMed1980

[Investigations on disinfection and sterilization of surfaces by ultraviolet radiation (author's transl)].

Some model investigations have been made in order to find out if disinfection or sterilization in an ultraviolet radiation cabinet (fig. 1) is effective. The reduction rate of spores of Bacillus anthracis dried to germ carriers of aluminium, ceramics or wood was used for indicating the germicidal effect. It was found, that a 7.5 times higher dose of radiation was necessary to reach a similar reduction rate of spores on germ carriers of ceramics as it was found for the ones of aluminium (tab. 1 and 2). Very high dosage of radiation was necessary to get a safe reduction of spores on each germ carrier (fig. 2 and 3). On wooden germ carriers an average logarithmical reduction (R) of no more than 0.67 was found after 30 h of exposure (tab. 3). Unreliable results have been found in the sterilization experiments with spore bearing germ carriers of aluminium and ceramics. In a few rare cases sterility could be obtained by an ultraviolet radiation dose of 2.000.000 microW s/cm2 (tab. 4). But generally a dosage of even 222.600.000 microW s/cm2 was not sufficient to sterilize the copntaminated germ carriers. The ultraviolet radiation cabinet cannot be recommended for disinfection or sterilization.

Bacillus anthracis↗
PubMed1982

Superior osteogenesis in transplanted allogeneic canine skull following chemical sterilization.

Sterilization of allogeneic bone increases the availability of this tissue for supplanting skeletal defects and effecting fusions. The optimal sterilant destroys micro-organisms, preserves the physical and chemical integrity of bone and possibly even reduces immunogenicity. Cortical bone of skull heals slowly and is variably resorbed. Of 36 dogs, spontaneous regeneration in 72 paired 20 mm defects was constant but always incomplete, and restored only about one third of the cross-sectional area of the defect at six months. The repair in defects replaced with canine allogeneic bony disc, sterilized with ethylene oxide (n = 9), gamma irradiation (n = 7), or methanol/chloroform/iodoacetic acid (n = 7) and then lyophilizedd, was compared with repair in defects filled with aseptically procured lyophilized only (n = 23) discs from the same donor. Criteria for evaluation of implants at six months included volume of defect filled, radiodensity, extent of fusion around circumference, revascularization, and remodeling. Bony discs sterilized with methanol/chloroform/iodoacetic acid remodeled at a superior rate (p less than 0.01). Radiation sterilization resulted in diminished density and inferentially reduced protection of the brain (p less than 0.025). Ethylene oxide, lyophilized implants, and implants lyophilized only produced comparable repair. Whereas an acceptable cranioplasty was achieved in 86% of methanol/chloroform/iodoacetic acid, lyophilize implants, all other alloimplants served an osteoconductive function with a successful repair occurring in 56% to 58%.

Animals↗
PubMed1982

[Hygienic precautions and microbiological quality control during the manufacturing of sterile drugs].

By the use of an example such as the production of a sterile solution, the hygienic precautions and control procedures required in the pharmaceutical industry are described. Starting materials should be free of germs and pyrogens. During production experimentally tested cleaning procedures for equipment are to be observed. A critical production step is the filtration. The time limits between starting and sterilizing the solution as well as the leakproofness of the filters have to be tested microbiological. --Special microbiological requirements exist for rooms, surfaces and clothes. Process-sterility control is carried out by periodic filling of ampules with nutrient broth. After running through the "compact unit" of the aseptic filling line the ampules contaminated before with endotoxin, are free of pyrogens. --Sterility depends on the count and kind of germs before sterilization procedure. The probability of survival of microorganismen should be less than 1:1 million.

Bacteria↗
PubMed1981

[Use of ionizing radiation for sterilizing alginate dressings containing various antibacterial preparations].

The effect of various doses of ionizing radiation on activity of antibacterial drugs contained in polymer alginate coatings was studied. Sensitivity of P. aeruginosa, E. coli, Staph. aureus, Proteus and B. subtilis used as the test organisms to the drugs and their combinations after radiation sterilization was determined on liquid nutrient media with the method of serial dilutions and agar diffusion and the use of the respective reference antibiotics. The coatings were irradiated in an isotope unit with 60Co at a dose of 7 Krad/min. The data are indicative of the possible use of ionizing radiation for sterilization of pharmaceutical alginate coatings in trade packings. Combined effect of antimicrobial substances and ionizing radiation plays an important role in the efficiency of radiation sterilization. Sterility of the majority of the drugs was achieved after irradiation in doses of 0.5-1 Mrad. The bactericidal activity of gentamicin, mafenid, polymyxin M and neomycin contained in the alginate coatings sterilized with gamma-radiation in doses of 1-2.5 Mrad did not decrease immediately and 1 year after irradiation.

