DE202012002701U1 - Device for rinsing surgical instruments - Google Patents

Abstract

Device for treating surgical instruments, which is suitable for carrying out a flushing process in which: the said surgical instruments are placed in a basket (1), - the said basket (1) is accommodated in a basin (2), - the said The basin is equipped with a drain (4) with a controlled opening, and which comprises the following steps: S1) spraying (3A, 3B) said rinsing liquid sprayed into said basin (2) up to a predetermined level, said predetermined level The status is such that he wets and preferably floods the surgical instruments mentioned in the basket (1), and S3) drains (4) the accumulated rinsing liquid; the device comprising: - a basket (1) suitable for holding surgical instruments, - a basin (2) suitable for accommodating said basket (1), - a ...

Description

FIELD OF THE INVENTION

The present invention relates to a device for carrying out a method for rinsing surgical instruments.

STATE OF THE ART

Surgical instrumentation currently includes single-use (and therefore disposable) instruments and those that are to be re-used for repeated use in separate surgical operations (or therapeutic treatments) intended for different patients; These surgical instruments include the real, so-called "surgical tool".

The present invention has been specifically devised to deal with undrawn, especially so-called "surgical tools".

As already known, the surgical instruments intended for reuse must be handled carefully between one particular application (for example, on a first patient) and a subsequent (for example, second) patient.

The complete treatment of surgical instruments, in particular those for dental purposes, from the completion of a medical operation in a first operation to the beginning of a second, subsequent surgery, involves the following phases:
FA) Primary decontamination,
FB) cleaning,
FC) drying,
FD) packaging,
FE) sterilization,
FF) Storage.

Each of these phases must be carried out carefully to meet the demands placed on the surgical instruments during surgical operations or therapeutic treatments.

Primary decontamination (Phase FA) should be performed immediately after use on a patient; the instruments should be dipped in a disinfecting solution of well-known activity against bacteria and viruses (in particular of the HIV species) in order to reduce the potential for infection of the personnel and the bacterial and viral load on the instruments; as a result, the instruments are typically rinsed off by hand (for example, by a flow water rinse) to remove remnants of the disinfectant from the instruments.

The cleaning (phase FB) is generally carried out by ultrasonic treatment in order to be particularly effective: the instruments are immersed in a (cold or preferably warm) detergent solution and subjected to ultrasound irradiation; Furthermore, the instruments are typically rinsed to remove the remains of detergent and dirt from the instruments.

The drying phase (FC phase) can take place via a contact (and a possible abrasion) with drying (of course not contaminating) materials; the care of drying is essential in order not to impair the effectiveness of the sterilization (Phase FE); small residual drops of water on the instruments could actually prevent even a small part of any instrument from reaching the high temperature intended for sterilization (typically 134 ° C); Thereafter, the instruments are typically inspected by visual inspection to provide macroscopic evidence of their integrity and cleanliness.

The packaging (phase FD) provides that each instrument is inserted into its shell and that it is then sealed (typically by thermal means); the purpose of the package is to allow the instrument to remain in place until the moment it is used on a patient, i. H. to keep the opening of the packaging sterile; the package, after being sealed, is such as to allow the introduction of a sterilizing agent to contact the instrument.

The sterilization (phase FE) is typically done in a pressure vessel with high pressure steam, typically 134 ° C) for a certain period of time, typically 4 minutes; After packing, the instruments are introduced into the pressure vessel.

The storage (phase FF) provides for storage of the packaged and sterilized instruments, for example in cupboards or drawers, possibly in a closed and clean room, so as not to impair the antimicrobial barrier provided by the packaging.

SUMMARY

The present invention sets out to improve the cleaning phase, in particular the rinsing of the surgical instruments after the actual cleaning: the exemplary embodiment which follows, however, is a device, which is intended for an advantageous implementation of the entire cleaning phase (phase FB) and drying phase (phase FC).

As already mentioned, the rinse is typically done by hand under running water.

• – eine gute Spülung ist nur schwer vorzunehmen,
• – Für die Durchführung einer guten Spülung (d. h. sämtlicher Oberflächen der Instrumente) ist eine Handhabung der Instrumente erforderlich, woraus sich das Risiko einer Selbstverletzung mit den Instrumenten ergibt, wenn diese noch nicht sterilisiert worden sind.
• – In der Durchführung einer guten Spülung tritt ein erheblicher Wasserverbrauch auf.

