Method of Cleaning Medical Instrument and Apparatus Therefor
The present invention relates to a method of cleaning a medical instrument to which a body fluid adheres and an apparatus therefor.
Generally, in a large hospital having 200 to 300 or more beds, medical instruments used in surgical operations or treatments are all carried to a room called a central supply room and they are cleaned for removing such a body fluid as adhering blood. Thereafter, the medical instruments are subjected to disinfection and sterilization treatment so that they can be re-used. Though the number of medical instruments used is different depending on operation or treatment details, an amount of use thereof is great in a large hospital and medical instruments variously different in shape are used. Therefore, cleaning of medical instruments has been automated, with a large-sized cleaning machine being used instead of hand-washing. In a medium- or small-sized hospital having 200 or less beds, actually, there is a case where, rather than a large-sized cleaning machine as in a large hospital, a medium- or small-sized cleaning machine or a household dishwasher has been introduced and used, and there is also a case where medical instruments are hand-washed with the use of toothbrushes or the like.
In privately owned dental clinics, although depending on the number of patients in a day, about 100 rod-shaped dental instruments such as a scaler and a cementation instrument on average are used every day and they are cleaned each time of use. With this scale of use of medical instruments, since those medical instruments can be hand-washed with the use of toothbrushes as in a small-sized hospital, there are few cases where a cleaning machine has been introduced.
There is a report that, in spite of utmost attention, hand-washing of medical instruments after surgical operations or treatments as such has sometimes led to injuries involving blooding due to a sharp medical instrument or a pointed medical instrument, which resulted in unintended infection due to pathogenic bacteria or infectious viruses. There is also a report example that, depending on skills or physical conditions of a person in charge of hand-washing, cleanliness of cleaned medical instruments varies.
Therefore, cleaning of medical instruments including also dental instruments with the use of a cleaning machine can be regarded as very useful in terms of safety and uniformity in cleaning.
In the case of cleaning with a cleaning machine, however, depending on the number and an amount of medical instruments and how to place and arrange the medical instruments, cleanliness of cleaned medical instruments varies. Unless blood or saliva is visually recognized on cleaned medical instruments, they are determined as having been cleaned, however, pathogenic bacteria or infectious viruses may remain. Therefore, even in a hospital where a cleaning machine has been introduced, it is expected that unintended infection attributed to cleaned medical instruments occurs due to insufficient cleaning.
In addition, blood or saliva which has adhered to a used medical instrument has been known to solidify over time and removal thereof is assumed as difficult. In order to remove such solidified blood or saliva, a cleaning method making use of such a physical action as jet blast or ultrasonic vibration, a cleaning method making use of a chemical action of a dedicated cleaning solution composed of an alkali drug solution, a surfactant solution, a surface modifier solution, or other organic agent solutions, or a cleaning method combining these is applied to a recent medical instrument cleaning machine.
For example, Japanese Patent Laying-Open No. 2002-355624 (PTL 1) discloses a cleaning apparatus, in which an object to be cleaned is cleaned by injection of a cleaning solution from an injection nozzle, thereafter the cleaning solution is stored in a cleaning tank, the object to be cleaned is immersed in the cleaning solution, and thereafter the object to be cleaned is subjected to ultrasonic cleaning. Even with the cleaning apparatus disclosed in PTL 1 as such, however, in order to remove blood or saliva which has adhered to a medical instrument as being solidified, a time period for cleaning long to some extent is required.
PTL 1: Japanese Patent Laying-Open No. 2002-355624
The present invention was made to solve the problems above, and an object thereof is to provide a cleaning method and a cleaning apparatus which are capable of removing blood or saliva effectively in a short period of time and capable of eliminating as much as possible variation in cleanliness of a cleaned instrument caused by the number or an amount of instruments placed in a cleaning machine or placement and arrangement thereof, in connection with medical instruments which were used in surgical operations or treatments and to which blood or saliva solidified after having been left for a long time adheres, which is considered as difficult to remove.
