Desenvolvimento de indicador químico para validação de processos de limpeza de instrumentais cirúrgicos em cuba ultrassônica e termodesinfectora

Abstract

The concern in the safety and quality of medical-surgical procedures seeking the avoidance of infections in patients resulted by the lack of proper hygiene of equipment and surgical tools is a very relevant topic in the healthcare area, due mainly for the nature of microorganisms that can survive for long period in contaminated instruments. The importance in cleaning and daily procedures through chemical, physical and biological processes are practices that ensure the integrity and functionality in preventing cross contamination in clinical and hospital environments. With this purpose, ultrasonic and thermodisinfector devices perform a fundamental role in the stages of preparation and cleaning of surgical instruments before disinfection and sterilization. Through the conduction of regular tests, it is possible to evaluate if the equipment are operating according to standards stablished by official norms of hygiene, ensuring that the cleaning process will be carried out completely and safely. This way, the proposal of this final paper is the development of a commercial prototype in the form of a chemical indicator that validates cleaning processes of medical-surgical instruments in ultrasonic cleaners and thermodisifectors. Using as reference norms stablishing parameters for the correct operation of chemical indicators, a survey for raw materials that would allow the development of a chemical indicator with organic and non-toxic basis. For this purpose, samples of the indicator ink with variable concentration of reagents applied in aluminum sheets to simulate the contaminated surface of metallic instruments. These samples were subject to cleaning tests in ultrasonic tanks that evaluated the capability of removal of the ink pigmentation using different parameters like the implementation of cavitation and enzymatic detergent. The chosen raw materials and the amount used for preparation of the samples ended up not bringing many information regarding the effects of the chosen materials in the properties of soiled indicator, except for the nontoxic white ink basis that showed an increase in the resistance of the ink under conditions of the cleaning tests. From this, it was possible to determine that an adjustment in the amount of the white ink basis was necessary, reducing to levels where the threshold where the test utilizing water and cavitation would have no effect, and the test utilizing cavitation and a enzymatic detergent solution would be cleansed. An evaluation of the results determined that the inclusion of new raw materials, like the ones, which could simulate other sources of soil other than blood, alike tissues and secretions. Therefore, the development of the chemical indicator has a prevision to continue for the search of innovation and update of the formulation to acquire an efficient, safe and market relevant product in validating the cleaning of equipment for instruments in the health-care area.