This handling has three basic disadvantages:

• - a good conditioner is difficult to apply
• - Performing a good irrigation (ie all surfaces of the instruments) requires handling of the instruments, with the risk of self-injury with the instruments if they have not yet been sterilized.
• - In the implementation of a good flushing occurs a significant water consumption.

The general purpose of the present invention is to overcome the disadvantages of the prior art.

These and other objects are achieved by a device which conforms to the features set forth in the appended claims, which form a unitary part of the present specification.

The concept on which the present invention is based is to carry out the rinsing, in particular directly in the basket and in the basin of the cleaning, thus typically with an ultrasound treatment, in an automatic manner.

In general, the surgical instruments are sprayed with a rinsing liquid, the rinsing liquid is collected in a basin to a predetermined level, the predetermined level is adjusted so that it wets and preferably flooded the surgical instruments, and the accumulated rinsing liquid is finally discharged. In a very advantageous manner, the existing in the basin level can be detected by a preferably connected to the drain of the basin itself level sensor.

According to a second innovation aspect, which can be favorably combined with the first innovation aspect mentioned above, the present invention takes an improvement of the drying phase.

As already mentioned, this drying is typically carried out manually, via a contact and a possible abrasion with drying substances.

• – eine gute Trocknung ist nur schwer vorzunehmen,
• – Zur Ausführung einer guten Trocknung (d. h. sämtlicher Instrument-Oberflächen) ist eine Handhabung der Instrumente erforderlich, woraus sich das Risiko einer Selbstverletzung mit den Instrumenten ergibt, wenn diese noch nicht sterilisiert worden sind.

This procedure basically has two disadvantages:

• - good drying is difficult to do,
• - To perform a good drying (ie all instrument surfaces) it is necessary to handle the instruments, which results in a risk of self-injury with the instruments if they have not yet been sterilized.

It has therefore taken the idea to carry out the drying in an automatic manner.

The drying is done in particular by means of a gas flow, in addition, the instruments, before exposure to the gas stream, wetted with a warm drying liquid.

The drying takes place in particular by leaving the instruments in the basket and basin in which the rinsing has been carried out after the ultrasonic cleaning.

BRIEF DESCRIPTION OF THE DRAWINGS

The technical characteristics of the present invention and its advantages will become clear from the following description, taken together with the accompanying drawings, in which:

a partially cutaway perspective view of a basin and a basket of an embodiment of the device according to the present invention,

a first partially sectioned perspective view of a basin and a lid of an embodiment of the present invention shows, and

a second partially sectioned perspective view of a basin and a lid of an embodiment according to the present invention shows.

DETAILED DESCRIPTION OF THE DRAWINGS

Be it this description it is the drawings are for informative and therefore non-limiting purposes, d. H. The present invention can also be realized according to other and different embodiments.

It should be noted that . and and the following description relate to one and the same embodiment.

The device described here carries out all intended treatments (rinsing, rinsing, and drying) in the basket 1 in a basin 2 inserted surgical instruments through without a displacement or handling of these instruments and / or this basket is required. It is of course desirable that the surgical instruments in the basket 1 be placed in a regular and orderly manner to make the treatments as effective as possible.

For purely persistent purposes, here are some pointers about the possible dimensions of the basket 1 and the pelvis 2 offered; the flanks of the basket 1 (which basically those of the Beck 2 20-30 cm × 25-35 cm, the depth of the basket is 3-6 cm and the depth of the pelvis 12-18 cm, so that the distance between the bottom of the pelvis 2 and the bottom of the basket 1 is about 4-6 cm.

• – Zunächst eine Ultraschallreinigung mit einer wässerigen, warmen Waschmittellösung,
• – Alsdann eine Spülung mit wiederholter Besprühung mit Wasser und Ansammlung,
• – Letztlich eine Trocknung in einem warmen Wasserbad mit anschließender Luftventilierung.

In summary, the device described here is capable of performing the following:

• - First an ultrasonic cleaning with an aqueous, warm detergent solution,
• - then a rinse with repeated spraying with water and accumulation,
• - Finally, a drying in a warm water bath with subsequent air ventilation.