Alginates↗
PubMedDate not supplied

[Indications for female sterilization in our surgical records].

During the period of 1970--1979 there were 303 patients sterilized by the Madlener method. Out of the them number. The highest number was delivered by caesarean section (182, 60%), and the highest number of the sterilized in the group of caesarean, section were multiparae with seven and more living children (102, 89.5%), then those with the third caesarean section (38, 76%), the fourth (3, 75%), the second (22, 10%), and the first caesarean section (17, 3.42%). Special conditions for sterilization were age, more than 30 years old, with three and more children with medical and socio-economic indications. In 21 women (40%) sterilization was performed as an additional intervention to the other laparatomies, when there was a special care about the number of living children (above three), age and medical indications. There were 3 (0,99%) failed sterilisations (one ectopic pregnancy and two in utero). The authors advocate women's free declaration for sterilization and respective legal acts.

Adult↗
PubMedDate not supplied

Liquid chemical sterilization using peracetic acid. An alternative approach to endoscope processing.

Recurrent episodes of endoscope contamination with nontuberculous mycobacterium and Pseudomonas species, coupled with employee concerns about exposure to 2% glutaraldehyde and the requirement for rapid scope turnover time, led to the investigation of an alternative method for endoscope processing. A prospective evaluation of 220 bronchoscopy procedures was carried out. Endoscope culture surveillance was performed twice a month for a 12 month period on all endoscopes. In addition, the deliberate inoculation of bronchoscopes with Mycobacterium gordonae was carried out. No indications of cross contamination were noted among the 220 bronchoscopy procedures after processing the scopes by the studied liquid chemical sterilization system using peracetic acid. Ongoing patient surveillance did not reveal any indications of cross contamination for nearly 15,000 patients diagnostic or surgical endoscopic procedures using instruments processed by this liquid chemical sterilization system. Twice a month for 12 months, bronchoscopes, colonoscopes, and gastroscopes were cultured for bacterium, fungi, and acid fast bacilli and showed no growth. Deliberate inoculation of bronchoscopes with M. gordonae showed the scopes were rendered sterile. No unusual occurrences of occupational chemical exposure were found in 11 individuals working with this liquid chemical sterilization system. The peracetic acid based sterilization system studied proved to be an effective, safe, and economical alternative to the glutaraldehyde method.

Adolescent↗
PubMed1995

Steam sterilization of laparoscopic instruments.

Because of the intricate internal parts of laparoscopic instruments, questions have been raised about the efficacy of cleaning and sterilization techniques. To assess these risks, hamburger meat was inoculated with high concentrations of vegetative pathogens and packed into laparoscopic cannulas. All openings of the cannulas were sealed during steam sterilization cycles ranging from 3 to 10 min in different experiments; cultures were obtained after cooling. Experiments were then performed using heat-resistant spore forms. Our studies showed that both the standard 10-min cycle and the 3-min "flash" were uniformly successful in killing all pathogenic microorganisms. A 7-min steam sterilization was necessary to kill spores within sealed cannulas. We conclude that a standard 10-min cycle within the steam autoclave provides complete sterilization of laparoscopic instruments; the 3-min "flash" sterilization is appropriate and safe for instruments that have been inadvertently contaminated or dropped during a surgical procedure.

Equipment Contamination↗
PubMed1994

A study of water flow efficiency in dental air/water syringe tips after repeated chemiclave sterilization.

In response to the need for dental office asepsis, many practitioners sterilize dental air/water syringe tips for each patient. It is hypothesized that repeated sterilization would lead to internal corrosion restricting the water flow. This study was conducted to evaluate consistency of water flow in a series of dental air/water syringe tips after multiple cycles of Chemiclave sterilization. An apparatus was constructed to deliver water at the same pressure and flow to each syringe tip. The flow rates between tips were significantly different (P < .001). Average water flow, in grams per minute, was determined by ten repeat trials for each tip. The tips were retested after 1, 5, and 25 cycles of Chemiclave sterilization. None of tips showed a decrease in water flow efficiency after repeated sterilization cycles. No difference in ability to remove etchant from enamel and dentin could be demonstrated using a 10-second wash.

Acid Etching, Dental↗
PubMed1994

Heat or gamma irradiation sterilization affects the hypocholesterolemic effect of guar gum in axenic and heteroxenic rats.

