Indications and limitations of different detergents used in the processing of health products
DOI:
https://doi.org/10.5327/Z1414-4425201700020008Keywords:
Central de Material e Esterilização, Limpeza, EnfermagemAbstract
Objective: To identify studies that address indications and limitations of different detergents used in the processing of medical devices.
Method: Integrative review that included publications in Scientific Electronic Library Online, Science Direct, Scopus, Web of Science and PubMed, from
2000 to 2016, in English and in Portuguese. Results: Nine studies were identified. Alkaline detergents remove dirt well, its use is indicated for automated
equipment, and they are suitable in processes that use hard water, compatible with surgical stainless steel instruments. They may damage the medical
device and react with aluminum, zinc, non-ferrous metals, rubber and latex. Enzymatic detergents are compatible with various materials and, due to the
presence of enzymes, remove different types of dirt from the instrument. Conclusion: Although alkaline and enzymatic detergents present similarities,
the choice of the product requires knowledge of its action, observing the characteristics of use, compatibility with the medical device and water quality.
References
Brasil. Ministério da Saúde. Resolução da Diretoria Colegiada (RDC)
n.º 15, de 15 de março de 2012. Dispõe sobre os requisitos de
boas práticas para o processamento de produtos para saúde e dá
outras providencias. Diário Oficial da União, Brasília, 2012 [acesso
em 28 set. 2016]. Disponível em: <http://www.sobecc.org.br/
arquivos/legislacao/06%20RESOLU %C3%87%C3%83O_RDC_%20
N%C2%BA15_ANVISA_%20MAR%C3%87O%202012.pdf>
A ssociation of Operative Registered Nurses. AORN Guidance Statement:
Reuse of Single-Use Devices. AORN Journal. 2006 [acesso em 9 set.
;84(5):876-84. Disponível em: <http://www.ascquality.org/Library/
singleusedevicereprocessingtoolkit/AORN%20Guidance%20Statement%20
on%20Reuse%20of%20Single%20Use%20Devices%202006.pdf>
Razak S, Yee R. Medical device reuse: the return of Robin Hood? Heart
Rhythm. 2010;7(11):1628-29. DOI: 10.1016/j.hrthm.2010.09.014
Graziano KU. Considerações sobre uso de detergente enzimáticos
no processo de limpeza: revisão de literatura. Rev SOBECC.
;7(4):18-21.
Centers for Disease Control and Prevention. Guideline for disinfection
and sterilization in health-care facilities. Atlanta: CDC; 2008 [acesso
em 1.º ago. 2016]. Disponível em: <https://www.cdc.gov/hai/pdfs/
disinfection_nov_2008.pdf>
Shoemake S, Stoessel K. Cleaning Reusable Medical Devices: a
Critical First Step. Clinical Issue. 2007 [acesso em 8 set. 2016]:11.
Disponível em: <http://pt.halyardhealth.com/media/1514/cleaning_
reusable_devices.pdf>
International Association for Soaps, Detergents, and Maintenance
Products. Guidelines on the implementation of the Detergents
Regulation. 2013 [acesso em 10 ago. 2016];2. Disponível em:
www.aise.eu/cust/documentrequest.aspx?DocID=234>
A ssociation of Operative Registered Nurses. Guideline Summary:
Cleaning and Care of Surgical Instruments. AORN Journal.
;101(5):553-7. DOI: http://dx.doi.org/10.1016/j.aorn.2015.01.001
Brasil. Ministério da Saúde. Agência Nacional de Vigilância Sanitária.
Informe técnico n.º 01/09 – Princípios Básicos para Limpeza de
Instrumental Cirúrgico em Serviços de Saúde. Brasília, fev. 2009
[acesso em 1.º ago. 2016]. Disponível em: <http://www.anvisa.gov.
br/servicosaude/controle/alertas/2009/informe_tecnico_1.pdf>
Root CW, Kaiser N, Antonucci C. What, how and why: enzymatic
instrument cleaning products in healthcare environments. Healthcare
Purchasing News. 2008 [acesso em 27 ago. 2016]:50-4. Disponível
em: <http://www.hpnonline.com/ce/pdfs/0811cetest.pdf>
Beilenhoff U, Neumann CS, Rey JF, Biering H, Blum R, Cimbro M, et
al. ESGE-ESGENA guideline: cleaning and disinfect in gastrointestinal
endoscopy. Endoscopy. 2008;40(11):939-57.
Brasil. Ministério da Saúde. Resolução da Diretoria Colegiada (RDC)
n.º 55, de 14 de novembro de 2012. Dispõe sobre os detergentes
enzimáticos de uso restrito em estabelecimentos de assistência
à saúde com indicação para limpeza de dispositivos médicos e dá
outras providências. Diário Oficial da União. 2012 [acesso em 1.º ago.
. Disponível em: <http://bvsms.saude.gov.br/bvs/saudelegis/
anvisa/2012/rdc0055_14_11_2012.pdf>
Society of Gastroenterology Nurses and Associates. Standards
of Infection Control in Reprocessing of Flexible Gastrointestinal
Endoscopes. 2012 [acesso em 14 mar. 2017]. Disponível em:
www.sgna.org/Portals/0/Education/PDF/Standards-Guidelines/
sgna_stand_of_infection_control_0812_FINAL .pdf
Pfiedler Enterprise. The Role of Detergents and Disinfectants in
Instrument Cleaning and Reprocessing. 2014 [acesso em 5 ago.