This unification of the treatment phases is very convenient and advantageous for the operator; In addition, it allows to obtain qualitatively excellent results.

In the basin 2 the treatment fluid is charged and / or accumulated and / or deflated, which is required for the particular moment of treatment; the treatment liquid may at certain moments be for example a cleaning liquid (for example an aqueous detergent solution), at other moments a rinsing liquid (for example ordinary water) and in still further moments a drying liquid (for example demineralized water).

For the loading of the treatment liquid there are two devices each 3A and 3B one for charging the water and the other for dosing the rinse aid not shown in the figures; the two devices 3A and 3B In particular, two are for spraying water into the basket 1 suitable nozzles containing the surgical instruments; the two devices 3A and 3B serve both the cleaning, rinsing and drying phases; the dosing device is used for the cleaning phase alone; the feeders of course operate with a controlled opening.

The two nozzles 3A and 3B suffice to cover the entire contents of the basket 1 to spray; Alternatively, a shower head (with a plurality of holes) may be used with the basket 1 appropriate extension; alternatively, a drip system could be used; It should be noted that the spraying of water from above (as just described) and / or from one or more sides of the basin 2 can take place.

For draining the treatment liquid is in the bottom of the basin 2 one with a drainpipe 4 connected opening provided.

In order to allow the accumulation of the treatment liquid (as it happens in a cleaning phase, a rinsing phase and a drying phase) is an emptying device with a to the pelvis 2 , in particular the drain pipe 4 provided connected controlled opening; the emptying device, such as a valve or a pump (which causes it to open and close), is not illustrated in the figures and may be, for example, an electrovalve or drain pump (the pump causes the treatment fluid to drain from the basin more quickly).

The amount of in the pelvis 2 liquid to be accumulated may depend on various circumstances, for example on the treatment currently being carried out; To control this amount, the device includes a level sensor 5 who is in the pelvis 2 can detect existing fluid level. According to this embodiment in the figures, the sensor 5 a pressure sensor, housed in a "Y" -shaped pipe and hydraulically connected to the drain of the basin 2 connected is; more specifically, the "Y" shaped conduit is in the drainpipe 4 built-in; the outflow control device (not shown in the figures) is inserted downstream of the "Y" shaped conduit; It should be noted that the sensor 5 and the "Y" shaped line in the not shown for the sake of simplicity.

To warm up the treatment fluid and / or the instruments in the basket 1 and / or in the room of the pool 2 are two heaters 6 inside the basin. According to the embodiment of the figures, these heaters consist of a single, located in the interior of the basin electrical resistance 6 ; when inside the basin 2 a liquid is present, transmits the resistance 6 the liquid heat by conduction, and the liquid in turn transfers heat by conduction to the in her immersed elements (especially those in the basket 1 contained surgical instruments); when in the pool 2 there is no liquid, the resistance heats up 6 strong and gives off heat in the form of a radiation, which thus both the space of the basin 2 like the basket 1 and warms the surgical instruments contained therein; overheating of the resistor 6 in the absence of a fluid in the pelvis 2 It is advisable to prevent the resistance 6 not continuously but intermittently.

In the case of solutions of an alternative type to the figures, special heating devices can only be used when in the pool 2 no liquid is located; these devices could be, for example, infrared radiation lamps or resistors specially designed for operation under these conditions.

To air in the basin 2 with the basket in it 1 and to inflate the surgical instruments contained therein and to be treated are in the pelvis 2 for the blowing of a gas, in particular the blown around from around the device sucked ambient air blowing devices 7 , especially towards the mentioned basket containing surgical instruments 1 provided for; These blowing devices consist in particular of a blower 7 ,

As already mentioned, the device in the figures is also able to carry out a cleaning of the surgical instruments, in particular an ultrasonic cleaning; For this purpose, the device also includes the pelvis 2 connected but not shown in these figures ultrasonic transducer in the basin 2 Ultrasonic waves can radiate, thus the cleaning liquid contained therein and in the basket 1 contained and in the pelvis 2 brushed surgical instruments. The cleaning phase continues to bear the resistance 6 by adding the (from a mixture of water from the nozzles 3A and 3B and detergent recovered from the dosing device) heated cleaning liquid after this in the basin 2 has been charged.

