What is pre-cleaning?
Pre-cleaning is the critical first step in preparing medical devices for disinfection. This step involves removing visible soil and organic matter to ensure that the subsequent disinfection process can effectively eliminate microorganisms. Simply put, it is the "pre-disinfection cleaning" phase, where water and a wipe are often sufficient to prepare the device for effective disinfection. For example, UV Smart devices focus on disinfection, so pre-cleaning ensures the equipment is adequately prepared for that process.
The primary purpose of pre-cleaning is to eliminate debris that could block UV light or other disinfection agents fromfully reaching the surface of the device. It is important to note that pre-cleaning is not designed to disinfect but rather to set the stage for successful disinfection.
In some countries, germicidal wipes have traditionally been used for pre-cleaning. However, national guidelines like the SRI Guideline in the Netherlands allow hospitals to use sterile water or water-based cleaning agents if they follow the manufacturer’s instructions, especially for flexible endoscopes. Immediate pre-cleaning is essential to prevent organic material from drying, as this can promote microbial growth and biofilm formation. To maximize effectiveness, pre-cleaning should be performed promptly after a procedure.
Pre-cleaning with water
Water is a simple, cost-effective solution for pre-cleaning. The process involves rinsing or wiping devices to remove debris and biofilm. When pre-cleaning equipment, it is important that you do this in a rotating manner, making sure all debris is removed before starting the disinfection process. Here again, it is important to follow guidelines of the equipment manufacturer.
Advantages of water pre-cleaning include its cost-effectiveness, as water is always available and affordable. It is also non-toxic, free of chemicals that could irritate the skin or damage sensitive devices. Additionally, it is environmentally friendly, reducing reliance on disposable materials like wipes.
Scientific findings
· Multicenter Study Results: Flexible endoscopes pre-cleaned with water and disinfected using UV-C technology (e.g., UV Smart D60) achieved higher contamination-free rates (81.6%) compared to traditional Endoscope Washer Disinfectors (71.4%). Read the study here.
· Microbial Reduction: Manual water pre-cleaning effectively removes debris, allowing UV-C disinfection to achieve significant bacterial reductions that meet or exceed traditional disinfection standards.
· Efficacy and Safety: Studies demonstrate that water-pre-cleaned devices, when disinfected with UV-C systems, achieve comparable microbial reductions to those pre-cleaned with germicidal wipes. Post-cleaning analysis revealed no high-concern pathogens, confirming water’s adequacy in routine clinical use.
· Cost-Effectiveness: Facilities adopting water-based pre-cleaning with UV-C disinfection reported reduced costs and environmental waste, aligning with sustainability goals.
Studies demonstrate that water-pre-cleaned devices, when disinfected with UV-C systems, achievecomparable microbial reductions to those pre-cleaned with germicidal wipes.
Pre-cleaning with germicidal wipes
Pre-cleaning with germicidal wipes involves the use of pre-moistened wipes containing cleaning agents that combine debris removal with antimicrobial action. They are often marketed as a more efficient and comprehensive solution.
The advantages of germicidal wipes include their convenience, as they are ready-to-use and combine cleaning with partial disinfection. They also offer broad-spectrum efficacy, being effective against bacteria, fungi, and viruses. Additionally, single-use wipes reduce the risk of cross-contamination.
However, there are limitations. Germicidal wipes tend to be more expensive compared to water-based methods. Some wipes leave chemical residues that require rinsing, which is particularly important for devices like endoscopes; failure to rinse can cause issues for patients. Furthermore, not all devices are compatible with the chemicals used in these wipes.
Conclusion
Pre-cleaning is a vital first step in ensuring effective disinfection of medical devices. By removing visible debris and organic matter, it prepares devices for thorough disinfection, such as UV-C technology, which relies on clear access to surfaces. Evidence supports the useof water-based pre-cleaning as a cost-effective, sustainable, and efficient method, aligning with national guidelines like the SRI Guideline, which permit the use of sterile water or water-based cleaning agents.
While germicidal wipes may offer convenience inspecific situations, such as when water is unavailable, they are not always necessary. Water-based methods, when performed promptly and according to manufacturer guidelines, are sufficient to meet the requirements for effective disinfection. This approach aligns with modern healthcare’s goals of improving efficiency, reducing environmental impact, and ensuring patient safety
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