1. Twenty-two axenic (germfree) or thirty heteroxenic (axenic colonized with human flora) 2.5-3.5 months old female Fisher rats were fed for four weeks either a hypercholesterolemic (HYPER) diet or a HYPER diet containing 5% guar gum (GG) sterilized by heat or by gamma irradiation. 2. Axenic rats fed the irradiated GG diet had higher cholesterolemia than their counterparts fed an autoclaved diet (4.50 vs 2.29 mmol/l), whereas the method of sterilization had no effect on plasma cholesterol in axenic HYPER or heteroxenic animals (7.35 vs 6.51 mg/dl). 3. The levels of hepatic esterified cholesterol were higher in heteroxenic animals fed the irradiated GG diet than in their counterparts fed the autoclaved GG diet (5.65 vs 3.57 mmol/g tissue). 4. The composition of volatile fatty acids in the cecal content of heteroxenic rats was dependent on the method of sterilization regardless of the presence of fiber: the levels of butyrate were 2.88 and 0.85 mumol/g for rats fed the autoclaved and irradiated diets, respectively. 5. Gamma irradiation abolished the cholesterol-lowering effect of guar gum, whereas sterilization by heat preserved this effect. 6. The hypocholesterolemic effect of guar was reduced by gamma irradiation sterilization and was probably mediated by qualitative changes in the intestinal microflora which interfered with bile acid absorption.

Animals↗
PubMed1993

[H2O2 low temperature plasma sterilization. New possibilities for use with eye surgery instruments].

The H2O2-low-temperature-plasma-sterilization (STERRAD 100) works with a temperature below 50 degrees C (140 degrees F). This system is appliable for thermostabile materials as well as for thermolabile materials. The efficancy of this new system is shown by a biological test with Bacillus pumilus spores. 5 typical ophthalmic surgical instruments were contaminated. After sterilization the numerical reduction of the microorganisms had to be at least 6 log levels. Corrosion caused by hydrogene peroxide was excluded after exposing steal with a high quantity of this substrate. Electromicroscopy analysations of the surfaces of stainless steal after LTP, steam sterilization and hot-air sterilization are compared. Options and limitations of this new sterilization technique are discussed. A newly developed operating system with a complete instrumental box (OP-Set) will be introduced.

Bacillus↗
PubMed1994

A model for resident surgical training in laparoscopic sterilization.

OBJECTIVE: To measure the effects of a specific instructional program designed to teach residents laparoscopic sterilization. METHODS: The teaching module consisted of a 40-minute videotape and monograph, which each resident studied 1-3 days before beginning a 4-5-week rotation on which he or she performed laparoscopic sterilization procedures. The change in knowledge was measured by comparing pre- and post-test assessments. Twenty-three PGY-2 gynecology residents were administered the peer-reviewed and validated pre-test, which consisted of 31 multiple-choice questions covering the following aspects of laparoscopic sterilization: 1) indications and complications, 2) general aspects of sterilization, 3) sterilization methods, and 4) technical aspects of occlusive device application. A post-test, which consisted of the identical 31 items with the question order changed, was administered after the teaching module was completed. RESULTS: The mean number of correct answers on the post-test (27.2 +/- 2.3, range 22-31) was significantly higher (P < .05) than the mean number of correct answers on the pre-test (17.9 +/- 3.4, range 13-24). There was no difference in residence scores if the module was completed early or late in the academic year or during the first or second year that the program was in effect. CONCLUSION: This study demonstrates that knowledge of a specific surgical technique can be measured and that structured learning packages can be effective. Efforts to teach residents a specific curriculum can have a significant effect on their fund of knowledge. Other specially designed programs may be applicable to procedures commonly performed by gynecologic residents.

Curriculum↗
PubMed1993

Heat sterilization of fluids for peritoneal dialysis gives rise to aldehydes.

OBJECTIVE: To chemically identify and quantify glucose degradation products in heat sterilized fluids for peritoneal dialysis. DESIGN: Three different brands of commercial PD-fluids and one laboratory made fluid, sterilized either by heat or filtration, were investigated for the presence of aldehydes. MEASUREMENTS: Aldehydes were identified and quantified using high performance liquid chromatography and gas chromatography. RESULTS: The tested brands of heat sterilized PD-fluids were found to contain several different aldehydes while the sterile filtered PD-fluid contained none. The highest concentrations in commercial PD-fluids of these aldehydes were: acetaldehyde (420 microns), glyoxal (14 microns), methylglyoxal (12 microns) and formaldehyde (11 microns). Valeraldehyde was also identified but not quantified. The presence of 5-HMF (15 microns) and 2-furaldehyde (2 microns), which has been identified by others, was confirmed. CONCLUSIONS: The heat sterilization of commercial PD-fluids gives rise to several aldehydes which may contribute to adverse effects of PD-fluids on patients.

Aldehydes↗