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7 6 O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | F E B R U A R Y 2 0 1 4 Background on biofilm Biofilm buildup can be especially common in flexible endoscopes. Even if reprocessing techs follow proper cleaning and disinfection protocols, subsequent storage with moisture in the channels can still lead to biofilm. Keeping internal channels clear of bacteria is impor- tant and requires attention to cleaning, disinfection and dry storage. Transmission rates of bacteria in flexible endoscopes are fairly high: Between 40% and 50% of patients treated with contaminated scopes will become colonized. The colonizing organisms may not cause infec- tions immediately, but because the bacteria are antibiotic resistant, they'll be the "last bugs standing" in patients subsequently treated with antibiotics. From a microbiology perspective, an absence of moisture means bacteria can't replicate and biofilm can't form. That's a pivotal point. Flexible endoscopes are supposed to be stored dry. If staff follow proper reprocessing practices and store scopes properly, biofilm won't be an issue. However, the frontline perception of what's considered dry for endo- scopes is not well understood and scopes stored with moisture in their channels are one of the biggest issues endoscopy centers face. After the final rinse, wipe down the exterior of the scopes, as well as the valves and attachments, with a lint-free cloth. Then purge all endo- scope channels with 70% to 80% isopropyl alcohol followed by forced air to ensure channel drying. Finally, hang scopes in storage with the valves removed so the internal channels remain dry. There is no standardized quality assurance program currently in place for endoscope reprocessing. According to the Association for the Advancement of Medical Instrumentation, the level of residual protein and hemoglobin in properly cleaned endoscopes should be <6.4 g/cm 2 and <2.2 g/cm 2 , respectively. C E N T R A L S T E R I L E Copyright ©2013 Ruhof Corporation For More Information and GENEROUS FREE SAMPLES 1-800-537-8463 www.ruhof.com *ISO/TS 15883-5: 2006 - Washer-disinfectors - Part 5: Test soils and methods for demonstrating cleaning efficacy - Annex F (normative) Test soil and method fo flexible endoscopes. (Test results available upon request) Ruhof's new Endozime ® Bio-Clean is the only enzymatic detergent that breaks through the extracellular polymeric layer that encases biofilm allowing for the complete elimination of all bioburden and biofilm by high-level disinfectants. Endozime ® Bio-clean is also the only enzymatic detergent on the market clinically tested to pass ISO 15883 Annex F*. ENDOZIME ® BIO-CLEAN ENDOZIME ® SPONGE ENDOZIME ® SLR PHASE ONE Endoscopy Bedside Care Kit PREPZYME ® PREPZYME ® FOREVER WET ScopeValet™ ECO-BEDSIDE KIT (Eco-Bedside Kit's tray and lid are 100% Biodegradable) OSE_1402_part2_Layout 1 2/6/14 2:58 PM Page 76