The present invention relates to a method of cleaning a medical instrument, in which a medical instrument to which a body fluid adheres is subjected to ultrasonic cleaning in a cleaning solution in which chlorine dioxide is dissolved.
In the cleaning method according to the present invention, preferably, the medical instrument to which the body fluid adheres is immersed in the cleaning solution after oscillation of ultrasonic waves in the cleaning solution contained in a cleaning tank.
In the cleaning method according to the present invention, preferably, chlorine dioxide dissolved in the cleaning solution is generated by mixing at least a chlorite aqueous solution and an activator.
In the cleaning method according to the present invention, preferably, a concentration of chlorine dioxide dissolved in the cleaning solution is raised after immersion of the medical instrument to which the body fluid adheres, and in this case, more preferably, the concentration of chlorine dioxide dissolved in the cleaning solution at the time point of immersion of the medical instrument to which the body fluid adheres is as close to 0 as possible.
The present invention also provides a cleaning apparatus for subjecting a medical instrument to which a body fluid adheres to ultrasonic cleaning in a cleaning solution in which chlorine dioxide is dissolved, which includes a cleaning tank constructed to be capable of ultrasonic cleaning, a mixing portion for generating the cleaning solution in which chlorine dioxide is dissolved, a first pipe for supplying the cleaning solution to the cleaning tank from the mixing portion, and a second pipe for supplying water to the cleaning tank, the cleaning apparatus being constructed to dilute the cleaning solution supplied from the mixing portion through the first pipe with water supplied through the second pipe such that a prescribed concentration of chlorine dioxide dissolved in the cleaning solution is attained in the cleaning tank.
According to the present invention, a method of cleaning a medical instrument and a cleaning apparatus therefor capable of removing such a body fluid as blood or saliva from a large number of medical instruments more quickly than in a conventional case of using an alkaline cleaning agent or a neutral cleaning agent common in cleaning of medical instruments and achieving also a remaining amount thereof equal to or less than the amount in the conventional case can be provided.
<Method of Cleaning Medical Instrument>
The method of cleaning a medical instrument according to the present invention is characterized by subjecting a medical instrument to which a body fluid adheres to ultrasonic cleaning in a cleaning solution in which chlorine dioxide is dissolved. The cleaning solution used in the present invention, in which chlorine dioxide is dissolved, is, for example, an aqueous solution in which chlorine dioxide called stabilized chlorine dioxide or the like is dissolved. The cleaning solution is often used in such an application as killing bacteria or viruses which adhere to medical instruments represented by an endoscope or the like having a shape complicated and difficult to clean, vegetables, fruits, fish, meat, and shells, or which are contained in water in hot springs or pools or in drinking water, that is, an application for the purpose of disinfection and sterilization, and many inventions in connection therewith have been made.
On the other hand, what is initially clarified is that the present invention is an invention of a method and an apparatus for cleaning a medical instrument which is cleaned after use in surgical operations or treatments and repeatedly used after disinfection and sterilization, but it does not mention disinfection and sterilization of medical instruments as described above.
Here, examples of “medical instruments” in the present invention include a surgical knife, a clamp, forceps, scissors, a needle, a needle holder, a retractor, a pus basin, and the like, and also encompasses such dental instruments as a scaler, a mirror, gum scissors, a sharp spoon, dental extracting forceps, an elevator, an excavator, an explorer, a plugger, and the like.
In addition, the “body fluid” which adheres to a medical instrument in the present invention refers, for example, to a liquid generated in a living body such as blood, lymph, and saliva.
According to the method of cleaning a medical instrument in the present invention, in which a medical instrument to which a body fluid adheres is subjected to ultrasonic cleaning in a cleaning solution in which chlorine dioxide is dissolved, such a body fluid as blood or saliva can be removed from a large number of medical instruments more quickly than in a conventional case of using an alkaline cleaning agent or a neutral cleaning agent common in cleaning of medical instruments and a remaining amount thereof can also be equal to or less than the amount in the conventional case.