There have been several components of the device have been mentioned, of which some are electrical and other hydraulic type; all of these are controlled by an electronic control unit, not shown in the figures, to which they are electrically connected; what the level sensor 5 This, of course, sends signals to the electronic control unit, but without receiving them. This electronic control unit preferably consists of a microprocessor equipped with suitable programs for carrying out suitable cleaning, rinsing and drying programs.

From a constructional point of view, the device of the figures comprises a lid 8th who is the pelvis 2 during the treatments can cover; This results in a closed, on its underside by the basin 2 and on its top through the lid 8th certain cavity. According to the embodiment of the figures is in the lid 8th the blower 7 with a suitably free circuit and also the nozzles 3A and 3B housed with a suitably designed hydraulic circuit that supplies the water to the nozzles.

The lid 8th is with two air supply lines mounted inside the lid 9A and 9B and several air openings (in particular slits) located on the lid surface 81 . 82 . 83 . 84 equipped; the opening 81 serves the external environment with the inlet of the blower 7 while the air supply line 9A the outlet of the blower 7 with the opening 82 combines. The opening 83 serves to the pelvis 2 with the air discharge line 9B to contact while the line 9B this serves the opening 83 with the opening 84 connect to. The opening 84 serves the lead 9B to communicate with the external environment; in practice and in general, the ambient air is sucked into the lid via suction devices, blown by the blowing devices and enters the basin, circulates in the basin (heating and moisturizing), leaves the basin and enters the lid, flows through a mounted inside the lid line and finally exits from the lid to get lost in the environment.

It should be noted that the blower 7 with the pelvis 2 is not geared to their heating due to resistance 6 limits; it requires the necessity of a connection line 9A between the outlet of the blower 7 and the air opening 82 on the lid 8th ,

Among other things, the device described and illustrated here leads, inter alia, favorably to a novel rinsing method for surgical instruments, be it a novel drying method for surgical instruments.

It should be noted that the proper performance of the drying process (as will more clearly be seen) also provides effective thermal disinfection of the surgical instruments.

• S1) ein Besprühen der Instrumente mit der Spülflüssigkeit,
• S2) ein Ansammeln der ausgesprühten Spülflüssigkeit im Becken bis zu einem vorbestimmten Stand; dieser vorbestimmte Stand ist derart, dass er die im Korb befindlichen Instrumente benetzt und vorzugsweise voll überschwemmt, und
• S3) ein Ablassen der angesammelten Spülflüssigkeit.

After the novel rinsing procedure, the surgical instruments are in a basket ( 1 in the pictures), the basket in a basin ( 2 in the pictures), and the pelvis is with a drain with a controlled opening ( 4 in the pictures); This method comprises at least the following steps:

• S1) spraying the instruments with the rinsing liquid,
• S2) accumulating the sprayed flushing fluid in the pool to a predetermined level; this predetermined level is such that it wets the instruments located in the basket and preferably fully flooded, and
• S3) draining the accumulated rinsing liquid.

The rinse liquid will typically be ordinary or demineralized water.

The spraying can be done from above and / or from the side, and is a very effective type of flushing.

Since the basket has a plurality of openings (especially as it is designed like a latticework with rounded edges to better embrace the instruments), the flushing liquid, after hitting the instruments, falls down by gravity, flows through the basket and collects in the underlying pool, where it remains accumulated as long as the drain remains closed.

Since the instruments are wetted and preferably submerged in the pooled liquid, flushing is also ensured at those points of the instruments which are difficult to reach by spraying.

The steps S2 and S3 may be repeated a predetermined number of times, for example three times, to achieve a still higher quality purging.

The rinsing process can be the subject of some variants; For example, a rinsing liquid can be sprayed on the surgical instruments during all or part of the step S2; for example, a rinsing liquid can be sprayed onto the surgical instruments during all or part of the step S3; in other words, the step S1 can be done wholly or partially during the execution of steps S2 and / or S3.

The rinsing process may include an initial step and / or a final step during which a rinse fluid is sprayed onto the surgical instruments and the sprayed irrigation fluid is discharged immediately thereafter.

