Evidence map›Paper›PMID 32909208›Full record

ArticleSurgical endoscopy2021

Assessing organic material on single-use vessel sealing devices: a comparative study of reprocessed and new LigaSure™ devices.

Swathi Ramesh Chivukula, Steven Lammers, Jennifer Wagner

Erratum issuedOpen access · hybridAbstract read
In one paragraph

Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.6field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 6 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Swathi Ramesh ChivukulaDepartment of Bioengineering, University of Colorado Denver | Anschutz Medical Campus, 12705 E. Montview Blvd., Ste. 100, Mail Stop 8607, Aurora, CO, 80045, USA.
Steven LammersDepartment of Bioengineering, University of Colorado Denver | Anschutz Medical Campus, 12705 E. Montview Blvd., Ste. 100, Mail Stop 8607, Aurora, CO, 80045, USA.
Jennifer WagnerDepartment of Bioengineering, University of Colorado Denver | Anschutz Medical Campus, 12705 E. Montview Blvd., Ste. 100, Mail Stop 8607, Aurora, CO, 80045, USA. Jennifer.Wagner@cuanschutz.edu.ORCID http://orcid.org/0000-0002-2835-4981
University of Colorado Denver · USUniversity of Colorado Anschutz Medical Campus · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReprocessed devices must be thoroughly cleaned prior to sterilization to ensure efficacy of sterilization agents. Many single-use devices are not designed to be thoroughly cleaned. Interlocking design features inherent to LigaSure™ vessel sealing devices may prevent thorough cleaning and promote accumulation of human tissue that cannot be removed. Thus, the aim of this study was to compare industry reprocessed and new LigaSure™ vessel sealing devices for organic material.

methodsA total of 168, 84 new and 84 reprocessed, vessel sealing devices were disassembled and inspected for the presence of residual organic matter using visual, microscopic, and chemical analysis. Devices were randomized and test conductors blinded to group membership. Devices were aseptically disassembled and sent through visual inspection. Next, devices were either examined using light microscopy, scanning electron microscopy (SEM) or exposed to a solution that luminesces in the presence of hemoglobin. Additionally, 165 reprocessed devices were sent to a 3rd party lab for sterility testing via direct immersion culture for 14 days.

resultsSignificant amounts of remnant organic material (C, N, O, S, Na, P) were observed with 81/84 reprocessed and 0/84 new devices failing inspection protocols. When tested for the presence of hemoglobin, only 1/12 reprocessed devices passed inspection. SEM of reprocessed devices revealed residues with liquid patterns and diffuse soiling with foreign material. Sterility testing of reprocessed devices revealed a sterility level < 6

conclusionsThe abundance of material resembling human tissue observed on reprocessed VSDs suggests inadequate cleaning prior to sterilization. Atomic and morphological analyses of the remnant materials suggest that bacterial biofilms could also be present. Additionally, surface degradation and release of reinforcing glass fibers from the device were observed. Devices designed for single use can harbor significant amounts of remnant material that likely interfere with the sterilization process.

Indexed as

Equipment ReuseSterilizationHumansMicroscopy, Electron, ScanningSurgical InstrumentsCleaningContaminationDesignDevicesReprocessingSterilization

Identifiers

PMID32909208
PMCPMC8263541
OpenAlexW3086536653

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.