In the cleaning method according to the present invention, preferably, the medical instrument to which the body fluid adheres is immersed in the cleaning solution after oscillation of ultrasonic waves in the cleaning solution contained in a cleaning tank. By doing so, as compared with a case where ultrasonic waves are oscillated after immersion of the medical instrument to which the body fluid adheres in the cleaning solution, advantageously, sticking of the body fluid to the medical instrument due to denaturation of protein which is a constituent element of the body fluid can be prevented and the body fluid is readily removed.
In the cleaning method according to the present invention, a frequency of ultrasonic vibration used is not particularly restricted because an effect is exhibited also in a frequency band from 5 kHz to 100 kHz as will be described later in an experimental example. In an ultrasonic oscillation apparatus represented, for example, by an ultrasonic cleaning machine for cleaning precision components, however, there are a large number of real accomplishments in adjustment of a high-frequency electric circuit for ultrasonic wave oscillation and ultrasonic waves can efficiently be transmitted to the body fluid. Therefore, a frequency band from 28 to 45 kHz is preferred.
A method of generating chlorine dioxide dissolved in the cleaning solution used in the present invention is not particularly limited, and for example, a method of generation by dissolving a gas supplied from a chlorine dioxide generation apparatus in water, a method of mixing at least a chlorite aqueous solution and an activator, and the like are exemplified. In the case of handling of a gas, however, adjustment of a concentration is difficult and the gas may be explosive depending on a concentration thereof. Therefore, chlorine dioxide is preferably generated with the method of mixing at least a chlorite aqueous solution and an activator.
In the present invention, examples of chlorites in a chlorite aqueous solution used for generation of chlorine dioxide include sodium chlorite, potassium chlorite, barium chlorite, magnesium chlorite, and the like. Since a concentration achieved of an aqueous solution in which chlorine dioxide is dissolved after mixing with an activator has substantially already been known, sodium chlorite is preferred.
In the present invention, a concentration of a chlorite aqueous solution should be adjusted such that a concentration of chlorine dioxide dissolved in an activated solution mixed with an activator attains to a defined value. In the case of setting a concentration of chlorine dioxide dissolved in a solution mixed with an activator to 20000 ppm, for example, if a chlorite aqueous solution is a sodium chlorite aqueous solution, a concentration of that aqueous solution is preferably in a range from 3 to 5%.
An activator used for generation of chlorine dioxide in the present invention means a drug having such a property that chlorine dioxide is liberated in a solution at the time when it is mixed with a chlorite aqueous solution to thereby generate an aqueous solution in which chlorine dioxide is dissolved, and for example, an organic acid represented by citric acid for adjusting pH, an inorganic acid represented by hydrochloric acid, alcohols represented by ethyl alcohol, and the like are exemplified.
Among these, with importance being placed on safety in handling, citric acid or a citric acid aqueous solution is preferably employed as an activator. In the case of using the citric acid aqueous solution as the activator, a low concentration thereof leads to a longer time required for activation, and a high concentration thereof leads to concern about re-precipitation of citric acid in a solution. Therefore, a concentration thereof is preferably within a range from 10 to 50%.
Though a ratio of mixing of a chlorite aqueous solution and an activator for generation of chlorine dioxide is not particularly restricted, for example, in the case of using a citric acid aqueous solution at a concentration of 50% as an activator with respect to 3 to 5% sodium chlorite aqueous solution, a ratio of mixing in volume is preferably within a range from 1:10 to 1:2 and more preferably within a range from 1:3 to 1:2. When a volume of a citric acid aqueous solution at a concentration of 50% is lower than a ratio of mixing in volume of 1:10, a concentration of chlorine dioxide dissolved after activation tends to be lower than a defined value. On the other hand, when a volume of the citric acid aqueous solution at a concentration of 50% is higher than a ratio of mixing in volume of 1:2, expectations that a time required for activation and a defined value for a concentration of chlorine dioxide dissolved after activation will change do not tend to be met.