• A1) Abfüllen des Beckens mit einer Trocknungsflüssigkeit bis zu einem vorbestimmten Stand; dieser vorbestimmte Stand ist derart, dass er die im Korb befindlichen chirurgischen Instrumente benetzt und vorzugsweise überschwemmt,
• A2) Erwärmen der Trocknungsflüssigkeit (die für den Fall des Beispiels der Abbildungen schon im Becken enthalten ist) bis zu einer vorbestimmten Temperatur; diese vorbestimmte Temperatur beläuft sich auf 60 bis 99°C (daher unter Vermeidung des Siedepunkts).
• A3) Vorzugsweises Erhalten der im Becken enthaltenen Flüssigkeit auf einer vorbestimmten Temperatur für eine vorbestimmte Zeitdauer.
• A4) Ablassen der im Becken enthaltenen Flüssigkeit, und
• A5) Einblasen eines Gases in das Becken, für eine vorbestimmte Zeitdauer.

After the novel drying process, the surgical instruments are in a basket ( 1 in the pictures), the basket in a basin ( 2 in the illustrations), and the basin is equipped with a controlled-opening drain ( 4 in the pictures); This method comprises at least the following steps:

• A1) filling the basin with a drying liquid up to a predetermined level; this predetermined state is such that it wets and preferably flooded the surgical instruments in the basket,
• A2) heating the drying liquid (which is already contained in the basin in the case of the example of the figures) up to a predetermined temperature; this predetermined temperature is 60 to 99 ° C (hence avoiding the boiling point).
• A3) Preferably maintaining the liquid contained in the basin at a predetermined temperature for a predetermined period of time.
• A4) draining the liquid contained in the basin, and
• A5) blowing a gas into the basin for a predetermined period of time.

The rinse liquid will typically be water, preferably demineralized water, to prevent limestone deposits at the high temperatures of step A2 on the instruments.

The injected gas will typically be air extracted from the environment.

The gas is preferably blown against the basket in which the instruments are located.

Step A3 is optional and will become clearer from the following description.

In view of the above steps, the drying process begins paradoxically with steps intended to wet the instruments; but actually, according to this method, the instruments are wetted at a very high temperature, and in such a way that when the "drying liquid" is removed, the instruments, which are themselves at a high temperature, dry faster, even if an airflow at ambient temperature (typically 15 ° C) ° C to 25 ° C), d. H. an intentionally heated airflow is used.

The gas injected into the basin draws moisture out of the internal volume of the pool (especially the aforementioned closed cavity of the pool and overlying lid) and promotes the evaporation of the drying liquid left on the surface of the surgical instruments after this liquid has been drained from the basin in step A4.

As already mentioned, step A3 can be avoided, i. H. the first period of time should therefore be zero.

Alternatively, the first time portion of step A3 may be short, especially less than 10 seconds, and only to ensure that the surgical instruments heat up to the predetermined temperature.

In a further alternative, the first time period of step A3 may be longer, in particular 3-10 minutes, to achieve full disinfection of the surgical instruments; in this case, as already mentioned above, the method simultaneously and advantageously provides both drying and thermal disinfection.

The drying process can be an object of several variants: the steps A4 and A5 can be partially overlaid, for example, in terms of time.

Advantageously, heating of the surgical instruments may be wholly or partially performed during step A5. As already mentioned, in the example of the figures, such heating is provided by an electrical (preferably intermittent) supply of energy to the resistor ( 6 ) reached; Alternatively, the heating can be accomplished for example via heating lamps. This heating additionally favors the evaporation of the drying liquid remaining on the surface of the surgical instruments after this liquid has been drained from the basin in step A4.

In the basin of the device liquids (for example, a cleaning liquid and / or a rinsing liquid and / or a drying liquid) are charged according to this invention; These liquids are very common on an aqueous basis. These liquids are typically brought to rather higher temperatures (for example, 50 ° C-90 ° C), resulting in evaporation. This steam spreads a little everywhere and therefore also in the lid of the device, for example in the fan. In order to avoid that this steam (possibly partially in condensed form) could damage the lid of the device and / or its components, the fan is advantageously operated at a lower speed if the liquid in the basin exceeds a predetermined temperature such that it discharges this vapor to the outside and avoids accumulations of condensing liquid from this vapor; for this function, for example, the fan may be operated at a rate of only 15% to 25% of the speed used during the drying phase; the predetermined temperature may be, for example, 40 ° C-50 ° C.

