Storage study of medical devices in Alkazyme® after use during the weekend

B. Hosten, N. Sut, B. Besnard, G. Nicolaos, A. Fabreguettes

Department of Pharmacy-Sterilization, Robert Ballanger Hospital Centre, 93602, Aulnay Sous Bois

INTRODUCTION
Predisinfection is the first step in the sterilization process. It
removes, kills or inhibits the micro-organisms present at that
time (AFNOR NFT 72-101). It must be performed
immediately after the use of the MD to reduce the initial load
and prevent the drying of soil
PURPOSE
As our central sterilization unit is closed on Sundays,
instruments are immersed in a pre-disinfectant (Alkazyme®,
Alkapharm) for 24 to 48 hours during the weekend. In order to
rationalise the immersion of Class I medical devices and
assess our practices, we compared the corrosion of these
instruments after immersion in Alkazyme® or water.

METHOD
Instruments Method of evaluation of corrosion
Four experimental groups were evaluated: service quality The following immersion times were tested: 20 minutes, 12h,
instruments immersed in Alkazyme® or water and operating 24h, 48h, and 7 days. Each immersion time was repeated 3
room quality instruments immersed in Alkazyme® or water. times. The pH and total water hardness (TH) were measured at
Instruments from the same group were immersed in the same each immersion. Corrosion was evaluated both
bath. Service quality groups comprised 7 instruments: scalpel macroscopically and microscopically and classified as
handle, scissors, artery forceps, needle holder, nasal follows: 1: low corrosion, 2: moderate corrosion; 3: high
speculum, curette and dissecting forceps. Operating room corrosion.
quality groups had the same composition with an additional
instrument, a gouge chisel. A comparison of 2 groups of
operating room quality was also made with new instruments

RESULTS / DISCUSSION
Colonne Gauche

Occurrence of corrosion on used service quality instruments soaked in water

Degree of corrosion 1a

scalpel handle, scissors, artery forceps, needle holder, retractor, curette and dissecting forceps
instruments

Legend for all histograms → 20 min 12 h 24 h 48 h 7 days

Degree of corrosion 1b

scalpel handle, scissors, artery forceps, needle holder, retractor, curette and dissecting forceps
instruments

Figure 1: Corrosion of used service quality instruments in water 1a and in Alkazyme® 1b. Low (1); moderate (2); high (3).

The results of this study show that:
/ for service quality instruments immersed in water, 4 out of 7 instruments developed
moderate (2) to high (3) corrosion at 24 h,/ for service quality instruments immersed in Alkazyme ®, a single instrument
developed low corrosion (1) from 24h but no alteration of the instruments was observed at D7.

20min 12h 24h 48h 7 days

TH Alkazyme 0 0 0 0 0
TH Water 8 30;16; 8 30;8;16 10;8;10 8;28;10

Figure 3: monitoring the of total hardness of the predisinfectant (used instruments)

 20min 12h 24h 48h 7 days
TH Alkazyme 0 0 0 0 0
TH Water 26 16;24;22 32;26;24 22;20;22 22;30;24

Figure 4: Monitoring of total hardness of predisinfectant (new instruments)

Monitoring of TH and pH showed that the water was softer and more alkaline in the Alkazyme® groups (TH = 0; pH = 10 for
the Alkazyme® group and TH between 7 and 30 and pH = 7 for the water group), which may explain the lower corrosion in
this group.

Colonne Droite
Occurrence of corrosion on used operating room quality instruments soaked in water

Occurrence of corrosion on used operating room quality instruments soaked in Alkazyme

Degree of corrosion

scalpel handle, scissors artery forceps needle holder retractor curette dissecting forceps gouge
instruments

2a 2b

Figure 2: Corrosion of used operating room quality instruments in water 2a and in Alkazyme® 2b

For used operating room quality instruments immersed in water, 6 out of 8 instruments developed moderate (2) to high (3)
corrosion at 24 hours whereas for operating room quality instruments immersed in Alkazyme ®, a single instrument developed
high corrosion (3) from 24 hours, and two low corrosion (1) at 24 hours, but nothing at D7.

Occurrence of corrosion on used operating room quality instruments immersed in water

Degree of corrosion No corrosion for new instruments immersed in Alkazyme

scalpel handle, scissors artery forceps needle holder retractor curette dissecting forceps gouge
instruments

5a 5b

Figure 5: Corrosion of new operating room quality instruments in water 5a and in Alkazyme® 5b

For new operating room quality instruments soaked in water, 2 instruments out of 8 had low corrosion (1) from 12 h and 3
instruments had low (1) to moderate (2) corrosion from 48h. New operating room quality instruments immersed in Alkazyme®
showed no corrosion even after 7 days of immersion.

CONCLUSION
1. Our study showed that the corrosion of used instruments immersed in Alkazyme ® is low. These results support our practice
of keeping instruments immersed in pre-disinfectant after use, rather than recommending that they are rinsed with water and
dried (this step is never optimal) or even stored in water. Water in fact causes significant corrosion of the instruments and
therefore accelerates their deterioration.
2. The results obtained with new instruments were even more in favour of soaking them in Alkazyme® rather than in water,
and this difference persisted for an immersion time of up to 7 days.
3. The softening of water probably explains this reduced corrosion of instruments immersed in Alkazyme®.
.