In the present invention, in order to stabilize a concentration of chlorine dioxide which is liberated in water, a stabilizer is preferably added in advance to the chlorite aqueous solution used in generating chlorine dioxide. Examples of the stabilizers include 2Na2CO3.3H2O2, NaHCO3, NaBO3, and the like.
In the cleaning method according to the present invention, preferably, after the medical instrument to which the body fluid adheres is immersed, a concentration of chlorine dioxide dissolved in the cleaning solution is raised. As will be described later in Experimental Example 2, when a concentration of chlorine dioxide dissolved in a cleaning solution is too high, chlorine dioxide is highly oxidative. In such a case that a body fluid which adheres to a medical instrument is blood, protein components in the blood is denatured and it becomes difficult to remove the blood. Alternatively, when a concentration of chlorine dioxide dissolved in a cleaning solution is too low, there is also a possibility that a time period for cleaning necessary for sufficiently removing a body fluid which adheres to a medical instrument becomes long. Therefore, in the cleaning method according to the present invention, preferably, a medical instrument to which a body fluid adheres is immersed in a cleaning solution where a concentration of dissolved chlorine dioxide is low and thereafter the concentration of chlorine dioxide is raised, so that a time for cleaning can be shortened without denaturation of protein components in the blood. In this case, since denaturation of protein components in the blood leads to sticking of the blood to a medical instrument and removal thereof is difficult, a concentration of chlorine dioxide dissolved in a cleaning solution at the time point of immersion of the medical instrument to which the body fluid adheres is particularly preferably as close to 0 (zero) as possible.
It is noted that medical instruments used in surgical operations or treatments are various and shapes thereof range from a simple shape to a complicated shape such as a shape of a clamp. In particular, it is recognized that it takes time to remove blood or saliva which has entered a very narrow gap seen in a clamp or the like, and it has been known that cleaning is insufficient in some cases even after cleaning with a commercially available cleaning machine with the use of a general cleaning agent. As will be described later in Experimental Example 2, the cleaning method according to the present invention exhibits a cleaning effect also in various instruments having such a complicated shape.
<Apparatus for Cleaning Medical Instrument>
Here,
In the example shown in
In the example shown in
In addition,
Then,
In the state shown in
Since water supplied into cleaning tank 2 in
Then,
Though the present invention will be described in further detail with reference to experimental examples below, the present invention is not limited thereto.
Here,
In the experiment in each of
As shown in
Furthermore, it was found from the results shown in Table 1 that a lower dilution factor led to a higher cleaning effect in the cleaning method according to the present invention, because the time for complete removal of blood mimicking fluid 102 was longer with solution B than with solution A and longer with solution C than with solution B in the experiment shown in
Moreover, in the experiment shown in
In addition, a higher dilution factor of a cleaning solution in which chlorine dioxide is dissolved leads to a longer time required for cleaning. Therefore, in the case of cleaning away of blood mimicking fluid 102 which has entered gap G as shown in
It should be understood that the embodiments and the experimental examples disclosed herein are illustrative and non-restrictive in every respect. The scope of the present invention is defined by the terms of the claims, rather than the description above, and is intended to include any modifications within the scope and meaning equivalent to the terms of the claims.
1 cleaning apparatus; 2 cleaning tank; 3 mixing portion; 4 first pipe; 5 second pipe; 6 delivery metering pump; 7 drainage pipe; 8 water; 9 cleaning solution in which chlorine dioxide is dissolved; 10 clamp; 100 sample to be cleaned; 101 stainless plate; 102 blood mimicking fluid; 200 cleaning solution in which chlorine dioxide is dissolved; 300 ultrasonic cleaning machine; and 400 clamp.
Number | Date | Country | Kind |
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2010-262452 | Nov 2010 | JP | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/JP2011/070730 | 9/12/2011 | WO | 00 | 4/1/2013 |