Claims (14)

Apparatus for the treatment of surgical instruments, suitable for carrying out a flushing procedure, in which: the said surgical instruments are placed in a basket ( 1 ), - said basket ( 1 ) in a basin ( 2 ), - said basin with a drain ( 4 ) is equipped with a controlled opening and which comprises the following steps: S1) spraying ( 3A . 3B ) of said instruments with a rinsing fluid, S2) accumulating in said basin ( 2 ) to a predetermined level, said predetermined level being such as to accommodate said surgical instruments in said basket ( 1 ) and preferably flooded, and S3) draining ( 4 ) said accumulated rinsing liquid; the device comprising: - a basket suitable for holding surgical instruments ( 1 ), - a for accommodating said basket ( 1 ) suitable basin ( 2 ), - one to said basin ( 4 ) connected to a controlled opening drainage device ( 4 ), - at least one charging device ( 3A . 3B ), in particular in the form of a for spraying a rinsing liquid in said basket ( 1 ) suitable nozzle; - one for displaying one in said basin ( 2 ) existing liquid level suitable level sensor ( 5 ), and - electrically connected to said discharge device ( 4 ), said at least one discharge device ( 3A . 3B ) and the said level sensor ( 5 ) connected electronic control unit. Apparatus according to claim 1, characterized in that it is adapted to repeat said steps S2 and S3 a predetermined number of times. Apparatus according to claim 1 or 2, wherein the apparatus is adapted to spray from the nozzle during said step S2 a rinsing liquid on said surgical instruments ( 3A . 3B ). Apparatus according to any one of claims 1-3, which is adapted to spray a rinsing liquid onto said surgical instruments during step S3 ( 3A . 3B ). Device according to one of claims 1-4, which is suitable for carrying out a rinsing method which comprises a first and / or a last step during which a rinsing liquid is sprayed on said surgical instruments ( 3A . 3B ) and the said rinsing liquid is discharged immediately thereafter ( 4 ). Apparatus according to any one of claims 1-5, wherein said floor sensor ( 5 ) to the said outflow ( 4 ) and in particular in a "Y" -shaped line is inserted, with the said outflow ( 4 ) is hydraulically connected. Apparatus according to any one of claims 1-6, further comprising a lid ( 8th ), which is suitable for upper covering of said basin ( 2 ) and in which the at least one charging device ( 3A . 3B ) on the above lid 88 ) is mounted. Device according to one of the preceding claims, characterized in that it is suitable for carrying out also a drying process comprising the following steps: A1) filling the pool with a drying liquid to a predetermined level, said predetermined level being such that it wets and preferably floats said surgical instruments in said basket, A2) heating the drying liquid to a predetermined temperature, wherein said predetermined temperature amounts to 60 to 99 ° C, A3) maintaining the liquid contained in said basin for a first predetermined period of time, at approximately this predetermined temperature, A4) draining the liquid contained in said basin, and A5) injecting a gas into said pool for a second predetermined period of time. Apparatus according to claim 8, wherein said first period of time is short term, in particular less than 10 seconds, and such that said surgical instruments warm to said predetermined temperature. Apparatus according to claim 8, wherein said first period of time is longer, in particular between 3 and 10 minutes and is such as to cause thermal disinfection of said surgical instruments. Apparatus according to claim 8 or 9 or 110, in which said phases A4 and A5 are partially superimposed in time. Apparatus according to any of the preceding claims 8 to 11, wherein during said phase A5, heating ( 6 ) of said surgical instruments is effected. Apparatus according to claim 12, in which said heating during phase A5 is effected by an interior of said basin ( 2 ) resistance ( 6 ) is effected, which is supplied intermittently or continuously electrically. Apparatus according to any of the preceding claims 8 to 13, further comprising blowing devices ( 7 ) suitable for introducing a gas into said basin and into a lid ( 8th ) to inflate the said basin ( 2 ) above and in which said blowing devices ( 7 ) in said lid ( 8th ) are housed.

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