. Disponível em: http://www.pfiedler.com/ast/1196a/files/
assets/common/downloads/The%20Role%20of%20Detergents%20
and%20Disinfectants%20in%20Instrument%20Cleaning%20and%20
Reprocessing%20-%20AST.pdf
Mendes KDS, Silveira RCCP, Galvão CM. Revisão integrativa: método
de pesquisa para a incorporação de evidências na saúde e na
enfermagem. Texto Contexto Enferm. 2008;17(4):758‑64.
Zuhlsdorf B, Floss H, Martiny H. Cleaning efficacy of nine different
cleaners in a washer-disinfector designed for flexible endoscopes.
J Hosp Infect. 2002;52(3):206-11. DOI: 10.1053/jhin.2002.1284
Zuhlsdorf B, Floss H, Martiny H. Efficacy of 10 different cleaning
processes in a washer–disinfector for flexible endoscopes. J Hosp
Infect. 2004;56(4):305-11. DOI: 10.1016/j.jhin.2004.01.001
A ssociation of Surgical Technologists. Standards of Practice for the
Decontamination of Surgical Instruments. 2009 [acesso em 6 ago. 2016].
Disponível em: http://www.ast.org/uploadedFiles/Main_Site/Content/
About_Us/Standard_Decontamination_%20Surgical_Instruments_.pdf
Hutchisson B, Leblanc C. The Truth and Consequences of Enzymatic
Detergents. Gastroenterol Nurs. 2005;28(5):372-6.
Roboz Surgical Instrument. Cleaning, Sterilization & Maintenance of
Surgical Instruments. 165-66. [acesso em 6 ago. 2016]. Disponível
em: http://www.roboz.com/catalog%20pdfs/sterilization_and_
maintenance.pdf
Sharn Inc. Anesthesia. Official Guide: Maintaining & Cleaning Surgical
Instruments. 2009 [acesso em 6 ago. 2016]. Disponível em: http://
www.sharn.com/images/art/Maintaining-and-Cleaning-Surgical-
Instruments.pdf
Olsen HS, Falholt P. The Role of Enzymes in Modern Detergency. J
Surfact Deterg. 1998;1(4):555-67. DOI: 10.1007/s11743-998-0058-7
American Society for Gastrointestinal Endoscopy. Multisociety
guideline on reprocessing flexible gastrointestinal endoscopes: 2011.
Gastrointestinal Endoscopy. 2011 [acesso em 16 set. 2016];73(6).
Disponível em: https://www.sgna.org/Portals/0/Education/PDF/
Standards-Guidelines/10_multisocietyguideline_2011.pdf
Mariano SFM, Santos AL , Ueda M, Oliveira RM. Análise das propriedades
superficiais do aço inoxidável ABNT 304 modificado por implantação
iônica por imersão em plasma de nitrogênio em alta temperatura.
Rev Bras Aplicações Vácuo. 2011 [acesso em 15 set. 2016];30(1-
:24-9. Disponível em: http://www.sbvacuo.org.br/rbav/index.php/
rbav/article/view/955
Buss GAM, Donath KS, Vicente MG. Utilização de aços inoxidáveis em
implantes. Boletim Informativo de Tecnovigilância, Brasília, Número
Especial, dez. 2011 [acesso em 6 mar. 2017]. Disponível em: http://www.
anvisa.gov.br/boletim_tecno/boletim_tecno_dezembro_ed_especial/
PDF/1-Utiliza%E7%E3o%20de%20a%E7os%20inoxid%E1veis%20
em%20implantes.pdf
Smith WG, McNeil J, Ramage G, Smith AJ. In vitro evaluation of
cleaning efficacy of detergents recommended for use on dental
instruments. Am J Infect Control. 2012;40(9):255-9. DOI: 10.1016/j.
ajic.2012.05.009
Johnson M. Protein Quantitation. Materials and Methods. 2012 [acesso
em 14 mar. 2017];2:115. Disponível em: https://www.labome.com/
method/Protein-Quantitation.html
Dr. Weigert. Demonstrando a Eficácia de Limpeza de Diferentes Tipos
de Detergentes para Limpeza Manual de Dispositivos Médicos. 2005
[acesso em 3 set. 2016]. Disponível em: http://www.humansp.med.
br/arquivos_dados/foto_alta/foto-educa-id-33.pdf
Kauffman M, Joseph C. Ultrasonic cleaning in the healthcare setting.
Healthcare Purchasing News. 2011 [acesso em 10 set. 2016]. Disponível
em: http://www.hpnonline.com/ce/pdfs/1101cestest.pdf
L abnews Soluções de Limpeza e Desinfecção [Internet]. Detergente
alcalino. 2013 [acesso em 5 set. 2016]. Disponível em: http://www.
labnews.ind.br/produtos/detergente-alcalino.html
A lfa MJ, Olson N, Al-Fadhaly A. Cleaning efficacy of medical device
washers in North American healthcare facilities. J Hosp Infect.
;74(2):168-77. DOI: 10.1016/j.jhin.2009.06.030
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